The American Corrections System: The Modern Day American Psychiatric Facility

The American corrections system has largely replaced psychiatric hospitals in the housing and treatment of some of America’s most severely mentally ill citizens. In an effort to protect the liberties of some mentally ill individuals through the closure of state-run institutions, the burden of serving this population has fallen into untrained, under resourced, and underfunded state and county correction systems.  State prisons and county jails currently hold ten times more mentally ill individuals than state psychiatric hospitals.  As a result, solitary confinement has become the number one tool for corrections officers to lean on when dealing with a severely mentally ill inmate.

After the deinstitutionalization of the seriously mentally ill, many were left to wander the streets.  Most mentally ill offenders commit relatively minor crimes such as theft, loitering, or shoplifting.  A recent 2014 study found that the number of severely mentally ill individuals housed in the prison system was 356,268 inmates.  This population is equivalent to the population of Pittsburg, Pennsylvania.  Illinois is not immune to this problem; in fact they are one of the worst offenders.  The population of mentally ill inmates in Cook County’s jail system is larger than the entire population of all mental hospitals within the state of Illinois combined.

Solitary confinement was originally created as a tool for corrections officers to utilize and separate the inmate from the general population until he could safely rejoin the others, typically lasting only a few hours.  However, in today’s correction facilities, it is often used as a long-term tool to either protect the severely mentally ill from other inmates, or to protect others from that mentally ill inmate.  Many researchers point to the use of solitary confinement as a direct result of limited funding.  For example, housing a mentally ill inmate in a mental health facility costs nearly $1,000 per day whereas housing that same inmate in a corrections facility only costs $120 per day.  But this cost-savings harms the well-being of the mentally ill.

It is well documented that mentally ill inmates do not fare well within the corrections system.  A study of 132 suicide attempts in Washington correction facilities found that 77% of them had a severe mental illness.  When this is compared to the suicide attempts of the entire corrections population, which is only 15%, the difference seems staggering.  It has been found that solitary confinement can exacerbate symptoms as well as provoke reoccurrence.  A majority of mentally ill inmates completely decompensate within solitary confinement.

The nature of the mental health services available for inmates within solitary confinement is severely lacking.  Typically, the treatment is limited to varying psychotropic medications, sparse check-ins from a clinician through the closed steel door, and an occasional meeting in private with the clinician.  Under these conditions, the proven and successful community based treatments are left largely ignored.

 The American correction systems have seen some changes begin to take place across the country.   These changes are largely driven by litigation and the development of guidelines by the National Commission on Correctional Health Care and the America Psychiatric Association. 

On December 24, 2015, an Illinois class action, consisting of nearly 11,000 mentally ill inmates, settled with the State of Illinois.  The class action claimed that the current state of Illinois correction facilities amounted to “cruel and unusual punishment” to its mentally ill inmates.  The settlement consisted of a long list of provisions including the creation of new treatment units at the Logan, Pontiac, and Dixon prisons as well as the hiring of additional staff members.  Another provision in the agreement was to reduce the amount of time mentally ill inmates spend in solitary confinement. The Illinois Department of Corrections Director, John Baldwin stated, Illinois prisons were never intended to be psychiatric hospitals, but they have become holding centers for people with serious mental illness.  He further added, “[t]his will improve correctional outcomes for those with mental illness and increase safety for our dedicated staff, all offenders, and the citizens we serve.”

Andrea Torgrimson is a current student at DePaul University College of Law in Chicago.  She holds a B.A. from the University of New Mexico, where she majored in Political Science and minored in Sociology.  Ms. Torgrimson plans to graduate in 2017 with her J.D. and Health Law Certificate.