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.