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Mental Health Problems Common in Prisons

LYNN NEARY, host:

Corrections officials have complained for years that America's prisons and jails are becoming the country's new asylums. A recent Justice Department study supports that claim. It says more than half of all prison and jail inmates have experienced mental health problems in the last year.

NPR's Ari Shapiro reports.

ARI SHAPIRO: Art Wallenstein is director of Montgomery County, Maryland's, Department of Corrections and Rehabilitation. When he entered the field 30 years ago, he didn't think he'd be working on mental health issues, but today ...

Mr. ART WALLENSTEIN (Director, Department of Corrections and Rehabilitation, Montgomery County, Maryland): Because the population has grown so large of incarcerated, mentally ill people, it literally is the single most discussed topic at correctional meetings.

SHAPIRO: He says the trend started in the 1980s, when the government shut down mental hospitals across the country.

Mr. WALLENSTEIN: And it was always intended that when state hospitals began to diminish in size and new drugs were developed that there was to be a community mental health system that would accompany these developments. And while there've been many efforts, community mental health program development has never kept pace with the rate of incarceration.

SHAPIRO: Since jails and prisons are the only facilities that can't turn people away, they've become the go-to-place for mentally ill people who can't get help elsewhere. Mike Lawler is a state representative in Connecticut.

State Representative MIKE LAWLER (Democrat, Connecticut): Many hospitals don't have the beds, don't have the funding to properly care for these folks. And there's an incentive for them to try and get rid of the person with mental illness and they can't discharge them without a proper plan. But what they can do is ask that they be arrested again, for example, if the person takes a swing at one of the nurses or security guards.

SHAPIRO: Although more people are aware of the problem than ever before, Lawler says that has not reversed the trend. In Connecticut, for example ...

State Rep. LAWLER: In recent years, we've had to dedicate an entire prison - a state-of-the-art prison built to deal with gangs - we've had to retrofit it and now it's used almost exclusively for inmates with severe mental illness issues.

SHAPIRO: Lawler says the threat of lawsuits gives corrections officers a perverse incentive not to identify the inmates who have mental health problems.

Mr. LAWLER: Once you attempt to identify inmates with mental health issues, then you - what comes with that is an obligation to provide quality health care. So in a way, the don't ask, don't tell strategy can save you some money. If you don't know a person has mental illness, you don't really have to provide the care, necessarily.

SHAPIRO: That's one reason people in the field were eager to see the findings of this Justice Department's report. Lauren Glaze is one of the authors.

Ms. LAUREN GLAZE (statistician, U.S. Department of Justice): The report is based on inmates reporting symptoms of mental health problems. It's not an official diagnosis of mental illness, which is typically done by a mental health professional.

SHAPIRO: Analysts say that may be one reason these numbers are higher than those in previous studies. A 1999 Justice Department study found that about 15 percent of people in prisons and jails suffer from mental illnesses. This report found that more than half of the people in prisons and jails have mental health problems. As in the general population, women reported more problems than men. And the study showed that many prisoners with mental health problems also have substance abuse problems.

Ms. GLAZE: We're seeing that nearly three-quarters of state prison and jail inmates who had a mental health problem, compared to more than half of those without, were dependent on or abusing alcohol or drugs.

SHAPIRO: The report says, between a quarter and a third of the people with mental health problems in state and federal prisons received treatment. That's an improvement from the past, but mental health experts say it's still not a good way to treat America's mentally ill.

Ari Shapiro, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

Ari Shapiro
Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.