A common refrain at the 2018 National Sheriffs Association annual conference in New Orleans was: “Jails should not be community mental health centers.” Yet perversely, conversations continue on how to turn jails into community mental health centers.
In July 2017, approximately 50 percent of inmates in the Orleans Parish jail had a psychiatric diagnosis with diseases ranging from mild to severe. This statistic illustrates that a full continuum of community psychiatric care does not exist.
While the mental health industry has the luxury of turning away people it doesn’t want the corrections system must accept whoever arrives at the door. If we "normalize" mental health jails for individuals with mental illness, we accept the shift from programs that help manage symptoms in the community, with or without supervision, to treatment in jail or prison as a first stop.
Mental illness is called a behavioral problem, but jails and prisons can no more correct the mental illness out of an individual than can correct the tumor out of a cancer patient. Like cancer, the prognosis for seriously mentally ill patients diminishes the longer they are left untreated.
Mental illness is a brain disease. Brain damage occurs with each psychotic break or major episode of clinical depression. The brain simply can't regenerate as fast as it deteriorates. Four percent of the most seriously mentally ill people in America have mental diseases so severe that their illnesses appear in brain-scan imaging. Approximately 15 to 20 percent of those are incarcerated.
It’s encouraging that Judge Lance Africk sees improvement in the New Orleans jail, but disappointing that he continues to support an additional 89-bed mental-health jail.
This would only further normalize the criminalization of mental illness, killing incentives for community-based psychiatric beds, a Crisis Receiving Center, robust civil and forensic outpatient services, and levels 1-4 recovery housing.
While one cannot negate the need for treatment and care for seriously mentally ill people while incarcerated, mental health jails will fail to deliver what is needed. Not only is it the most restrictive and least therapeutic environment, but a modern five-star jail facility offers only the false promise of recovery and management of mental diseases.
I can think of nothing more inhumane than doing nothing for people whose only crime is that they were born with an incurable disease. With the right treatment and care, seriously mentally ill people have a much better chance at a good quality of life if they can be treated medically, in the community, and kept entirely out of the criminal justice system. This is why we need a front-end approach to treatment and care. Not institutionalized harm and neglect.
founder and president, Healing Minds NOLA