Schizophrenia refers to a chronic mental illness that affects the patients thought process, feelings, perception, and behavior. The disorder may manifest in positive symptoms such as hallucinations and delusions, negative symptoms such as flat affect and depression, and other cognitive symptoms (Pinta). The fact that it affects the volitional and emotional aspects of the patients makes it a function of interest in criminal law. The evaluation of mental conditions is critical in labeling accused criminals, adjudication of guilt, and in proffering jail terms. Various reports have established a relationship between the illness and the increased risk of violence. Accordingly, it has been attributed to a large number of schizophrenic patients in correctional facilities. This paper delves into the prevalence of schizophrenic patients in jails, the management, and the effects on their lives.
Prevalence of Schizophrenia in Jails
Various research studies have associated mental illnesses with an increased predisposition to crime. Canady indicates that correctional facilities in the United States house more patients for mental illnesses than psychiatric hospitals. For instance, the county jail in Los Angeles serves as the largest inpatient facility for psychiatric conditions with about three thousand and four hundred patients while New Yorks Rikers Island houses about three thousand inmates suffering from mental disorders. According to Pinta, a survey of one hundred murderers in prison established that twenty percent had a mental illness such as psychosis and schizophrenia. The incidences of association are higher in females as up to twenty-nine percent of female inmates have been found to be suffering from a mental disorder (Torrey). However, Canady indicates that most of the schizophrenic patients in jail have been charged with petty crimes such as trespass. Most of these kinds of patients are more likely to harm themselves than the public as violence is not a sign of schizophrenia. Most of these patients are withdrawn from other people and prefer to stay alone and only become aggressive when one appears to invade their personal space. However, of note, is that abuse of alcohol or any other drug raises the risk of becoming violent, especially if not receiving medication (Canady). Such violence, in most cases, is directed to friends and family members usually at their homes.
Prison facilities have continued to accept mentally ill patients since their inception, though reluctantly. Despite several countries establishing commissions and departments to look into the issue, the problem has persisted and appears to be getting worse. For this reason, it has made many jails in different parts of the world act as extensions for general services for mental health. Around forty years ago, the then president of the United States assented into law the Community Mental Health Centers Act for the large hospitals in the states dealing with mentally ill patients to give way to smaller community clinics. It was in response to the change of attitude to the increased number of psychiatric patients during the post-war period. Media exposure about the incompetency of major hospitals regarding the management of such patients called for a more sober approach (Pinta). Additionally, the law for civil liberties started to gain momentum for the same reasons which made it hard for judges to execute their judgments on the increased number of mentally ill suspects. The transfer of responsibility of the patients was to be accompanied with funds transfer from the states to facilitate the same. However, it never happened, and the local communities became overwhelmed. For this reason, a significant number of patients who have schizophrenia ended up in prison systems.
It is not clear if the relationship between the mental disorder and criminality is direct as some scholars have attributed it to inadequate health systems. Lack of enough medical management of schizophrenia has been blamed for violent cases and subsequently for the increased numbers of such patients in jails (Torrey). Additionally, despite the level of risk established, it is relatively low when compared to other causes in the society. For instance, while the estimated risk for causing violence is about three percent, other causes such as substance abuse have been estimated at over ten percent (Torrey). Furthermore, the reports may not be accurate as they associate any crime committed by a mentally ill patient to their condition. In reality, however, the mental condition may not have contributed to the crime or violence behavior.
Management and Conditions in the Prisons
Prisoners with mental illnesses usually have their conditions amplified and exacerbated due to confinement. According to Canady, those having depressive or bipolar symptoms can become worse in a hostile and restrictive environment. Due to the inadequate number of health specialists managing psychiatric patients, those responsible are primarily focused on confinement rather than improvement of the health condition as a result of the mental disorder. In effect, Pinta indicates that there has been a trans-institutionalization of mental disorders from hospitals to correctional facilities. Therefore, the level of care and management appropriate for such kind of patients has not been achieved.
Most of the prisoners suffering from mental disorders are suffering greatly. Some experience social withdrawal while others find themselves in solitary incarceration whose intentions is to keep them protected. According to a report, confinement may lead to resulting mood disorders such as bipolar disorder, dysthymia, or a major depressive disorder (Torrey). The main problem is attributed to the fact that all inmates of solitary incarceration are treated the same way. In most cases, they remain ignored and may only be allowed less than one hour daily for walking within a caged area. Also, they receive food and other necessities in small windows in their cells. While such facilities are meant for punishment to criminals, they are used by correctional officers for confining mentally ill patients, and this is one of the worst punishments for such people. Additionally, according to Pinta, proper diagnosis of mental conditions is not done before committing individuals to a jail term, and therefore, no clear plan of treatment. The condition, consequently, worsens while in prison.
The above literature exemplifies the fact that correctional facilities are full of largely ignored victims who require professional psychiatric care. Evidently, the officers responsible for taking care of inmates do not receive any formal training on how to deal with psychiatric patients. For this reason, they are not sensitive to the needs of such kind of inmates, yet there exists a significant percentage. In the United States, Canady indicates that solitary incarceration has remained as the method of choice for patients demonstrating mental disorders that appear harmful or disruptive. It is, perhaps, the cruelest and most inhumane form of punishment to a schizophrenic patient. It results in many people, who had gone to prison with a mild illness, leaving with a major illness which becomes even harder to manage outside. Therefore, such inmates end up in the prison even after they are reformed. Therefore, there is a need for stakeholders to come together to solve the issue of mentally ill inmates.
There have been concerns about what happens after these inmates are released from jail while still suffering from the mental conditions. Evidently, in most cases, they are worse off in their illness. For this reason, they pose a danger to the other community members. Given that they have been associated with an increased risk of being violent behaviors, they are likely to be a menace to the society (Torrey). It is the reason why activists for human rights advocate for better treatment of prisoners diagnosed with schizophrenia. While the ideal solution would be to prevent the people with a mental health condition from indulging into criminality by having better policies for health care, there is a need for stakeholders to look into mentally ill patients. Effective protocols for management and treatment of mentally ill patients in jails are long overdue. Pinta indicates that correctional services should seek the services of professional workers to offer treatment to the inmates who have been diagnosed with schizophrenia.
Schizophrenia has been a common problem among inmates for over two-hundred years. Various research studies have linked schizophrenia to an increased risk of violence, and thus the increased number of mentally ill patients. However, it is not clear if the association is direct as some scholars have argued that it may be as a result of systems failure. The correctional facilities do not have the capabilities to manage such patients effectively. For instance, the US applies solitary incarceration on them which worsens their condition. Therefore, schizophrenic patients leave the prisons worse and may pose a danger to the rest of the community. For the above reasons, it is agreeable that stakeholders need to come up with appropriate policies in prisons to treat the inmates who are suffering from any mental illnesses. This way, it upholds their dignity and helps them to keep the symptoms under control.
Canady, Valerie A. Survey Finds County Jails Unequipped for Inmates with SMI. Mental Health Weekly 26.28 (2016):7-8. Web.
Pinta, Emil R. Community Treatment for Violence in Released Inmates with Schizophrenia. American Journal of Psychiatry 171.7 (2014): 796-797. Web.
Torrey, E. Fuller. Violence and Schizophrenia. Schizophrenia Research 88.1-3 (2006):3-4. Web
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