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Prisons have become mental health asylums. The data is overwhelming. While researching my last post about Dorothea Dix, an early advocate for mentally ill prisoners, I learned more about the how mentally ill persons are treated in prison populations. I also became aware of parameters that proscribe the legal rights of mentally ill inmates. The breadth of information on this topic is enormous.

We’re going to look at important highlights of the role of prisons when it comes to inmate populations. While there’s a national movement focusing on the problem, I limit my scope to what’s happening in California.

A recent San Francisco Chronicle editorial, California prison reforms are leaving behind the mentally ill, that used the findings of a Stanford Justice Advocacy Project report as its source had some eye-opening information about the current status of mentally ill inmates in California. Here is an overview from the May 29, 2017, editorial:

  • In 2011, the U.S. Supreme Court affirmed a court order stating California must reduce its prison population to improve psychiatric and medical treatment for the inmates. [For more about the Supreme Court case of Brown v. Plata, see my prior post Two Known Channels for Change.]
  • The prison population has been reduced, [but] mental illness appears to be getting worse, not better, in California’s prisons.
  • More than 30 percent of California prisoners are receiving treatment for a serious mental disorder — that’s a 150 percent increase since 2000.
  • The severity of prisoners’ psychiatric symptoms has increased dramatically over the past five years.

So, what’s going on? The Stanford Law School Three Strikes Project report, When did prisons become acceptable mental healthcare facilities?, explains why there’s been a 150 percent increase of prisoners with mental illnesses in California’s inmate population after the overall prison population has been reduced. Why is mental illness getting worse, not better, in the state’s prisons?

The report makes some startling findings:

We spend far more on imprisonment of the mentally ill than we would otherwise spend on treatment and support. It is immoral because writing off another human being’s life is utterly contrary to our collective values and principles.

The numbers are staggering: over the past 15 years, the number of mentally ill people in prison in California has almost doubled. Today, 45 percent of state prison inmates have been treated for severe mental illness within the past year. The Los Angeles County Jail is “the largest mental health provider in the county.”

The Irony of Prop. 36 upon the Mentally Ill

Proposition 36 was approved by California voters in November 2012, and its approval changed California’s “Three Strikes” sentencing law. The intended primary effect of repealing the law was to reduce the inmate population in the state in accordance with the Supreme Court’s Brown v. Plata decision. It worked. What followed was Assembly Bill (AB) 109, or the public safety realignment, which significantly reduced the California prison population. In November 2014, state voters passed Proposition 47, which reduced sentences for many drug and property offenses. According to a report by the Public Policy Institute of California, by 2015, some 18,000 inmates had been released because of Prop. 47 coupled with AB 109.

Circling back to the Three Strikes Project report, the impact of the reduction in California’s prison population has not fared well for the mentally ill. Key points made by the report follow:

  • Sentencing is disproportionate. Statistically, mentally ill inmates receive longer sentences than non-mentally-ill prisoners:

For example, the number of mentally ill prisoners denied relief under new resentencing laws enacted under Proposition 36 is three times greater than the number of non-mentally-ill prisoners who have been denied relief. (emphasis added)

  • Once those suffering from mental illness are released—having served longer sentences—the system delivers the ultimate knockout blow. We provide virtually no effective mental health facilities and programs to help released prisoners who are in desperate need of mental health treatment.
  • This service deficit naturally results in higher recidivism rates and an ongoing sense of social isolation and abandonment. And the cycle then begins again with new arrests, new prosecutions, new lengthy sentences, new impediments to release, and eventual release into a system that provides nothing but an inevitable, tragic trajectory back into the criminal justice system. This cycle is as truly appalling as it is truly avoidable.


The Three Strikes Project report makes the following recommendations:

  1. Reform the Way We Sentence the Mentally Ill
  2. Provide Meaningful Treatment in Prison
  3. Continue Meaningful Treatment After Prison

Within the report are comments from Craig Haney, a distinguished professor of psychology at the University of California, Santa Cruz. His words represent unmitigated motivating factors for prison reform for the mentally ill:

Prisons and jails are singularly ill-suited to house the mentally ill. Premised on punitive forms of social control, prisons are not remotely compatible with the kind of supportive therapeutic milieus that the mentally ill require. They are austere and intimidating environments that are painful and difficult for even the strongest and most resilient prisoners to withstand. The pains of imprisonment—severe material deprivations, highly restricted movement and liberty, lack of meaningful activity, a nearly total absence of personal privacy, high levels of interpersonal uncertainty, danger, and fear—are powerful psychological stressors that can adversely impact a prisoner’s well-being.

More Work Needed

The work of Dorothea Dix on behalf of mentally ill prisoners continues today. It’s hard to measure the advancements in prison reform since her years of advocacy in the nineteenth century. What is it about human beings that continues the harsh reality of ignoring and abusing mental patients in jails and prisons? I wish I had an answer.

This is a difficult post to wrap up. Many more issues need to be discussed and more in-depth analyses must be brought forward. Check out the links I reference for more thought-provoking background and information. Let’s start a discussion.


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