Incarcerated with the madness
Abby Haglage has an article at the Daily Beast on the shocking number of incarcerated prisoners with mental health issues:
In a new study by Treatment Advocacy Center (TAC), a nonprofit dedicated to eliminating barriers to treating the mentally ill, (Dr. E Fuller) Torrey and his colleagues expose just how bleak America’s mental health situation has become. In 2012, an estimated 356,000 mentally ill inmates were being held in state prison, compared to just 35,000 in state-run psychiatric hospitals. In other words, the number of mentally ill people in prisons is ten times that of mentally ill in state-run psychiatric hospitals.
Without going into my (very strong and perhaps radical) opinions on mental health treatment in the United States, I’m not sure the TAC study bothers me in the way Haglage intends it to bother me. First, there is the fact that we tend to identify mental health issues in association with actions that we consider abnormal and undesirable – i.e. the kinds of actions that put people in prison. This might suggest a meaninglessness to Haglage’s large numbers beyond just their lack of denominator.
The decision of whether or not someone is placed into a psychiatric hospital or a traditional prison after committing a crime is governed by available resources, whether that person is considered a danger to self or others, and whether or not that person is considered to have had the proper agency to have willfully committed the act. There are enough squishy concepts in fugue with each other here that I do not know how we could go about evaluating the dependent normative question of whether or not putting potentially mentally ill prisoners in with not mentally ill prisoners is unethical.
It seems to me that prisons should exist not for prisoners but for non-prisoners. That is, the first purpose of a criminal justice system should not be to punish, nor should it be to rehabilitate, nor should it be about justice for the offenders or victims; but prisons should exist to remove from the greater society those who have clearly demonstrated a potential to cause harm to the innocent. Whether the potential of an individual to inflict harm derives from misfiring neurons, social constructs, or Satan, or whether it is just random and meaningless seems to me a very secondary concern.
For the record, I am strongly opposed to the death penalty, I do think that our prisons are almost without exception overcrowded and poorly policed, and I believe that a disastrous future awaits us if we do not reform our prisons in ways forcefully advocated by dispassionate scholarship. But, regarding the role of a prison in society and whether or not our current system properly classifies the mentally ill, I do not think it matters whether Mr. Smith murdered three people because he wanted to collect on their life insurance or whether he murdered three people because he believed they were sent by the CIA to kill him. Criminal justice, as a means to protect the greater society, should respond to actions and not to our feeble, human attempts to interpret what those actions might mean.