Mentally Ill Offenders in Jail or Prison Essay

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The status and treatment of mentally ill offenders is one with many ethical concerns. The needs of this population are oftentimes unmet or unrealized. The closing of mental institutions and the decrease in government funding for mental health caused serious concerns for the mentally ill. Individuals who had been committed to institutions were released without any arrangements made for their long-term care, and in turn were taken into the criminal justice system on charges of vagrancy, disturbing the peace, or more serious crimes. Ethically, any individual living with a mental illness who enters the criminal justice system should receive due process and the same rights enjoyed by the general inmate population, including all the services available for their rehabilitation, as well as treatment for their illness.

For mentally ill offenders in jail and prison, one of the biggest ethical concerns is treatment. The needs of the mentally ill are pharmaceutical, psychological, and physiological. In some instances, though, if an individual exhibits a series of behaviors associated with a mental illness, he or she may not be diagnosed prior to their arrival in the jail or prison.

As jail is used for shorter sentences, a year or less, there are fewer resources and possibilities for diagnosis and treatment. While prisons are used for longer sentences and therefore increase the points of contact where an individual may be identified as needing treatment, the opportunities for proper diagnosis and stable treatment regimens are limited.

Availability of treatment is a serious concern. Not all incarceration facilities have a psychologist or psychiatrist on staff. Not all incarceration facilities include a mental health evaluation on entry or during the adjustment period as an individual is introduced to life in the incarceration facility. Because of time and staffing constraints, this adjustment period may be very short or even nonexistent. Even in incarceration facilities where mental health professionals are on staff, their time is limited, decreasing the availability of prolonged interaction or counseling. This may mean that the only interaction with a mental health professional may be group sessions including inmates with a wide variety of disorders and the dispensing of medication, with limited follow-up for evaluation of dosage or interaction with other medications.

The emotional needs of the mentally ill in the incarceration process are underfulfilled. While the majority of mentally ill offenders are declared fit or competent to stand trial, confusion usually surrounds the outcome of those trials. Emotional distress is common for individuals being incarcerated, even without the added concerns of mental illness. The process of being incarcerated, being separated from the outside world and one’s personal belongings, can be very disorienting. It is not uncommon for new inmates to experience anxiety and depression. The newness of the experience can exacerbate or mask symptoms and behaviors of the mentally ill.

Stigma is another reason why an individual with a mental illness may not get the treatment and assistance needed while incarcerated. This stigma exists both within the incarcerated community and on the outside. Because of this, some individuals who are experiencing symptoms of mental illness may go out of their way during incarceration to not be identified. The potential for abuse and violence from other prisoners, the difference in the environment between incarceration and the world outside, can even exacerbate behaviors that are typically under the control of the individual, causing fear and uncertainty.

Fraud is problematic for the mentally ill. As most mental illnesses are treated with some pharmaceutical regimen, nonmentally ill offenders looking for the effect offered by the available drugs may mimic symptoms in order to acquire a diagnosis that would provide access to the medication. They may also seek the diagnosis in order to receive different treatment from guards or even the parole board. Such fraudulent practice by inmates simply decreases available resources and interferes with the availability of treatment for those who legitimately need it. Problems may also arise between legitimately mentally ill inmates and correctional officers who have only interacted with an individual faking a mental illness. Further, a corrections officer may be less likely to believe a legitimately mentally ill inmate’s behavior as it may be less pronounced than fraudulent behavior. On the other side, mentally ill inmates may be identified as needing or deserving negative treatment, or may be abused or misused by corrections officers because of the decreased likelihood that the mentally ill inmate would report the behavior.

Because the various mental disorders possessed by the mentally ill include a wide range of behaviors with which most correctional officers are unfamiliar, any behavior outside of the normal range of interaction with inmates may be met with hostility, increased force, or the loss of privileges inappropriate for the situation. While most correctional officers receive some training in interacting with the mentally ill, individuals who are not identified as mentally ill or exhibit symptoms and behaviors outside of the scope of the training present an unknown variable for correctional officers. In an incarceration facility setting, most unknowns must be treated as potential dangers, and for the mentally ill in prisons and jails, this increases stigma, as much as it increases stress, uncertainty, and fear.

Interaction with fellow inmates presents a variety of problems. While the mentally ill need not be isolated from the general population, the often predatory nature of inmates within the prison system can present the mentally ill as popular and easy targets for a wide range of malignant treatment from their fellow inmates. Prison victimization is wide ranging, from simple assault, to theft, to extortion, to sexual assault. Depending on the functionality of an individual with mental illness, he or she may not be able to avoid or recognize situations or scenarios where they are being used, abused, or endangered. Further, a mentally ill inmate may not be able to identify fully or utilize the prison’s system for reporting these events and situations.

Interaction with legal assistance while in prison can be more complex for the mentally ill than it was during the trial process. Because of the inmate’s status as incarcerated, and the previous experience with legal assistance as part of the trial process that led to this incarceration, mentally ill inmates may avoid or be more distrustful of legal assistance. The appeals process is far more complex than the trial process, increasing confusion. Because of this confusion and potential avoidance and lack of trust, mentally ill inmates who may be well served by the appeals process may not engage this process, nor understand when it is employed for them. In other cases, a mentally ill offender may obsess about the process and alienate him or herself from legal assistance; legal counselors for the incarcerated may dismiss claims from the mentally ill if symptoms and behaviors make it difficult for the attorney to distinguish what they may be able to pursue for an appeal and what may be a delusion.

Interaction with the public upon release is another concern for the mentally ill who have been incarcerated. While an individual with mental illness in the prison system may have received regular treatment, there is no guarantee that the same individual will continue to receive treatment upon his or her release. The public is wary of most individuals who are returning to the community from the prison system, and the combined stigma of incarceration and mental illness can decrease the availability of services and assistance for the mentally ill upon release into the community. Further, the exacerbation of symptoms and behaviors from the incarceration experience or the development of new symptoms and behaviors based on paranoia, victimization, depression, addiction, or anxiety may overwhelm the resources of rehabilitation or mental health assistance for returning inmates.

Upon release, interaction with law enforcement may also change. Mentally ill inmates who have returned to the community and found the experience less structured than their incarceration may commit new crimes to draw the attention of law enforcement and be returned to their incarcerated state. Unfortunately, law enforcement training on interaction with the mentally ill is as varied and limited as that of correctional officers. This can result in dangerous encounters for both the mentally ill and the officers themselves.


  1. Erikson, Patricia and Steven Erickson. Crime, Punishment, and Mental Illness: Law and the Behavioral Sciences in Conflict. New Brunswick, NJ: Rutgers University Press, 2008.
  2. Kupers, Terry. Prison Madness: The Mental Health Crisis Behind Bars and What We Must Do About It. San Francisco: Jossey-Bass, 1999.
  3. Pfeiffer, Mary Beth. Crazy in America: The Hidden Tragedy of Our Criminalized Mentally Ill. New York: Basic, 2007.
  4. Slate, Risdon and W. Wesley Johnson. The Criminalization of Mental Illness: Crisis and Opportunity for the Justice System. Durham, NC: Carolina Academic Press, 2008.
  5. Steadman, Henry J., et al. The Mentally Ill in Jail: Planning for Essential Services. New York: Guilford Press, 1988.

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