There are many issues we must face when discussing inmates with mental health disorders, there are many barriers which stand between our current application of Corrections within the United States, and a future of improving our society to provide proper medical and mental health care.
Yet, understanding where we are at with treatment of inmates who suffer from mental illness requires that we understand why we have these issues in the first place. The Center for Prisoner health and Human Rights details, “the closing of state psychiatric facilities during the process of deinstitutionalization in the 1960s was intended to improve care for people suffering from mental illness and shift treatment provision to less restrictive settings. People with mental illness left state-funded institutions to return home, to nursing homes and other community-based residences.
However, nearly half of the proposed community-based health centers that were to replace state psychiatric facilities were never built, and those that were completed ran into financial distress when federal money ran out a few years later” (Lewis 2018). The lack of leadership and oversight of the process was only exacerbated in later years by the continued war on drugs, which saw drastic increases in incarceration rates nationwide. Due to the previously mentioned phenomenon of co-occuring disorders (the interconnectivity of mental illness and substance abuse) we found an incredible number, over half of those incarcerated, suffer from mental health issues within our correctional institutions (Lewis 2018).
In recent times, we have made significant strides that address the lack of care being given to our imprisoned citizens. Championing these strides is the eighth amendment of the United States Constitution, “Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted” (LII 1992).
The history of the eight amendment, and the cruel and unusual clause goes back to the ideas of both the English bill of rights, and even to the magna carta, both of which dictated that the punishment will fit the crime (Klein 1979). Following these ideas through the last century we continue to find an expansion on the interpretations of the eight amendment, first was Trop v. Dulles (1958), where Chief Justice Warren wrote in the majority opinion, “the eight amendment must draw its meaning from the evolving standards of decency that mark the progress of maturing society” (Oyez).
The idea that the definition of cruel and unusual punishment was based in the eyes of our ever-evolving society, was prominent for the time, and was later expanded in Gregg v. Georgia (1976). In the majority opinion, a test was devised which required standards of cruel and unusual that must be met.
The analysis required the punishment must not inflict unnecessary and wanton pain as well as the punishment must not be grossly out of proportion to the severity of the crime (Klein 1979). Understanding that the idea of cruel and unusual is malleable, and changes as a society grows and matures is the basis to understanding how our current incarceration system has been shattering the rights of those without proper mental health care.
In another case, Bowring v. Godwin (1977), it was dictated by the Fourth Circuit Court, that psychiatric treatment was a constitutional right (Klein 1979). These cases set the precedent that many people who are suffering from mental health issues are having their constitutional rights being violated, when not given proper treatment for their ailment.
In recent decades we have expanded the ideas of these rights and applied them to our correctional systems nationwide, but it, unfortunately, hasn’t been enough to make any astounding difference, as the courts seem hesitant through following court decisions to pass anything substantially that would affect the revolving prison door. The use of pharmacotherapy, self-help groups, and counseling have been largely accepted in correctional settings, yet due to the high cost requirements, these practices are not widespread (Reingle 2014). What we do know is that one of the major problems is properly identifying mental health issues, especially when the correctional staff are typically not trained mental health professionals, and due to the ever-tightening corrections budget, there is an excessive lack of resources in many areas.
