Opinion: Behind Mental Bars

By Caroline Mazur-Sarocka (2021 Contest Submission)

The recommended treatment plan for an individual diagnosed with a mental health disorder includes: psychotherapy, antidepressant medications, mood stabilizers, hospital residential treatment programs, etc. (Mayo Clinic). For an individual incarcerated with a mental health disorder such as the case of Charlton Cash Chrisman, a recovering drug addict who struggled with mental illness prior to being sentenced to the Oklahoma County Jail, the ‘treatment plan’ he received, or lack thereof, did not mirror any of the Mayo Clinic’s recommendations. Rather, prison guards responded to Chrisman’s mental illness by shooting him with pepper ball guns upon leaving his cell, being shackled, and having a spit hood placed over his face. Two days after Chrisman entered the county jail, his body was moved to an autopsy room where “pepper ball injuries” were listed as a significant cause of death (Clay). The passing of Charlton Cash Chrisman is not a rare occurrence with over 900 inmate’s dying from unnatural causes while behind bars, many of which are suspected to have had mental illnesses. However, the federal justice system does not account for the possibility of mental health risks when recording these statistics. Without changes to the treatment of inmates, the death toll of the prison will continue to rise and cost the United States through costly legal repercussions. To improve the deteriorating conditions of mass incarceration, the judicial system must mandate mental health services for prisoners diagnosed with mental health disorders. By doing so, the United States Judicial System will decrease spending and increase prison and community safety.

While law enforcement and current legislation have assumed that community safety is promised by incarceration alone, the implementation of mental health services for prisoners both within prisons and externally will create a safer atmosphere for community members, prison guards, and the prison population. Upon comparing data from those held in incarceration to those benefiting from community mental health and substance abuse programs, the Stanford Law and Policy Review saw a positive correlation between external mental health programs and increased safety. The individuals who were held in incarceration demonstrated higher recidivism and parole violation rates when released (Baillargeon). Without receiving external treatment for mental health problems, these complications persisted upon release from prisons and then caused elevated parole violation rates. An increase in parole violations meant that the communities which past convicts returned to witnessed a greater number of unlawful, often violent incidents, decreasing the safety of the community’s constituency. The safety of the prison population is harmed as well from the presence of prisoners in need of, but lacking mental health treatment. In an analysis of 99 Texas state prisons filed from 2006 to 2012, the New York Times found far more reports of violence at facilities housing high numbers of mentally ill, violent offenders than at other prisons (Grissom). Without providing mental health services for the prisoners that need them, the safety of all prisoners is harmed because the mental health problems that initiated offenses that placed individuals into incarceration have not been resolved leading to the same safety risks inside prisons. The perpetuation of these safety risks caused by mentally ill prisoners to both communities and prisons will only continue unless mental health rehabilitation services are provided both in prisons and for after inmates are released. Critics of implementing mental health rehabilitation programs for prisoners point to prison understaffing as the preliminary problem to safety risks. Steve Gillan, the general secretary of the Prison Officers Association, places blame on the decreasing amount of prison guards spending time talking to prisoners and noticing signs that they are stressed as the cause of rising mental health problems and safety risks in prison (Gayle). Though prison guards have one-on-one interaction with prisoners, they cannot be held accountable for identifying mental health risks. In order to be able to make a health diagnosis of a mental illness, prison guards would need to have a rigorous background in medical training which is highly unlikely. Rather, the implementation of mental health testing for at risk prisoners and rehabilitation programs would bring medical expertise to correctly help prisoners recover from the mental health risks that are dangerous to their surroundings. Currently without mental health rehabilitation services, the menatlly ill incarcerated population has been subject to higher parole violations and violence at housing facilities. However, without means to improve their condition, prisoners cannot be expected to change their actions and will be prone to repeat offenses and violence in prison. Instead by instituting a mandate within the judicial system to provide mental health services, the prison system will have the resources to rehabilitate prisoners to reduce safety risks without overburdening already short staffed prison guards with the responsibility of acting as mental healthcare providers. By investing in the implementation of external mental health programs, the amount of unsafe incidents will decrease, providing communities and prisons with safer surroundings rather than the increased crime rates.

A decline in recidivism rates resulting from mental health programs will be cost-efficient for the United States prison system, which is already placing a heavy financial burden on taxpayers. Mental health courts are specialized courts within the judicial system which place prisoners who have been diagnosed as mentally ill into long term community-based treatment programs rather than prison. When predicting the result of an investment in the mental health of the incarcerated population, the PEW Charitable Trust and the MacArthur Foundation found that every $1 spent on one state’s mental health court system resulted in $7 in incarceration savings (Mental Health and the Role of the States). With mental health court investments, the quantity of prisoners incarcerated would decrease both in the short term by immediate relief of the amount of people entering prison and long term by decreasing recidivism through turning those who are mentally ill away from crime. Providing that there will be a decrease in prison residence, economic benefits such as not having to pay for amenities and housing and these finances can be shifted towards mental health courts and their rehabilitation programs. This redistribution of finances towards mental health courts is in dire need due to a cut of over $4 billion in public health funding after the 2008 recession which caused prisons to be the de facto places to warehouse those with mental illnesses (Osher). Without the funding for public mental health programs, many sufferers turned towards crime as means of survival causing an influx of the mentally ill in the prison system. While the opportunity has passed to provide those punished for the state's lack of mental health support with a clean slate, the rehabilitation of these individuals needs to be prioritized and the implementation of preventative programs mandated. However, since the prison has gained a reputation of housing those with mental illnesses, the mentally ill have grown to rely on incarceration to provide services for them. The reliance on incarcerated treatment has caused mentallly ill convicts to come back, costing $87 million (Murphy). While mandating mental health services for those entering incarceration would incentivize recidivism to receive these services, the implementation of mental health rehabilitation for those leaving incarceration in community centers would allow for those seeking treatment to not hold a reliance on the prison system. To alleviate the financial stress that is burdening the prison system, recidivism needs to decrease and for the mentally ill population, this is attainable through both in-prison and out of prison mental health services. The investment in the underfunded mental health service sector outside of prisons for recovering inmates will allow crime rates to decrease because these services could provide early intervention for the mentally ill. As well, the community based services would allow prisoners to discontinue their reliance on the prison system to fulfill their healthcare needs. Through investing in mental health courts and services, the judicial system will see a cost saving return on their investment through a declining prison population and the replenishment of the public health sector now that the economy has recovered.

Upon testing as mentally ill, all prisoners within the United States prison system should take part in mandatory mental health services to decrease spending and increase prison and community safety. Without providing services that rehabilitate convicts to becoming productive citizens upon their release, prisons throughout the United States will continue to place a heavy burden on taxpayers and face escalating overcrowding. While it may initially be difficult to effectively diagnose prisoners and institute mental health services on a large scale, the finances used to provide these services are ultimately a cost efficient benefit towards saving money on future incarceration costs. As well, the reliance of individuals on incarcerated mental health services can be alleviated by providing the same services in communities of those leaving a state of incarceration. By shifting the focus of the prison system from incarceration to rehabilitation, those whose mental illness puts their life at risk, like Charlton Cash Chrisman, would be given a second chance to give their life meaning, before it is too late. The handcuffs of mental illness have bound our incarcerated population to increased recidivism and decreased community safety. Take the key of mandated mental health services for prisoners and unlock their mental handcuffs.

Works Cited:

Baillargeon, Jacques et al. “Parole revocation among prison inmates with psychiatric and

substance use disorders.” Psychiatric services (Washington, D.C.) vol. 60,11 (2009): 1516-21. doi:10.1176/appi.ps.60.11.1516

Clay, Nolan. “Oklahoma County Jail Inmate Died of Agitated Delirium.” Oklahoman.com

Oklahoman, 25 May 2017,

Gayle, Damien. “Prison Funding Cuts 'Are Putting Vulnerable Prisoners at Risk'.” The Guardian,

Guardian News and Media, 5 Feb. 2016,

Grissom, Brandi. “A Tie to Mental Illness in the Violence Behind Bars.” The New York Times,

The New York Times, 22 Sept. 2013,

Osher, Fred. “Getting the Mentally Ill Out of Jail and Off the Streets.” The New York Times,

The New York Times, 9 May 2016,

“Mental Health and the Role of the States.” The Pew Charitable Trusts and the John D. and

Catherine T. MacArthur Foundation, June 2015,

“Mental Illness.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 June

2019,

Murphy, Bill. “To Get Help, Mentally Ill Go in and out of Harris County Jail.” Houston

Chronicle, Houston Chronicle, 22 July 2011