5-1 Final Project Milestone Three Project Preview and Theory Application

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5-1 Final Project Milestone Three: Project Preview and Theory Application Tiffany White Southern New Hampshire University SOC 324: Sociology of Crime and Violence Kelle Daniels February 17, 2024

Introduction: The chosen topic, "Prisons as Mental Health Institutions," is profoundly personal as I've witnessed family members being incarcerated despite evident mental health needs. According to the World Health Organization, mental health is characterized as "a state of well-being wherein an individual recognizes their own potential, manages everyday stresses effectively, engages in productive and fruitful work, and contributes to their community." This concept encompasses well-being across emotional, psychological, and social dimensions.(Green,2020) Recognizing the dual role of prisons is imperative for upholding human rights and ensuring public safety. The misuse of prisons for mental health care poses substantial risks to both inmates and staff, underscoring the urgent need for enhanced safety conditions within correctional facilities. Addressing this issue is essential for mitigating potential harm, combating mental health stigma, and cultivating a compassionate societal attitude. Effective resource allocation is crucial to promoting impactful mental health treatments beyond the confines of the criminal justice system. The current practice of utilizing prisons for mental health reasons, as observed both locally and globally, is counterproductive. I advocate for a shift in approach, emphasizing that jails are designed for lawbreakers, not individuals born with mental illnesses who require specialized care in mental health institutions. This change is imperative for the well-being of those affected and for creating a more humane and effective system. Analysis: This position paper is aligned with the overarching goal of the social advocacy group, "Mental State Not Up State," which aims to catalyze a paradigm shift prioritizing mental health over incarceration. Through an exploration of the crime and violence issue, our objective is to heighten awareness, influence policy changes, and cultivate a compassionate societal attitude that resonates with the mission of the advocacy group. The ultimate goal is to decriminalize mental illness, guide individuals towards appropriate care, and advocate for systemic reforms within the criminal justice system. The evidence employed in our analysis encompasses a diverse range, including personal narratives, case studies, and statistical data. Annually, over 2 million individuals with severe mental illnesses are registered in jail. According to the U.S. Department of Justice's 2011–2012 national inmate survey, 1 in 7 individuals in state and federal prisons and 1 in 4 in jails exhibited signs of "serious psychological distress." The survey also revealed that over one-third of incarcerated individuals received a clinical diagnosis of a mental health disorder, a prevalence higher than the 1 in 5 observed among nonincarcerated individuals.(Ives- Rublee & Stafford, 2022) This multifaceted approach ensures a nuanced understanding of the issue, integrating qualitative and quantitative elements to fortify the case for reform while upholding ethical standards and respecting the dignity and privacy of those affected. Utilizing the social theory of criminalization as a guiding framework, our analysis aims to uncover the systemic factors contributing to the disproportionate representation of individuals with mental health conditions in prisons. In the realm of sociology, one could broadly define crime as the exploration of social deviance and the transgressions of established norms. (National University, 2021) This approach sheds light on the societal and institutional structures that perpetuate punitive approaches. Firmly asserting that the current response to mental health within the criminal justice system necessitates urgent reform, our paper advocates for a shift towards a more humane, rehabilitation-oriented approach. We advocate for increased mental health awareness, diversion programs, and a comprehensive reevaluation of social roles within institutions, all aimed at better addressing the mental health needs of individuals entangled in the criminal justice system. Through evidence-based arguments and a commitment to ethical considerations,

our position strives to contribute to a society where individuals receive the appropriate care and support they need, moving away from punitive measures. Persistent stereotypes surrounding "Prisons as Mental Health Institutions" play a detrimental role in shaping public perceptions and exacerbate challenges for individuals within the criminal justice system. Individuals with severe mental illness often face dual challenges. On one front, they grapple with the symptoms and disabilities arising from the condition. Simultaneously, they encounter the hurdles of stereotypes and prejudice rooted in misconceptions about mental illness. This dual struggle deprives people with mental illness of opportunities crucial for a quality life, including access to good employment, secure housing, satisfactory healthcare, and connections within a diverse social network. (Corrigan & Watson, 2002) The stereotype of inherent dangerousness fosters biased beliefs, leading to harsh judgments and unwarranted incarceration. This oversimplified link between mental health and criminal behavior lacks validity and is perpetuated by media portrayals, particularly in crime dramas. Additionally, the stereotype of an inability to participate in society isolates individuals, hindering integration efforts and reinforcing biases. Media depictions further this misconception, portraying individuals with mental health conditions as socially incapable. Addressing and challenging these stereotypes is crucial for an accurate understanding of the mental health-criminal justice relationship, advocating for nuanced media portrayals, and raising awareness to dismantle stigmas. A noteworthy shift in societal perspectives regarding mental health services is evident through the implementation of mental health treatment programs within correctional facilities. This transformation underscores an increased recognition of the essential nature of mental health services in prison settings. Many psychologists are dedicated to preventing the entry of individuals with mental health issues into correctional facilities, developing numerous programs for this purpose. Dr. Robert Morgan, a psychology professor at Texas Tech University in Lubbock, exemplifies this dedication by evaluating a novel program within the prison system. This program aims to assist inmates in acquiring skills to steer clear of behaviors that could result in re-incarceration upon their release. As Morgan notes, "We learned through a series of studies that people with mental illness in the justice system are there in part because they present with criminal risk in similar ways to those who are not mentally ill— they interpret interpersonal situations differently than noncriminals" (Stringer, 2019). The media has played a significant role in shaping perceptions of mental health within the prison system, as illustrated by the extensively covered Gypsy Rose case across various media formats. This case not only highlights the intersection of mental health and the criminal justice system but also enhances awareness of the crucial role mental health services play in addressing the needs of individuals within the legal context. Gypsy Rose expressed in one of her interviews, "If I feel overwhelmed at any point, I will listen to music. That’s how I release the anxiety. I will close myself off in a room, or be in a closed space, put on my headphones and I’ll journal for a little bit or lay back in my bed and decompress while listening to any song I feel like is relatable at that moment. That’s how I relax and stay mentally sane" (Olson, 2024). The evolving perspective is further influenced by ongoing social movements advocating for increased mental health awareness and reforms within the legal system. Historical events have profoundly shaped the landscape of mental health within the criminal justice system in the United States, leaving a lasting impact on policies and practices. The emergence of mental health institutions and early psychiatric treatments signifies a shift in societal attitudes toward mental health. For instance, Dorothea Dix's 1830s campaign led to the establishment of state hospitals,

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reflecting a growing recognition of the need for specialized care for individuals with severe mental illness. The Civil War and the era of slavery have left indelible imprints on perceptions and practices surrounding mental health in prisons. Drawing parallels with past wars and soldiers may provide valuable insights into the consequences of present-day combat. According to Roxane Cohen Silver, Ph.D., from the Department of Psychology and Social Behavior at the University of California, Irvine, "There can be serious mental and physical health costs of traumatic war exposure. While the specific forms of trauma may have changed, the message is the same" (Levin, 2006). The psychological toll of war contributed to evolving attitudes, influencing how mental health was understood and addressed within the criminal justice system. Policy changes, particularly through the introduction of Medicaid and the Affordable Care Act, have significantly shaped mental health policies within the criminal justice system. These legislative measures aimed to enhance access to mental health services for incarcerated individuals, resulting in a considerable impact on their overall treatment and care. People entering and leaving the criminal justice system often comprise low-income adults dealing with substantial physical and mental health requirements, along with various economic and social obstacles. The Affordable Care Act (ACA), especially the Medicaid expansion, presents fresh prospects to enhance health coverage for this demographic. This could lead to better access to care, increased stability in their lives, and lower rates of reoffending. (Artiga & Gates, 2016) By expanding healthcare accessibility, these policies addressed disparities in mental health support, creating a more inclusive and comprehensive approach within correctional facilities. Recognizing the intersectionality between mental health and the criminal justice system, Medicaid and the Affordable Care Act played a crucial role in fostering a more humane and effective mental health care environment for those within the legal context. Historical events and policy shifts have collectively shaped the changing viewpoints on mental health within the criminal justice system. Each of these factors has made a unique impact, illustrating the intricate interaction between societal attitudes, legal structures, and continuous endeavors to confront mental health issues in the realm of incarceration. Contemporary perspectives on mental health in prisons demonstrate an increased awareness of the intricate challenges faced by incarcerated individuals, signaling a shift in societal views. Narratives, like those of Ty and Teresa, illustrate the multifaceted nature of mental health issues in prison, involving trauma, substance use disorders, and other complexities. "Ty and Teresa are composite characters, built on traits and experiences that I’ve seen in countless detention facilities in the United States over the past three decades." (Pinals, 2023) Additionally, the recognition of racial and socioeconomic disparities within the criminal justice system highlights systemic inequalities that warrant attention. There is a growing consensus on the overrepresentation of individuals with mental illnesses in the criminal justice system, marking a contemporary concern. Statistics revealing the significantly higher likelihood of arrest among individuals with mental illnesses contribute to the acknowledgment of a pseudo-criminalization trend. In this context, correctional facilities inadvertently operate as de facto mental health institutions, exposing systemic failures in addressing the mental health needs of incarcerated individuals.

Joshua Francisco's situation deteriorated to the point where his family could no longer accommodate him at home. Consequently, his mother contacted his probation officer in Missouri, who recommended his return to a state hospital. During the two-month wait for a hospital bed, an incident occurred that led Francisco to believe he was dying. Seeking help and viewing parole as the best chance for treatment, he was sentenced to prison by the judge. Unfortunately, Francisco never reached the prison's mental health department as intended; instead, he took his own life in his cell on October 22, 2014 (Bao, 2020). His tragic journey through the criminal justice system underscores the failure of both mental health and criminal justice systems to adequately address the needs of individuals with serious mental illnesses, exemplifying the challenges families face in navigating a system ill-equipped to handle mental health crises. The social theory of criminalization is a conceptual framework that aids in understanding the systemic factors that lead to the disproportionate representation of individuals with mental health conditions in prisons. The theorization of criminal law has not only been shaped by philosophical perspectives over the past two centuries but has also been significantly influenced by the practical aspects of codification, law reform, and constitutional discussions regarding the appropriate boundaries of criminal law.(Nuotio, 2010) This theory serves as a guiding tool to uncover the intricate societal and institutional structures that contribute to the adoption of punitive approaches within the criminal justice system. This theory excels in offering a comprehensive perspective, serving as a valuable tool to grasp the intricate dynamics between social structures and mental health within the criminal justice system. By examining historical and contemporary contexts, it enables a nuanced analysis of how societal attitudes, policies, and institutional practices contribute to the overrepresentation of individuals with mental health conditions in prisons. Conclusion: Placing individuals with mental illness in jails and prisons has consistently proven ineffective over the years. This approach not only leaves them untreated but also increases the risk of tragic outcomes, including suicide. What individuals with mental illness truly need is access to effective treatment, affordable health insurance, and appropriate care, not incarceration. To make jails or prisons effective for those with mental illness, comprehensive measures are required. This includes providing proper training for correctional officers in dealing with mental illnesses, ensuring access to necessary medications, having on-site psychiatrists, and offering therapy services. It is essential to recognize that individuals with mental illness have the same rights as those without, and the focus should be on providing the care they need. Rather than confining them, we should prioritize offering all-encompassing care and allowing them to decide whether they wish to pursue treatment or not.

References: Artiga, S., & Gates, A. (2016, June 23). Health coverage and care for the adult criminal justice- involved population. KFF. https://www.kff.org/uninsured/issue-brief/health-coverage-and-care-for-the- adult-criminal-justice-involved-population/ Bao, J. (2020, March 9). Prisons: The New Asylums. Harvardpolitics.com. https://harvardpolitics.com/prisons-the-new-asylums/ Corrigan, P. W., & Watson, A. C. (2002, February). Understanding the impact of stigma on people with mental illness. World psychiatry : official journal of the World Psychiatric Association (WPA). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/ Green , E. (2020, May 4). Illinois Criminal Justice Information Authority. ICJIA. https://icjia.illinois.gov/researchhub/articles/mental-illness-and-violence-is-there-a-link/ Ives-Rublee, M., & Stafford, C. (2022, September 8). Long-term solutions to the overincarceration of people with mental health disabilities. Center for American Progress. https://www.americanprogress.org/article/long-term-solutions-to-the-overincarceration-of-people-with- mental-health-disabilities/ Levin, A. (2006, April 21). Civil War trauma led to combination of nervous and physical disease. Psychiatric News. https://psychnews.psychiatryonline.org/doi/full/10.1176/pn.41.8.0002 National University. (2021, July 27). Sociological theories of Crime & Deviance. https://www.nu.edu/blog/sociological-theories-of-crime/ Nuotio, K. (2010, November 11). Theories of criminalization and the limits of Criminal Law: A legal cultural approach. OUP Academic. https://academic.oup.com/book/11319/chapter-abstract/159929787?redirectedFrom=fulltext Olson, C. A. (2024, January 15). Gypsy Rose Blanchard reveals her go-to mental health reset. Forbes. https://www.forbes.com/sites/cathyolson/2024/01/10/gypsy-rose-blanchard-reveals-her-go-to- mental-health-reset/?sh=33ed19ce1e7d

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Pinals, D. A. (2023a, December 8). For too many with mental illness, incarceration is the default. The Pew Charitable Trusts. https://www.pewtrusts.org/en/trend/archive/fall-2023/for-too-many-with- mental-illness-incarceration-is-the-default Pinals, D. A. (2023b, December 8). For Too Many With Mental Illness, Incarceration is the Default. The Pew Charitable Trusts. https://www.pewtrusts.org/en/trend/archive/fall-2023/for-too- many-with-mental-illness-incarceration-is-the-default Stringer, H. (2019, March). Improving mental health for inmates. Monitor on Psychology. https://www.apa.org/monitor/2019/03/mental-heath-inmates

5-1 Final Project Milestone Three Project Preview and Theory Application

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