Prison population in R.I. largely comprised of mentally ill people

Of Rhode Island’s more than 3,000 prison population, approximately 500 are living with a serious mental illness, said Susan Jacobsen, MA, LMHC, executive director of the Mental Health Association of Rhode Island.

That figure is calculated by taking the incidence of mental illness in the general prison population (14-17 percent) and multiplying it by the Rhode Island prison population, Jacobsen said.

“It certainly is the case in many communities in Rhode Island that local [jails] are the largest mental health providers de facto,” she said. “They can’t turn anybody away.”

She added that the state hospital has fewer than 140 beds available to those dealing with mental illnesses. Acute care is available only at private hospitals, she said.

That means many people dealing with serious mental illnesses often end up homeless or cycling through the corrections system, Jacobsen said.

Rhode Island is not alone in this issue.

According to the National Institute of Corrections Web site, a 2006 report estimated that 705,600 adults dealing with mental illness were incarcerated in state prisons, 78,800 in federal prisons and 479,900 in local jails. It said that people dealing with mental illnesses make up two to four times the general probation and parole population.

In part, this issue occurs because of a shift that started in the 1960s to de-institutionalize those dealing with mental illness. According to the National Institute of Corrections, in 1959, almost 560,000 mentally ill were housed in state mental hospitals. By the late 1990s, that figure dropped to around 70,000.

Up until the 1960s, one in every 300 Americans was in a psychiatric hospital, said Madelon Baranoski, Ph.D., associate professor of psychiatry at Yale University School of Medicine. Now, one in every 200 Americans is caught up in the criminal justice system, she said.

Baranoski was one of the speakers at a forum in December hosted by the Mental Health Association of Rhode Island on the “Criminalization of Mental Illness.”

The meeting was informational and focused on policy options around community treatment, police training, and supported employment, to help alleviate the issue, said Jacobsen.

“It’s critical that our community infrastructure and supports are adequate. Otherwise, people end up churning in the deep end,” Jacobsen said. “The deep end is homeless shelters, hospital rooms, and correctional institutions.”

Baranoski said she spoke at the forum about “a menu of services from pre-arrest through release” used in Connecticut that have helped those dealing with mental illnesses from being locked up in the criminal justice system.

That includes the Memphis Model Crisis Intervention Team training for police officers that gives first responders the tools to de-escalate a situation with a person dealing with a mental illness in crisis and keep it from reaching a point of arrest or deadly force. Jail diversion programs place a clinician in the courtroom for assessment and provide other resolutions other than incarceration for those with mental illnesses facing charges. Supervised release programs allow charges to be dropped if a person dealing with a mental illness on probation stays in treatment, she said.

“All of these share the intent and the assumption that the bad behavior is less malicious, that it was the result of mental illness or substance abuse,” she said.

Baranoski said often those with mental illnesses are locked up for lower-level charges. “In our local jail, the only people in jail for disturbing the peace were people with mental illness,” she said.

Support and resources like jobs, housing, and access to resources are necessary to helping them get out of the criminal justice cycle, she said. Treatment as usual should not just be giving medication, Baranoski said.

Jacobsen said she hopes state lawmakers will support policy and funding changes to help deal with the issue.

Baranoski said to address this issue at a deeper level, communities need to start handling the stigma of mental illness. “The community has to value the investment in bringing everybody to their best mental health,” she said.