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  • Emma Benjamin

Mental Illness in America: Obstructing the Cycle

It has long been known that issues in the U.S. regarding poverty, illicit substance use, and America’s abnormally high recidivism rates that accompany its idle prison system fall into a lattice of socioeconomic and criminal justice issues plaguing the nation. One element that appears to be embedded in all of this is mental health. Not only is mental health one of the most common health conditions in the United States, but it appears to be an exacerbating force in this lattice of aforementioned social issues that has historically been under-addressed.

While it’s perhaps impossible to discern one sole root to any one of these issues, it is evident that poverty, poor mental health, drug abuse, and the criminal justice system each serve as aggravating factors that intertwine and cycle each other. The U.S. Department of Housing and Urban Development reported that of the 564,708 individuals homeless each night in the U.S., a minimum of 25 percent of these individuals were reported to be seriously mentally ill, while 45 percent were said to have a diagnosed mental illness. For reference, a 2019 national drug use survey conducted by SAMHSA reported that 5.2 percent of U.S. adults were diagnosed with a serious mental illness, revealing a disproportionate amount of these found amongst the homeless. Additionally, 60 percent of the chronically homeless have experienced mental health problems, while 80 percent have dealt with lifetime drug abuse, further demonstrating the jointness of these issues.

Ultimately, these statistics are congruent with the general consensus among researchers that mental illness, drug abuse, and homelessness share a requited relationship. While all these concerns appear to affect one another in some way, mental health specifically has been shown to increase vulnerability to homelessness through factors such as poverty, disaffiliation, ability to sustain employment, and behavioral issues. In turn, homelessness reportedly amplifies pre-existing psychological issues through stress, anxiety, fear, depression, and substance use, and is suspected to be both a cause and consequence of criminal records. Consequently, there appears to be a cycle that ensues between homelessness and prison that fuels and is fueled by mental illness.

To address this aspect of the cycle, the systemic deficits surrounding policies and institutional regulation that affect mental health must be addressed. From jail systems and police that are unequipped to respond to mental health, to the often high frequency of traumatic experiences reported in current inpatient psychiatric facilities, a thorough examination of such institutions might posit a remedy to the cycling of persons through jails, streets, and hospitals, as well as these individuals in stagnant or even worsened mental conditions. Additionally, the most pertinent institution to treating mental health is the actual psychiatric care institutions tasked with attacking this issue; however, epidemiological research has unveiled a considerable number of patients who not only found psychiatric centers to be ineffective, but also traumatic. Thematic analysis conducted on psychiatric centers found persistent reports of neglect and abuse, dehumanization and fear, and potentially traumatic coercive practices.

There has been critique made about the social and physical structure of the psychiatric facilities as well. Most of this critique is in reference to the cold, depressing atmosphere of many facilities which appears to promote isolation and boredom, being averse to these treatments’ goals of helping patients. Therefore, in addition to a call for better regulation to combat the coercive, authoritarian essence of these professional and institutional settings, a reconstruction of these facilities’ environments is also warranted. Specifically, staff, patients, and visitors making requests to design environments would facilitate positive social interactions, thus improving the patients’ mental health. These design environments requests would actually place the facilities within local communities, as opposed to isolated locations. Putting psychiatric institutions in local communities and improving interior design interventions, such as building homelike facilities with a large number of communal areas to promote socializing, would encourage family visitation, integration into the community, and reduce the stigma surrounding mental illness. With a more positive social atmosphere, family presence, genuine peer support, better staff-patient relationships, and increased stimulation, more successful health outcomes would be expected, increasing the effectiveness of such psychiatric institutions.

Photo of Inland Northwest Behavioral Health Center

Combatting issues regarding mental health extends beyond just treatment facilities; prisons are also key targets. The ineffectual conditions of prisons impede the rehabilitative efforts of such facilities, as the trauma endured in prison has been shown to worsen or even trigger mental illness. Not only is there deficient access to proper mental health care in prisons, but incarceration leads to isolation, loss of autonomy, atypical social exposure, lack of purpose, boredom, and a cluster of symptoms and traits similar to that of PTSD. These consequences are worsening the mental health of a segment of people that faces substance abuse and mental health issues at disproportionate rates. Therefore, mental health must be addressed as a key aspect to rehabilitation efforts to help reduce America's high recidivism rates, which is a large component of the aforementioned cycle. One study between better in-prison and post-prison mental health and lower recidivism found financial and structural reform of prison is warranted by the association. This study goes on to theorize this association, highlighting how stressors that arise in prison and post-prison, when inadequately addressed, add strain to already difficult aspects of rehabilitation (i.e. finding employment, re-building familial relations). This may consequently encourage crime as a coping mechanism as well. Ultimately, with a statistically significant decline in recidivism in those with mental illnesses upon more comprehensive mental health and substance abuse services, it is evident that more attention and funding needs to be concentrated to better combat these issues.

A glimpse into the American prison environment at the Draper Correctional Facility

Further, to combat a direct funneling of the mentally ill to jail, law enforcement is being called upon to better screen for mental health, allowing for involuntary treatment for the mentally ill instead of immediate arrest. Multiple studies also vouch for expanding recent community-based reforms to include crisis teams, crisis intervention training for police, and clinical social workers who ride along with those suspected mentally ill. Doing this would be another viable approach to combating recidivism rates to ultimately sever a huge component of the junction of issues plaguing America. It must be noted that these actions only work if efforts to increase accessibility and financial support to actually provide resources and programs to all are pursued in tandem with them. Nonetheless, these instruments must undergo reconstruction so that these resources are actually serviceable in the first place. With adequate concentration of funding and attention, perhaps some of the key components to this cycle of poverty and instability in America can be quelled.


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