March 22, 2006

Prison, Discrimination and the Mentally ill

The mentally ill comprise a group of people that often faces discrimination.

This week Prof. Hal Smith, psychiatry professor at State University of New York, spoke at Cornell University on the misconceptions often associated with mentally disabled offenders.

"I spent my entire career working exclusively with mentally disabled offenders. I hope to contribute some things to this topic and the understanding here at Cornell," Smith said. "I'm pretty much freelance now. I don't speak on behalf of any public or private entity. All of these opinions are my own."

Smith first pointed out that many of our conceptions of the mentally disabled come from the way they are portrayed in the media. He cited examples such as Robert De Niro's character in "Cape Fear" and Jack Nicholson's role in "The Shining" as stereotypical portrayals of psychopathic and sociopathic disorders.

These portrayals accurately represent their respective disorders with symptoms such as a lack of conscience and egocentrism, according to Smith.

"[However,] one of the flaws with all of these characterizations is that people start to generalize," Smith said.

Such violent portrayals of those with mental disabilities give a false representation of the norm.

"People with mental illnesses are no more violent or no more apt to commit a crime than the general public," Smith said. "Movies and some media can totally distort perception."

Violence usually only increases when someone with a mental disease is also involved in substance abuse, according to Smith; however, this rise in violence under such circumstances is also seen in the general public.

Smith also addressed the prevalence of mental illness in the correction system.

He said that there are 283,800 people with mental illnesses in United States federal, state and local jails. About 70,000 prison inmates are psychotic, while 200,000 suffer from schizophrenia, bipolar disorder and depression. He also pointed out that a significantly larger percent of jail inmates suffer from mental illness compared to those in prison.

"[Most of these inmates] have pre-existing cases of a mental disability before being sent to jail or prison," Smith said.

In 2000, 70 percent of prison inmates were diagnosed with mental disorders, and 15 percent with "severe" mental illnesses. From 1980 to 1992, the number of inmates with mental disabilities more than doubled.

In contrast, the number of inpatients in the old Department of Mental Hygiene was about 90,000 in the late 1950s, and that number has now dropped to 4,000 patients in the current State Office of Mental Health, Smith said.

"How did we end up with these huge numbers [of mentally disabled inmates]?" Smith asked.

According to the National Alliance on Mental Illness, as people are released from mental institutions, they are not given the proper resources to find jobs and acclimate to society. This leads to higher incarceration rates.

Smith pointed out trends over the years that support this theory. In 1955, there were 560,000 people with mental disabilities in state hospitals and only 200,000 in jails and prisons. In the 1960s and 1970s, the use of anti-psychotic drugs and cuts in state hospital budgets led to high rates of deinstitutionalization. No services were provided to help patients reintegrate into society, and by 2002, there were only 60,000 patients in state hospitals. However, the number of inmates with mental illnesses rose to two million.

Smith also gave a brief history of the current system, showing how we got to this point.

In 1859, a State Lunatic Asylum for Insane Convicts was established at a prison in Auburn, and 200 beds were reserved for the mentally disabled. When capacity was exceeded, similar asylums were established at Matteawan and Danneamora State Hospitals with a cap of 500 beds at each hospital. Some asylums were for convicted and sentenced prisoners, while others included violent civil patients who had not committed any crimes.

The system remained the same, constantly expanding, until litigation began to "shape the system" in the 1960s, resolving many abuses in the state hospital system, according to Smith.

"People began to realize that Metteawan was a bad place," Smith said.

As a result, the responsibility of state hospitals was transferred to what was then called the Department of Mental Hygiene.

Today, many major prisons have small sub communities, which are mental health centers inside the prisons.

"[The patients] live and work in the general population of the prison," Smith said.

Smith also briefly touched on the ethical issues involved with the mentally disabled, such as whether or not those with mild mental disabilities should be forced to take their medications. This could also lead to abuses such as overly medicating patients in order to help control them.

"I think [this event] raised a lot of basic issues ? [and] will encourage further discussion on this topic," Mack said. "It gave people a bit of the opportunity to see ? a bit of the history and [will maybe encourage them to] go forward and do some outside research."

The lecture was co-sponsored by Cornell Union for Disabilities Awareness and Cornell Minds Matter.


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