Evaluation Of A Psychiatric Placement Without Legal Intervention

The incarceration of those who are mentally ill is on the continual rise. Many states juggle with the decision of placing offenders in Mental Hospital or locating them in State Prisons. Latessa and Holsinger (2011) discuss two major reasons for the increase of those with mental illness within the prison system. First, many states have no longer allow for the insanity plea during criminal trials, thus those who suffer from mental illness are not required to receive mandatory mental treatment. This is due to the discomforting idea that criminal offenders should not be given the same living conditions as those whom are patients of mental wards. Secondly, longer sentences have created a surplus of mentally ill offenders needing treatment. Soderstrom (2007) added that the lack of mental health support systems in

Given the number of incarcerated inmates who suffer from some form of mental illness, there are growing concerns and questions in the medical field about treatment of the mentally ill in the prison system. When a person with a mental illness commits a crime or break the law, they are immediately taken to jail or sent off to prison instead of being evaluated and placed in a hospital or other mental health facility. “I have always wondered if the number of mentally ill inmates increased since deinstitutionalization” Since prison main focus is on the crimes inmates are incarcerated; the actual treatment needed for the mentally ill is secondary. Mentally ill prisoners on the surface may appear to be just difficult inmates depending on the

The shutdown of state mental hospitals and lack of available financial and institutional resources force mentally ill people to the United States Judicial System for mental health. Every year thousands of people are arrested for various crimes and they are sent to jail. Sixteen percent of these people have some type of mental health problem (Public Broadcasting System , 2001). When we consider that the United States has the largest incarcerated population in the world at 2.2 million, this number is staggering (Anasseril E. Daniel, 2007). This is about 1% of the entire population of the United States. There are many reasons as to why the situation has taken such a bad turn and when the history of the treatment of mental illness is examined one can see how the situation developed into the inhumane disaster it is today.

Today, it seems almost incomprehensible that so many people with serious mental illnesses reside in prisons instead of receiving treatment. Over a century and a half ago, reform advocates like Dorothea Dix campaigned for prison reform, urging lawmakers to house the mentally ill in hospitals rather than in prisons. The efforts undertaken by Dix and other like-minded reformers were successful: from around 1870 to 1970, most of the United States’ mentally ill population was housed in hospitals rather than in prisons. Considering reformers made great strides in improving this situation over a century and a half ago. Granted, mental hospitals in the late 19th and early 20th century were often badly run and critically flawed, but rather than pushing for reform of these hospitals, many politicians lobbied for them to close their doors, switching instead to a community-based system for treating the mentally ill. Although deinstitutionalization was originally understood as a humane way to offer more suitable services to the mentally ill in community-based settings, some politicians seized upon it as a way to save money by shutting down institutions without providing any meaningful treatment alternatives. This callousness has created a one-way road to prison for massive numbers of impaired individuals and the inhumane warehousing of thousands of mentally ill people. Nevertheless, there are things that can be done to lower the rate mentally ill persons are being incarcerated. Such

The United States criminal justice system has been continuously increasing incarceration among individuals who suffer from a sever mental illness. As of 2007 individuals with severe mental illness were over twice as likely to be found in prisons than in society (National Commission of Correctional Health Care, 2002, as cited in Litschge &Vaughn, 2009). The offenses that lead to their commitment in a criminal facility, in the majority of cases, derive from symptoms of their mental illness instead of deviant behavior. Our criminal justice system is failing those who would benefit more from the care of a psychiatric rehabilitation facility or psychiatric hospital by placing them in correctional facilities or prisons.

A lack of infrastructure and monitoring in correctional institutions leaves the public unaware of the aforementioned human rights violation of individuals diagnosed with mental health disorders (Mfoafo-M’Carthy and Huls 2014). In the case of Ashley smith, she was often confined for long periods of time without appropriate cause and were then subjected to conditions that included violence, substandard nutrition and cleanliness, torment, unconsented medical treatment, loss of dignity, and sedation as a control method. In addition, her diagnosis of personality disorder was used against her because she did not conform to the dominant cultural, moral, and religious standards of society.

In the book, Crazy, by Pete Earley, provides a detailed overview of the mental health system in the United States, as it presents a first hand narrative of Earley’s family journey through the system. The author’s major premise and arguments, in the book, is to highlight the history of mental health, navigation through the judicial system with mental illness, the bureaucracy and policies of hospitals, society views on human rights and client safety, and the impact on the individual, family, and community. The content suggests that human service workers and public health workers should extend their professional lens to advocate for change in the mental health system in the United States.

Over the past thirty years, there has been a 500% increase in the U.S incarceration rate. (The Sentencing project, 2014) Advances in medicine, such as the discovery of psychoactive drugs, led to the deinstitutionalization of mentally ill patients from psychiatric hospitals. With a long record of horrific abuse,

Deinstitutionalization is defined as the movement of severely mentally ill people out of large state institutions. In the 1950s, public hospitals housed well over 500,000 people. The reduction in the number of institutionalized people began in 1956. By 1980, the residential population in mental hospitals dropped by nearly three-quarters, an average of 154,000 individuals. This decrease is due to the process of closing public hospitals and transferring patients to community-based mental health services. Consequently, community services were implemented (Talbott 2004).

Within contemporary society, the legal process of placing an individual into a detention or psychatric treatment facility is called "civil commitment." Typically, this is reserved for the mentally ill, or those people who have satisfied the Court's rule that they are a danger to others, or to themselves. Society realizes that, at times, an individual may pose a danger to themselves or to society and be unable to make rational decisions. In fact, in most jurisdictions in the modern world, involuntary commitment procedures are specifically applied to individuals who have manifested some form of serious mental illness that acts to impair their reasoning to such extent that they are unable to make cogent and logical decisions. Therefore, at these times the state (the Court system) must intercede to find ways to make the appropriate decisions under a legal template. Involuntary commitment may have, in the past, been used in certain situations, inappropriately, but the statutory criteria that indicates one is a danger to self or others usually acts as a legal axiom (Korba, 2008).

The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus

The use of mental health courts has been growing in the U.S., which has led to the discussion about how the mental health courts further promote medicalization of deviance; this is true. As outlined by Tammy Seltzer (2005), mental health courts have only been successful due to failures in the

The use of civil commitment or involuntary hospitalization is controversial because it involves a serious deprivation of a person's liberty. Mental health practitioners must evaluate the risk in the context of civil commitment.

The case of Mills v. Rogers has a significant importance in virtue of the human, civil and constitutional rights of the patients who are hospitalized at mental institutions. Despite the fact whether the patient was there voluntarily or contrary, Rogers believed that the institutions should respect the patient’s decision when it involved antipsychotic drug treatments. Rubie Rogers was a 36-year old black woman who voluntarily institutionalized herself at the Boston State Hospital (BSH). Rogers suffered from hallucinations along with delusions and acquired a history of thought disorder such as violent behavior. Before Mills v. Rogers, a prior lawsuit was filed.

Psychiatric care 80 years ago was quite different to how standards are set today. The cases of Youngberg v. Romeo and Wyatt v. Stickney both played big roles in developing standards that help maintain humane conditions in institutions nowadays. Both cases played a part in determining the rights of involuntarily committed patients under the Due Process Clause of the Fourteenth Amendment. Before both cases, patients may have been living in inhumane conditions, refused the right to psychiatric care, and neglected proper habilitation. But now, standards have been set and it’s been deemed appropriate that involuntarily committed patients’ rights must be protected under the Fourteenth Amendment with such standards.