Process of Involuntary Commitment to a Psychiatric Facility

Despite the fact that my parents have worked in the criminal justice system for many years, I have never given much thought to the treatment of prisoners. As we learned from the readings, the current state of the United States criminal justice system is imperfect to the point of cruelty to those involved in it. This is truer for individuals with a mental illness. Due to a lack of psychiatric facilities throughout Alabama and overcrowding of those that do exist, many criminal offenders with mental illnesses are sent to prisons instead. State prisons are currently overcrowded, leading to substandard conditions such in almost every aspect.

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.

The stigma of mental illness creates a barrier for those who need treatment. Over the years, cases dealing with mentally ill persons involved with the criminal justice system have been prevalent. The cycle of courtrooms, prisons, and jails dealing with these individuals proved to be costly and an ineffective use of these resources (Docgurley, 2011). As a result, mental health courts have been established. This is essentially a therapeutic place where the focus is less on the crime and punishment and more on helping the client, which is usually in lieu of a jail or prison sentence. Particularly in this setting, it is important to understand the process of court proceedings, how client rights are protected, the importance of client safety and welfare, the gaps in services, and the course of involuntary treatment.

The subject of how to ethically treat prisoners is a contentious one, and when the struggles of mental illness are added to the equation, it becomes even more complex. In attempt to manage difficult or dangerous prisoners, solitary confinement has increasingly became the punishment of choice by prison officials. Solitary confinement can intensify or aggravate detrimental occurrences in behavior in prisoners when they are exposed to this isolation for extended amounts of time. The article “Solitary Confinement and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics,” was written by Jeffery L. Metzner M.D., a Clinical Professor of Psychiatry along with Senior Counsel of Human Rights Watch, Jamie

Many ethical issues surround the involuntary psychiatric commitment of mentally ill patients. In the 1980s, the city of Manhattan was overwhelmed by the surplus of mentally unstable and homeless individuals residing on the streets. In an effort to help relieve the burden on the city, Project Help was created to provide assistance to the needy. Joyce Brown, a 40-year-old homeless woman, slept outside of an ice cream parlor for 18 months. Her appearance suggested that she was mentally unstable and in a state of constant self-neglect. Project Help forcibly admitted her to the emergency department of a local hospital and injected with antipsychotic drugs and tranquilizers. After being evaluated

After the “deinstitutionalization” of the mental hospitals in the United States during the 1960s there has been a great increase in the amount of persons with serious mental illness incarcerate in jails and prisons (Torrey et al., 2014, p. 6). The incarceration of a mental ill person is inhumane and should be illegal. This action not only causes a deterioration of the individual that is suffering from the illness but causes problems with other inmates, the jail and prison staff, and the public. The inability to provide the proper treatment to these subjects through the criminal justice system is an emotional and financial burden for all parties involved. Mentally ill persons who have said to committed crimes should

In our county, state and federal correctional institutions across the United States, inmates are being imprisoned for awaiting trial, during trial or convicted for some crime. According to the Bureau of Justice (BJS, 2006), Fifty-six percent of inmates in a state prison and forty-five percent of inmates in a federal prison, suffer from or had a past of mental illness. In our American society, individuals who suffer from mental illness seem to be publicly perceived as a nuisance. This can be due to the fact that the media over the years consecutively scrutinized individuals who use the insanity defense in criminal trials. The insanity plea is negatively publicized if the defendant is using it in a high profiled case which their actions resulted in severe harm or death to another individual. In addition, the public perceives the use of this plea as a scapegoat for the defendant to avoid serving punishment in a penal environment. Mentally ill individuals, who are being civilly committed or charged with all levels of crimes, are being heavily prosecuted and sentenced into correctional facilities rather than psychiatric hospitals. This leads me to discuss the lack of treatment for patients in Bridgewater State Hospital (BSH) located in Bridgewater, Massachusetts. This three hundred and fifty bed facility houses Massachusetts most criminally insane. This facility is also use to evaluate patients/inmates for competency to stand trial and for those who get civilly

There are three common reasons for the mentally ill to be prevalent to isolation in our prisons systems (Torrey, 1997). First, those prisoners with preexisting mental illness may find it difficult to conform to prison regulations. They are therefore are often placed in solitary confinement for disciplinary purposes or administrative reasons. Second, many prisoners who are placed in solitary confinement develop severe mental illness as a result of the extreme isolation. Dr. Terry Kupers, one of the foremost psychologists on the impact of solitary confinement on mental health, explained: Being asked whether prisoners with serious mental illness are selectively sent to punitive segregation, or whether the harsh conditions of isolation and idleness cause psychiatric DE compensation in a vulnerable sub-population of prisoners. Of course, both mechanisms of isolation and segregation are in play and is of deep concern to all (Knowles, 2015). Third and lastly, mentally ill prisoners in isolation are more likely to violate prison rules and fail the requirements of so-called "step-down" programs, thus prolonging their solitary sentences. The confluence of these three factors has led to high rates of mentally ill inmates being confined in isolation. Empirical studies show that solitary confinement is linked to suicidal thoughts, impaired concentration, confusion, depression, anxiety, paranoia, and hallucinations making it a clear factor in the increase numbers of mentally ill inmates

According to the Human Rights Watch report, "unnecessary, excessive, and even malicious force" is used prisons to control inmates with who suffer from psychotic episodes. The callous force used in prisons to control the mentally ill is continuously ignored with many ignorantly believe that a mental illness is a personality flaw. These people do not realize that these episodes are cause by a serious chemical imbalance in the brain. Clearly, prison is no place for the mentally ill because it is not treatment, “Vera Institute of Justice found… 2 million people are incarcerated each year with mental illness and more than 80% do not receive mental health treatment” (NAMI 1). To imprison a citizen who does not have the capacity to understand reality and neglect them proper treatment, would be cruel and unusual punishment.

We can no longer ignore this on-going age old problem of dealing with the mentally ill by hiding those plagued, away in a prison cell to be forgotten. Despite the success of Dorothea Dix in solving the problems with adverse conditions in the prison system, we have come full circle and are currently back where we started over a century ago. There has been so much focus put on housing the mentally ill, we have all but forgotten about any type of treatment plans to help the overall growing problem. The handling of the mentally ill in the prison system was on a collision course with the Court. Most of the prison systems have one time or another violated prisoners’ rights under the 8th amendment, cruel and unusual punishment.

An article written by Carl Elliot in Mother Jones magazine tells the case of 26 year old Dan Markingson. Dan was enrolled in a psychiatric drug study at the University of Minnesota in 2003. Dan’s mother, Mary Weiss had him admitted to a hospital on November 12th because he was having delusions and threatened to kill her and other people. Dan was taken to a teaching hospital at the University of Minnesota,where Dr. Stephen Olson diagnosed him as psychotic and dangerous and unable to make decisions for treatment. A week later on November 20th , Dr. Olson asked the court to grant Dan a “stay of commitment” where the patient can leave as long as they abide by the treatment prescribed by their doctor. Olson did not practice standard treatment and

Outpatient Commitment also referred as Assisted Outpatient Treatment (AOT) alludes to state psychological well-being laws that make civil court technique where in a judge requests a man with serious mental sickness to stick to an outpatient treatment arrangement intended to relapse and unsafe worsening. Assisted Outpatient Commitment permits the helped involuntary treatment of people determined to have serious mental issue who are living in the community and encountering an psychological illness emergency that require intercession to avoid further detorioration that is hurtful to themselves or others, instead of held in medical

Examines join involuntary outpatient commitment with enhanced patient results, filling debate on its moral defense.The survey thinks about inpatient usage for conferred outpatients in the 1990s with the individuals who were not under outpatient civil commitment orders. Discoveries uncover submitted outpatients had higher usage of inpatient administrations and restriction scenes preceding their dedication contrasted and a control catagory. Commitment outpatients likewise will probably have been on release status at the time of confirmation, have been admitted automatically under crisis legitimate strategies, and have had a more prominent number of admissions and clinic days before their dedication. Taking after responsibility, patients had less hospitalizations, shorter lengths of stay, less isolation scenes and hours, and less restriction scenes and hours. Discoveries are talked about inside of the connection of parens patriae and helpful jurisprudence, and hold on therapeutic and public policy supports for moral needers of outpatient civil commitment laws for genuinely mentally illness individuals

Involuntary commitment of the mentally ill is surrounded by continual controversy especially since mass shootings like the one at Sandy Hook Elementary are on the rise. Some argue that anyone with a mental illness should not be permitted to purchase a firearm. And their contenders claim such a measure would “infringe upon their civil rights” and would result in discrimination towards the mentally ill (Barusch, 2015, p. 236). Society is angry seeing so many mentally ill homeless in their communities. Some blame it on the strict regulations defining who can be Baker Acted, as the mentally ill cannot be involuntarily committed unless they are an imminent danger to themselves or others. Socioeconomically challenged families have no choice but to sit back and wait until their relative is so ill that they become a danger to themselves or society before they can get the care he/she needs. At that point, often learning the illness has reached chronic proportions and may take a lifetime to cure. They argue that the seriously disabled should be committed “regardless of their dangerousness” (Barusch, 2015, p. 244). It just seems

Another term that is too broad to interpret is “commitment to a mental institution” (Bramble 309). This was also defined by the AFT. Their definition is,