“. . . Justice systems are built on the notion of free will and thus
require an examination of the state of mind of the accused. .
– M. E. Rice, et. al
It is often argued that a person’s presence in a correctional
facility, in itself, points to a level of social maladaption as to
constitute a possible mental disorder.
One study found that only 5% of
penitentiary inmates did not have some sort of mental disorder. This study
counted “. . . psychosis, a problem of substance abuse or dependence, or
a diagnosis of antisocial personality disorder” as “mental disorders.”1
Other studies have aimed to show direct genetic (biological) causes of
aggression and violent tendencies by searching for an “aggression” gene
among prison inmates.
2 Segregation and victimization of mentally ill
inmates within prison-inmate culture has also been observed. Apart from
expected levels of social malada ption among inmates there is a minority
population of mentally ill inmates distinct and differentiated from the
larger inmate culture. These inmates are set apart from the general prison
population and stigmatized for their Mental Illness Essay, especially if it is
quite apparent or visible.
After studying populations of prisons and psychiatric hospitals in
Europe, researchers in 1939 observed that “. . .
as the size of prison
population goes up, the size of mental hospital population goes down
proportionately, and vice versa, presumably because people move from one
system to the other.”3 Applying this theory to the current situation,
one would expect to find rising prison population, and in fact, this is the
case.4 Whichever study one chooses to believe, the incidence of mental
illness in prisons is high. One recent study found that 35% of prison
inmates sentenced to periods less than two years qualified as mentally ill
compared with 10.3% of the general population5. Another study, which
took into account severity as well as prevalence, found that 7.
inmates had severe mental illnesses6. In comparison, the number of
patients in state psychiatric hospitals has fallen dramatically. In 1955,
there were 559,000 patients in state psychiatric facilities. Today there
are under 100, 000.7 Once adjusted for population growth, it can be seen
how drastic these numbers actually are.
The terms “mentally disordered” and “mental illness” tend to be
overly broad generalizations that cover diverse and dissimilar phenomena.
For the purposes of this discussion, “mental illness,” “mental disorder,”
and “mental disability” will refer only to clinical psychoses, meaning
nuerobiological conditions such as schizophrenia, bi polar disorder, major
depression, obsessive compulsive disorder and organic brain syndrome. In
addition it will refer to developmental disabilities (persons who are
mentally retarded). It will exclude any other problems that may be
perceived as mental, such as substance abuse and “antisocial personality
disorder.” It will also exclude the category, “mentally disordered sex
offender,” since sex offenders rarely suffer from any of the above
mentioned clinical psychoses.8
In the latter half of this century, the country has seen progressive
“deinstitutionalization,” the steady dismantling of state psychiatric
hospitals9. During the height of the civil rights reforms of the late
1960’s and 70’s, concerns were raised about the abuse of involuntary civil
commitment, and the constitutional right to refuse treatment.
more people became aware of horror stories10 such as patients receiving
involuntary lobotomies, and nondisabled people being detained. Public
opinion soon after began to be reflected in courtrooms.
In years past, clinicians have been delegated the authority to
determine whether or not an individual required psychiatric
hospitalization, and also have had the authority to detain patients against
their will for indefinite periods of time.11 In the 1979 landmark case
of Addington v. Texas,12 the Supreme Court set out to analyze whether it
was more appropriate for courts or clinicians to decide where involuntary
civil commitment was warranted. Specifically, the legal issue that was
raised was whether existing statutes authorizing clinicians to determine
commitment violated the Fourteenth Amendment right to due process,
especially where loss of liberty is involved.
The court ruled that “. . . a
‘clear and convincing’ standard of proof is required by the Fourteenth
Amendment in such civil proceedings under state law to commit a person
involuntarily in a mental institution for an indefinite period of
time.”13 This means that under the current rule of law, in order for a
patient to be committed involuntarily, civil proceedings must take place,
whereas before, the decision was up to the clinician’s discretion, and
hence more easily implemented .
In addition to the reformed process of detaining a ps ychiatric
patient, the standards for detention have become stricter as well.