Prison madness: America’s crisis of incacerated mental health patients
1. Prison Madness by Ben Wilkins
America’s Crisis of Incarcerated Mental Health Patients
WARNING: THIS ARTICLE CONTAINS SUBJECT MATTER AND LANGUAGE THAT MAY BE DISTURBING TO SOME READERS. READER DISCRETION IS ADVISED.
I distinctly remember a CO who often worked the “Crazy Mod” as they’re called in prison. He’s a short gent with a fiery red Viking beard and hazel eyes. He works as a prison guard to pay off college debt because the position earns three more dollars-per-hour than his last job. Not many guards like having to work a shift there, but he says calmly, “/t’s always crazy in there, the worst thing is it always smells like fresh shit, but once you get past that it’s a decent paycheck.” I ask him, ““What’s the craziest thing you’ve ever seen happen in the Crazy Mod? He scrunches his brow in thought for a moment, “Once during meal service I saw a guy full on Jacking-off over his uneaten food tray.” “What the hell?” I] exclaimed. “Yeah, so he finishes off on top of his food and then eats it all, then I walk over to his cell and ask him what the heck he’s doing and tell him not to do it again, the guy looks me right in the eye and says, ‘I like it salty.’” I respond, “Aww, that’s gross, man.” He tells me another story about how a prisoner warned the COs for three days straight that he was going to operate on himself. They ignored him as simply bat-shit-crazy since he talks to himself all day. Viking beard says, “Then on the fourth day the mental health inmate took a pencil and ripped his nuts wide open. Blood splattered and one bloody testicle dangled from his sac on a vein-like cord while he ran circles around his cell screaming gibberish. Then he finally received medical attention.” These are but two tales out of thousands taking place all across the United States every day. Surely we could do better.
In our current state of affairs it’s undeniable that we are divided as a nation on many important issues. Tackling these issues will play a pivotal role in the success or failure of our future democracy. On issues regarding guns, religion, and abortion it’s unavoidable that major differences of opinion will remain intact for decades to come. Sometimes the truth is unfortunate. But shying away from the rock-hard topics won’t help anybody. A single question begs for attention. Please pardon the French: exactly WTF is happening with America’s ongoing mental health crisis? The sheer enormity of interrelated problems uncovered is enough to blow one’s mind. It’s difficult to navigate a clear path without focusing on a specific area of mental health troubles, i.e. gun availability, professional athletes, lack of psychiatric bed space in general, or the ballooning numbers of incarcerated mental health patients. Let’s take a peek at the prison aspect.
Christine Montross, author of the book, “Waiting for an Echo” takes a look at the past in order to understand how nonexistent our state mental-health system has become today. Her book is perhaps one of the best ever written on the subject. Here’s an excerpt that lays the foundation of this broken system.
“It is now understood that the closing of state psychiatric hospitals in the 1960's, ‘70’s, and ‘80’s led directly to the influx of mentally ill people into correctional facilities. In 1955 state psychiatric hospitals held more than 500,000 patients with severe mental illness. Today our jails and state prisons contain an estimated 356,000 inmates with serious mental illness, while only about 35,000 people with serious mental illness are being treated in state hospitals—stark evidence of the decimation of the public mental-health system. This reality is worth reiterating: ten times more people with serious mental illness are in our nation’s correction facilities than in our state psychiatric hospitals.”
These numbers may seem like only black & white on paper, but when you experience first-hand the travesties these mental health inmates endure then the picture becomes more vibrant like HDTV. We’ll call him “Johnny.” He’s any one of those hundreds of thousands and he’s in the prisoner’s visitation cell directly next to me. Large square plexiglas windows and white concrete bricks separate us physically, but he can see me and my visitor and I can see him and his visitors. We can also hear each other. “Wahhh yaa nah uh duh eeooowl!” He screeches full-gale to his visitors through the window. His parents are on the other side. Mom’s bawling her eyes out saying, “J know honey, we're trying to get you bail soon to bring you home, I love you too.” My lawyer and I exchange a glance which equals unspoken feelings of heartbreak. Johnny doesn’t understand why he can’t hug his Mom. He announces with gusto, “Rah furrt yaaa daa duuuur!” Dad’s speechless, with his head hanging dejectedly in both hands. Mom replies, “J don’t understand either, they say you have to stay for observation because the hospital doesn’t have bed space, stay strong Johnny we’ll bring you home soon as we can baby.” Tears streaming, hands cupped to her mouth for volume, she chokes then enunciates slowly, “WE—LOVE—YOU—JOHNNY.”
This is only the tip of the iceberg with what all takes place within the belly of the beast. Again Christine Montross nails it accurately with behind the walls insight to common problems with the overpopulation of mental illness in jail. The consequences are a severe strain. “Floridly psychotic men shout at their voices and visions; paranoid men lash out against their cellmates; disorganized men climb into the wrong bed, or continuously disrobe, or defecate in the [shared] cell sink. Some of the men here are so suicidal that they must be watched to be prevented from hanging themselves, or they are chronically self-injurious and so must be continuously monitored to be sure they do not bang their heads against cell walls or bite their own limbs or tear into their own skin.” [Or stuff their mouths full of fresh shit and finger-paint the excess all over the cell walls, floor, and windows.]
The rate at which our mentally ill citizens are being warehoused in prisons has reached epic proportions. In “Waiting for an Echo” this description of a notorious county jail brings light to the oft hidden dark side of mental health avoidance.
“Welcome to the pit,” Elli Montgomery says as she opens the door of what looks like an industrial loading dock at Chicago’s Cook County Jail. Montgomery is a clinical social worker and the jail’s director of mental health policy. On any given day, the Cook County Jail houses an average population of 9,000 inmates, more than 2,000 of whom are mentally ill. Because of this, the jail has earned the distinction of being the largest mental-health institution in the country.”
Hold the phone. A quick recap is in order. America’s largest mental health facility is a jail, not a hospital or psych ward. Wow. Let’s face it, there’s no question these stats are atrocious. The more we dig, the worse it gets. One noteworthy idea has surfaced in this sea of madness. Lack of proper training repeatedly shines through giving us a message that behooves us to explore further. Here’s an interview excerpt taken by Christine Montross from a CO on the east coast.
“A Rhode Island correctional officer who has held his position for more than twenty-five years tells me, “We’re not trained for that. We are trained in suicide prevention, yes. Otherwise, the mental-health stuff? Like when people break down or have psychotic breaks? I guess I’d say it’s on the job training.” So in addition to their charges of maintaining order and safety, COs must now also handle the erratic and potentially dangerous behaviors of psychiatrically ill inmates. This contributes to burnout, frustration, and even fear among officers.
Switching gears, these issues aren’t exclusive to the male population. Men, Women, all Genders are affected. Another major problem arises because the wrong types of mental health care are often provided to the wrong patients or at the wrong time. And many others in desperate need slip through the cracks with zero care. Imagine a distraught mother who doesn’t know where her babies are at because she got arrested at work on trumped up charges. Understandably she’s freaking the fuck out and wants to figure out the facts. Where her kids are at, what if any—charges are going to be filed against her, and when the heck is she allowed her “one phone call.” Next, after her two-minute cursory mental health evaluation she’ll likely end up in a straight jacket for the seventy-two-hour minimum “medical observation hold” before she learns a single answer to her pressing questions. All this torture because she answered one question “wrong” on her antiquated evaluation quiz. Keep in mind there are people who need these extreme restraints, but not her. She’s not crazy. She needs someone to talk to, perhaps a counselor or even a female guard, anyone to help calm her. Heaven forbid she finds out what’s happening with her young children’s welfare or she gets help to set up a bail hearing.
The next quote from “Waiting for an Echo” is disheartening to say the least. The above scenario plays out in real life with plenty of quandary. “Through her tears the woman says her charges are “something about my babies.” She looks over her shoulder at the other women in the cell... on the table is a bag of maxi pads. There is nothing else in the room. The woman is at most thirty. She could be younger. Her curly black hair is pulled back into a short, gelled ponytail, and she is wearing a navy-blue uniform with the logo of a local chain restaurant stitched onto the pocket. Her accent suggests she is Latina. In between sobs the woman recounts that she is a single mother of three girls, ages two, three, and six. She works ten hours a day, six days a week, to try to make ends meet. She gestures at the uniform she is wearing to emphasize the point... Also on her hand is a script tattoo that reads “Trust No Man Fear No Bitch” and I cannot help but wonder about the hurt in her life that led her to make that message indelible on her skin.” “I was at work. My niece was supposed to be watching my girls,’ she tells us as she cries, describing how she ended up in jail, ‘but I don’t know what happened. The police found my kids walking in the streets by themselves.... They took them into DCFS [Department of Children and Family Services] custody, and now I don’t even know where my daughters is at.’ ” Montgomery asks her gently again whether she is suicidal. ‘Right now I have nothing to live for,’ the woman says.
Let’s close with a couple of timely observations on those with difficult mental illnesses: the battles they seek—if any and the conflict they create are not with you or the person they interact with but with themselves. It’s their way of requesting the help they’re not getting. Keeping that in mind makes it easier to observe them with some level of compassion and dignity. Being able to treat such a person with kindness, despite the stereotypes a select few of them have caused, is a direct reflection of your strong character and willingness to bridge the gap of equality. We have to start someplace, why not begin with dignity.
Sometimes the best way to learn how not to do something is to study another person’s epic failure and learn from it. This way it saves you the trouble of repeating a similar mistake. Case in point: we can learn a whole lot of what not to do by studying America’s mental health crisis, particularly the mental health patients who are often torn from their families—charged or uncharged—then caged behind bars. To be clear, this is not an outcry to go soft on crime. Rather this is a bullhorn call to humanity, a call to open discussions on how we can help everyday people avoid needless suffering. To help people like the woman working to support her kids that gets jammed up and arrested on a fluke. Or to help someone like “Johnny” who needed proper mental health services before he ended up a statistic. A statistic consumed by one of the hundreds of “Crazy Mods” that are spread across America like modern-day purgatory. Is there not a better place to allot these billions of taxpayer dollars? One can only hope.
Ben Wilkins is a contributing writer for the National Writers Association and Spotlight on Recovery magazine. His work has been published with the Prison Journalism Project, Freebird Publishers, and elsewhere. Though currently imprisoned in Alaska, he aims to inspire people thru writing. Ben is now finishing his first book “Laugh Love & Hustle” and he is hungry for opportunity & feedback. He accepts all tasks, heckles, letters, and critiques @ the listed address.
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