Psychiatry isn’t a boutique sideline of the state Department of Corrections. It’s a core mission of the prisons, which house thousands of convicts with mental illnesses.
Some state lawmakers are addressing that hard fact with a promising idea: a 700-bed prison in South Thurston County that would specialize in mental health care. Lawmakers should also consider creating similarly specialized jail facilities where professional care could be focused on the short-term prisoners now scattered across dozens of counties.
Such is the state of mental health care in this country that jails and prisons have become de facto psychiatric hospitals. For a multitude of reasons — most related to lack of funding — many sick people are allowed to go untreated until some of them run afoul of the law. In the worst cases, they commit crimes of violence that might never have happened if they’d gotten help sooner.
A national study in 2014 estimated that more than 2 million of the roughly 12 million Americans jailed from year to year suffer from serious mental illnesses. A report done for the state Office of Financial Management last year noted that, as of Sept. 30, nearly 5,000 of Washington’s 17,500 prison inmates needed some form of mental health treatment.
The OFM report concluded that states and counties aren’t set up to deal with that much psychiatric illness:
“From a system point of view, jails and prisons are missing effective treatment, behavior management programs, and trained staff to work with mental illness. The seriously mentally ill have access to some services, but supply is limited and little service is available to the moderately mentally ill.”
The public should be especially concerned about what happens — or doesn’t happen — when sick prisoners are ultimately put back on the streets:
“Only a small percentage of inmates with mental illness (those identified as seriously mentally ill) receive transitional case management to effectively connect them to community based services when they leave prison.”
As a result, they are “unsupported upon return to the community and vulnerable to high re-offense conditions.”
To put it another way, Washington has an inadequate patchwork of treatment and assistance for psychiatric patients who’ve been caught up in the criminal justice system. Good things are happening here and there, but the state as a whole isn’t doing nearly enough to help inmates get better and protect the public.
Part of the solution might be the proposed prison in the Centralia area, which would occupy part of the closed Maple Lane juvenile detention center. A prison that did nothing but mental health would likely be far more effective than the existing hodgepodge of treatment programs, most of which are poorly funded and some of which offer minimal services.
The same logic would apply to county jails, which confine criminal defendants as well as convicts serving sentences of a year or less.
If anything, jails are less equipped to deal with mental illness than the prisons. Pierce County, for example, spends millions of dollars on psychiatric treatment for sick prisoners, but the high-stress atmosphere of any urban jail undermines effective therapy.
Like a hospital-prison, specialized jail wards could offer high quality treatment for the severely ill. They might not cost more than the fortunes we’re already spending for treatment at conventional jails, and they’d be far more likely to discharge their prisoners in a healthy, less dangerous condition.