Prisons as Asylums: Looking at Correctional Treatment of Mentally-Disordered Inmates

By NIH estimates, nearly ten million American adults suffer from serious mental illnesses. We are routinely made aware of the prevalence of mental illness, particularly the frequency of untreated mental illness. Unfortunately these reminders are often only the results of a violent act by a mentally ill individual and its ensuing coverage. It only follows that many mentally-disordered individuals will have committed crimes that led them to prison, where they may or may not receive treatment, if even diagnosed. In reviewing previous literature on the issue, Lynn A. Stewart and Geoff Wilton found a wide range of reports of the prevalence of mental disorders among criminal offenders (as low as 15 percent and as high as 80 percent).

To establish a better understanding of the prevalence of mental disorders as well as the effects of these disorders, Stewart and Wilton co-authored “Correctional Outcomes of Offenders with Mental Disorders” in the January 2014 issue of Criminal Justice Studies. From their results, the authors determine that offenders with mental disorders are treated more harshly by correctional officials than other offenders and achieve less success in avoiding rearrest after release.

In this study, the authors examined a total sample of 796 offenders (753 men and 43 women) consisting of offenders with and without a major mental disorder. Offenders were classified as having a major mental disorder if they had been diagnosed with at least one of the following: major depression, bipolar disorder, schizophrenia, other psychotic disorders, or anxiety disorders. The sample included 463 consecutive admissions to the Regional Reception and Assessment Centre (RRAC) for Correctional Service Canada’s Pacific region between October 2006 and December 2007, combined with 333 offenders who were referred to their Community Mental Health Initiative (CMHI) program. The offenders from the CMHI were included to ensure that the study had enough offenders with diagnosed mental health disorders for meaningful analyses. Of the 796 offenders (43 female) in the sample, 202 of the 753 male offenders (26.8 percent) had diagnosed major mental disorders and 17 of the 43 female offenders (39.5 percent).

In their evaluation, the authors used information from components of the Offender Management System (OMS), the official electronic record on all Canadian federally-sentenced offenders. This includes demographic information, sentence information, criminal history, admissions to segregation, correctional program participation, history of institutional disciplinary charges, and parole board release information, as well as the results of an assessment conducted upon entry into the system. The intake assessment process includes two principle components: (1) an assessment of dynamic criminogenic risk factors (subject to change in response to intervention) and (2) an assessment of static (or inherent) risk, which uses an actuarial risk tool and a review of the offenders’ criminal histories. Additionally, the Custody Rating Scale (CRS) is applied at intake to assess the appropriate security placement of offenders with determinate sentences.

Using the data collected at intake, the authors found that offenders with mental disorders (OMDs) were treated differently and received worse results than other offenders on several levels. First, OMDs were significantly more likely to be placed in a maximum-security institution and less likely to be placed in a minimum-security institution. Additionally, the Custody Rating Score was more likely to be overridden to a higher level of custody for the OMD group than for other offenders. On top of being placed in higher-security facilities, OMDs tended to serve more than half of their original sentences (55 percent), while the offenders in the comparison group were incarcerated for less than half of their original sentences (46 percent). The proportion of offenders in each group who had completed one or more correctional programs in prison versus in the community under supervision was also measured. The proportion of OMDs who had completed at least one correctional program (61 percent) was significantly less than that found in the comparison group (69 percent), showing that these inmates either had less access to these programs or more frequently failed to complete them.

OMDs exhibited worse behavior during their incarceration than the other offenders did: they showed higher rates of major incidents, minor incidents, voluntary segregation, and involuntary segregation. Additionally, OMDs spent a greater proportion of their sentences in involuntary segregation. In measuring the likelihood of reconviction after release, the authors compared OMDs against the other offenders in a raw comparison, after controlling for other criminogenic need factors, substance abuse, and age at admission. Repeatedly, OMDs were significantly more likely to be reconvicted than other offenders, as well as being more likely to have their parole revoked.

In their discussion, the authors determine that offenders with mental disorders suffer worse treatment in corrections than other offenders receive. Additionally, OMDs are more likely to reoffend upon their eventual release. Currently, OMDs are treated much like other inmates are treated, and it seems that this approach is failing them. Hopefully, this and other research will lead to more effective treatment and rehabilitation of criminal offenders with mental disorders.

Article Source: Lynn A. Stewart and Geoff Wilton, “Correctional Outcomes of Offenders with Mental Disorders,” Criminal Justice Studies, 2014.

Feature Photo: cc/(John W. Iwanski)