It might be cheaper to jail people who turn out to commit crimes than to treat everyone who might commit crimes, because most people who might commit crimes don’t commit crimes. But we should treat people with mental illness anyway, because public safety is not the only issue. We should treat people who need treatment to give them a better life.
Agreed. Plus there are many hidden costs that don’t get factored into the equation. Any time we can help individuals maximize their functioning, benefits are attainable that ripple through society at large, starting immediately with family members. On a purely economic level, there is a lot of productivity lost by not providing assistance.
@techmom99 - I didnt think they still used injectable prolixin decanoate, but I am kinda glad to hear they do. I thought, back in the day, they were looking into replacing it with clozaril, but clozaril has some bad side effects and you have to be carefully monitored, and that schizophrenic subpopulation is often non-compliant.
I find the term “sicko” to be terribly pejorative and further stigmatizes mental illness. Will try to avoid political comments, but the use of a mirror might come in handy…
As a social worker who deals with the mentally ill on a regular basis, I will add that the closing of state hospitals and move away from group homes for this population has been problematic and dangerous for not only society but the patient as well. A job I held in 2015 and 2016 was supporting mentally ill persons in independent living situations, many of whom really needed to be better monitored than the bi-weekly visits I was making. Most held dual diagnoses and many had aggressive, if not violent, tendencies. The aggressiveness often comes from the frustration of not receiving services they need. Of my caseload that ranged from 24-30 clients, at least 1/3 had violent infractions on their record, most with police involvement. It is my opinion that few of my clients were living in safe or healthy situations, more often in filth and unable to care properly for their own health or hygiene. No one can convince me that these people are better off “independent” than they would be in group or institution situations. And I do not believe that society is better off either.
No I am not convinced they are better off independent.
From what I can find it is a lot more expensive to jail someone mentally ill versus someone minus mental problems.
Mainly because the mentally ill can’t/don’t follow rules and therefore don’t get out on “good behavior” and so are incarcerated longer.
But still cheaper than long term health care would be.
It appears from stats I’ve found that drug use really complicates this issue big time (because mentally ill people tend to self-medicate). It seems that mentally ill but non-drug users are essentially the same risk for violent behavior as a normal population. Add drugs (high incidence) and it’s a much different picture.
(Also have to separate the "seriously"mentally-ill stats (schizo,bi-polar, violent) from the “severely depressed”) It’s a quagmire.
The mentally ill make up a large percent of incarcerated individuals, but get terrible treatment, partly due to the attitude of the guards. I had a friend who was a psychologist in the prison system. He said that the healthcare staff used to rotate from facility to facility because the guard “politics” (for lack of a better term) made it hard to get cooperation. Once he was trying to take care of and advocate for an inmate who was not “liked” by the guards. He came out at the end of the day and found his tires slashed.
What do other countries do with untreatable or non compliant citizens? We aren’t the best country at many things so it seems we would look toward other countries for best practices.
@jym626 --With that perspective you’d really like to read the book I recommended. It has many views from psychiatrists who try to treat those in the prison system.
I don’t think I could stomach a book about this, if it chronicles the mistreatment of these folk ;(
I read about the Winchester stabbing in the WaPo. This guy had tried to bash in a neighbor’s door. Isn’t that a crime anymore? Why hadn’t he been arrested, tried and jailed for that? It’s like the Parkland case. All those prior assaults, cruelty to animals and fights and absolutely nothing was done. Are the jails so crowded that smaller crimes are no longer punished?
Some interesting stats and a timeline:
https://www.thebalance.com/deinstitutionalization-3306067
@jym626 -
I am not certain what the specific medication used is. All I know is that it was an injection once a month and that the woman is a paranoid schizophrenic with delusions. She has been symptom free for a number of years now.
If part of the problem is the stigma attached to mental illness, then you are shooting yourself in the foot by adding to the stigma. We talk alot about treating “mental illness” and the lack of funding to do so, but who wants to spend tax dollars treating “sickos”?
I don’t have a solution. I don’t think there is some single solution that would fix everything. I do find it very disturbing that so many people tried to do something in the Parkland case, but it came to naught.
The challenge seems to be the balance between individual rights and the protection of the public. There is a Habeas corpus component (will defer to the attorneys here to address this) and, when a person has not committed a crime, to avoid unlawful detention. The stalker laws have similar challenges.
Another recent, excellent book written by a father of twins with schizophrenia, one of whom committed suicide, is “No One Cares about Crazy People”: https://www.amazon.com/One-Cares-About-Crazy-People-ebook/dp/B01GQIY9HY I highly recommend it.
As the mother of a young adult with schizophrenia, I don’t even know what to think about the problem. My son has been stable for three years. He told me more than once he knows he has to take meds because he feels so horrible off of them. Yet last week, he threw his meds out and told the responding police officer that he’d stopped taking meds “awhile ago.” He’s been in the hospital for a week now, and hasn’t allowed us or anyone else to visit him. It’s costing the state of Maine over $1,000 a day. A person has to agree to take the monthly injections, which have their own unpleasant side effects, and he hasn’t agreed to them.
From what I understand, it’s very rare for a schizophrenic person to truly be “symptom free,” even on meds. And sometimes the person covers up what he or she is experiencing because of the fear of increased med dosages.
My son lives in a four-unit apartment building that has staff in an upstairs office, 24/7. They do a pretty good job, but there’s a good bit of turnover since the pay is low. I’m hoping they will take him back when he gets out of the hospital, but I’m not sure yet.
@NEPatsGirl, I’m confused about your reference to a “move away from group homes” for mentally ill people. When were mentally ill people taken care of in group homes? The closing of mental hospitals was supposed to be accompanied by an increase in group homes, not a decrease. We can argue (and I do argue) that we should be providing more group homes with better support, but at what point did we decrease group homes?
@techmom99 - This is what was used in the past (not sure if still is) and sounds like what you described. Injectible Rx that lasts about 3-4 weeks. https://www.webmd.com/drugs/2/drug-48/prolixin-decanoate-injection/details
We have quite a number of tenants who are rather marginal and would probably have been institutionalized in an earlier time. At last count we were receiving rental assistance for them from six different agencies tasked with looking after them. Most of them manage well enough, although we had one tenant die in her apartment (possibly suicide) and another one who had to go to a psych ward.
“I don’t think I could stomach a book about this, if it chronicles the mistreatment of these folk ;(”
It chronicles the workings of the criminal justice system and how it doesn’t help to put people mentally ill into the system making it a lose-lose situation for everyone.
It’s not about mistreatment in the least–it’s about the NON-treatment of those who might need it most.
(and how some well-meaning laws have long range ill effects for some).
It’s about people caught in the system–who get on meds (and get better) then taken off them because a court appearance doesn’t allow medications in their system. (so they start over and over)
It’s about guards who DO try their best–but don’t have a clue as to what to do in the limits allowed.
It’s about frustrated psychiatrists who have a patient population so large that it’s impossible to help anyone.
It’s obviously written first-person with a point of view but it’s a unique point of view–someone who knows the system, has a son caught in it and a great writer to boot.