Psychiatric hospitalization once was the mental health system. When it became apparent that thousands and thousands of people were basically being abandoned under the most horrific circumstances, that abuse and maltreatment were endemic, and that any chance people had of living a decent and happy life was being destroyed by their placement in an institution supposedly set up to help them a process of deinstutionalization was started. The hospitals were closed. It was the first seismic event of the mental health system.
The same description of what it meant to be in a psychiatric hospital is still true. It is a description of what it means to have serious mental health issues in your life and be in jail or prison. Nothing has changed other than the location. Basically the same amount of people who used to be in state hospitals are now in jails and prisons for the same reason: “mental illness.” And once again they have basically been abandoned. And only time will tell if this is to be the second seismic event of the mental health system.
It is the shame of all of us. It is, I believe, the fuel behind the passion with which many people embrace the Murphy Bill. The mental health system hasnt been part of the solution for the people they love. Its inemptitude in reaching people with severe needs has been part of the problem. A major part. Talk of recovery seems empty chatter. Perhaps useful to other people, but not to the people they care about.
The place that “helps” you should not hurt you. It just isnt okay, justifiable or something that should be tolerated. And despite our outrage we largely have.
Many people point to a defiency in psychiatric beds as a basic part of the problem. Personally I think it is a lot more complex than that. Many of the people in jail have spent time, often a lot of time in psychiatric hospitals to little or no avail. Hospitals may provide people safe housing and stabilization but I know of little evidence they do more than that and sometimes not even that very well.
Even if the lack of hospital beds could be proven to be part of the problem I dont see how anybody can realistically believe they will be part of the solution. There are somewhere in the neighborhood of 300,000 people with mental illness in jail. No where close to 300000 hospital beds are happening. In most states little or none are happening if for no other reason the money it takes to add even one bed is unlikely to be found. Whatever the solution a primarily hospital based solution is not going to happen. Anyone who tells you that psychiatric hospitals are the only answer are telling you there is no answer.
Let me now say something that will be very unpopular among many people. The “recovery movement” has largely been silent on this issue and basically conceded the playing ground to people like the Treatment Advocacy Center. And politically as they are finding out now trying to stem the momentum of the movement towards the Murphy Bill, that was a very poor choice. It has made it easy to tar them in the public eye as being against being at all proactive on this issue.
Over the last weeks in particular, as you may be able to tell by the links to articles on this blog, I have been more and more concerned with the issue of “mental illness” in the jails and have come up with a few conclusions:
1. The recovery movement prides itself as being about civil and human rights. Aside from the widespread psychiatric hospitalization of hundreds of thousands of people and basically leaving them for dead the single greatest assault on human rights is what is happening for people with mental health diagnoses in jails and prisons.
2. So far, little of value, little of leadership, little of even recognition of the problem has come from the recovery movement.
3. This challenge will be the real test of the staying power of the recovery model.
4. I believe that advocacy efforts that only target the dangers of coercive care to defeat the Murphy bill will in the end fail. Writing off the stories and concerns of family members who have people being tortured and abused in jails as being dupes of the Treatment Advocacy Center is not only a bad tactic, I think perhaps it is unethical. Our message has to be more than what we complain about. It must be about what we offer.
One friend put it well:
“Continually traumatizing traumatized people isnt going to help. You can use bigger and bigger sticks to manage them but eventually no stick will be big enough. I dont think I have all the answers but part of the answer is to make the trauma informed perspective a concrete and impactful part of what it means to be mentally ill and in jail.”
I think the jails and prisons are drowning in people that shouldnt have ended up there. No one answer is enough. It will take an effort of immense commitment to even scratch the surface.
But I do believe I know the starting point: We must all see the flood.