According to the Treatment Advocacy Center, approximately 20 percent of inmates in jails and 15 percent of inmates in state prisons have a serious mental illness. Based on the total number of inmates, there are approximately 356,000 inmates with serious mental illness in jails and state prisons. This is ten times more than the approximately 35,000 individuals with serious mental illness remaining in state hospitals (Torrey et al., 2014). In addition, people with mental illness stay in jail and prison longer than people without mental illness. The recidivism rates are also higher for special populations:
54% re-incarceration for people with severe mental illness
60% for those with no diagnosis
66% for those with substance use disorders
68% for those with co-occurring mental illness & substance use
The high recidivism rates indicate the need for more integrated services upon release (Wilson et al., 2011).
The 30% in the illustration above, derived as the average from various studies, indicates a range of 20-45% (higher in jails than in prison, approximately 70% of this group have a co-occurring drug use disorder.) (Charles Goldstein, M.D., 2021)
It is punitive to punish people with mental illness by incarcerating them for minor crimes related to their mental illness rather than treating them in longer, more appropriate stays in psychiatric hospitals followed by appropriate community housing with supportive services.
Sadly, the nation’s jails and prisons have replaced hospitals as the primary facilities for people with mental illness. Having a conviction record comes with additional burdens post-conviction with far-reaching consequences, both legal and non-legal. These include loss of civil rights, inability to get a job, inability to live in specific apartments or upscale areas, and loss of public benefits (Chin, 2017), e.g., medical insurance through Medicaid. The effects on family and children can be devastating. “In 2010, for instance, an estimated 2.7 million children had an incarcerated parent.” (Turner, 2017). Children who grow up with an incarcerated parent have a much higher risk of becoming incarcerated, and eventually suffering collateral consequences of their own. They do more poorly in both cognitive and cognitive outcome measures (Morsy & Rothstein, 2016). In addition, the familial relationship to mental illness also contributes to poorer outcomes and the likelihood the children are at a higher risk for justice involvement.
There is a myriad of legal collateral consequences that attach to a criminal conviction. U.S. citizens can be barred from federal or state office, barred from certain professions, subject to impeachment as a witness, disqualified from serving as a juror, and lose the right to have a firearm. Noncitizens with criminal convictions can be deported. Sex offenders must register and are excluded from living in certain areas.
“Most people experiencing mental health disorders are not a threat to public safety. Yet a significant portion of the population of our jails and prisons remains comprised of people with mental health disorders. Our jails and prisons become, by default, the largest mental health facilities in the state; and far too often, people with a mental health disorder are released from jails and prisons without a treatment plan or support services in place.” Bronx DA Darcel Clark
The fact is the average parolee is a minority male in his 30’s, 30% have a mental illness, 20% have co-occurring mental illness and substance use problems, and return to economically disadvantaged communities (Turner, 2017). And now society expects them to overcome egregious collateral consequences to boot! These factors pose an uphill battle when it comes to regaining some sort of normalcy in life.
I think it’s evident that the best way to alleviate the burden of collateral consequences that disproportionately affect released offenders with mental illness (OMI) is to change the culture of the criminal corrective system. This would entail changing from the retributive to the rehabilitative/utilitarian model. Using community punishment and appropriate treatment instead of incarceration would be a much better option for OMI.
First Step Alliance. (2012, July 1). Reducing recidivism: Creating a path to successful reentry. First Step Alliance. Retrieved September 23, 2021, from https://www.firststepalliance.org/post/reducing-recidivism?gclid=EAIaIQobChMIw9OTqLiV8wIVSR6tBh3jIAi5EAAYASAAEgL81_D_BwE.
Morsy, L., & Rothstein, R. (2016, December 15). Mass incarceration and children’s outcomes: Criminal justice policy is education policy. Economic Policy Institute. Retrieved September 26, 2021, from https://www.epi.org/publication/mass-incarceration-and-childrens-outcomes/.
Support Discipline Support Initiative. (2010). Pipeline to prison: School discipline support initiative. Pipeline to Prison | School Discipline Support Initiative. Retrieved September 23, 2021, from https://supportiveschooldiscipline.org/school-to-prison-pipeline#:~:text=The%20pipeline%20to%20prison%20refers,criminal%20justice%20systems%20increasingly%20for.
Torrey EF, Zdanowicz MT, Kennard AD et al. The treatment of persons with mental illness in prisons and jails: A state survey. Arlington, VA, Treatment Advocacy Center, April 8, 2014.
Wilson, A. B., Draine, J., Hadley, T., Metraux, S., & Evans, A. (2011). Examining the impact of mental illness and substance use on recidivism in a county jail. International Journal of Law and Psychiatry, 34(4), 264–268. https://doi.org/10.1016/j.ijlp.2011.07.004
This recent article below supports our opinion that jails and prisons are not therapeutic for people with serious mental illness often causing more harm.
Mental Illness In Solitary Landed These Men An Extra 842 Years In Illinois Prisons, Advocates Say
Warning: This article contains stories of people who have engaged in self-harm and attempted suicide. If you or someone you know is struggling with mental health, the National Suicide Prevention hotline number is 1-800-273-8255.
Christopher Knox already had a long history of living with mental illness when he was sentenced to time in an Illinois prison. He has had a litany of diagnoses, including bipolar disorder and PTSD, and a history of self-harm going back to when he was just 7 years old. When he was locked inside prison at age 19, his mental health deteriorated. He lashed out at a fellow prisoner and he said he was sent to solitary where he was in a cell 23 hours a day, seven days a week.
“It caused me to go into the dark places that I never want to ever go again,” Knox said. “It put me in a mind frame where I didn’t care about anyone or anything. I just gave up. I had lost all hope.”
In solitary, Knox mutilated himself and attempted suicide multiple times. Other times he’d yell or throw things at staff. That too, he said, was a kind of self-harm. If he provoked staff, they may rush into his cell and violently drag him out. Those interactions gave him the painful sensations he craved, and he hoped maybe one day an officer might kill him so it could be over.
During 17 years in solitary, Knox was criminally charged for spitting on an officer and was sentenced to an extra five years behind bars. His conviction for kicking a guard added four more years. A conviction for throwing liquid soap at a guard’s face landed him another six. As he continued to get in trouble, what started out as an anticipated 11 years in prison turned into a projected 41 years behind bars, according to data from the Illinois Prison Project, an advocacy organization.
Jennifer Soble, executive director of the Prison Project, said she can’t imagine that Knox would have been charged with new offenses behind bars, let alone multiple cases, if he hadn’t spent so many years in solitary with little to no mental health treatment.
The project currently represents 43 clients it says have similar stories to Knox. They were all convicted of staff assaults, many for spitting or throwing urine on staff. According to Soble, all their clients have mental illness, and about 60% were on suicide watch at the time of the crime.
Soble said the prison environment, especially solitary, exacerbates people’s mental illnesses, and then the prison system punishes them for it. The punishments can be severe. The prison project said its clients have had an average of 15 additional years added to the time they expect to serve in prison — collectively, an additional 842 years.
This week the prison project plans to file 43 petitions for commutation that, if approved by the governor, would move up their release dates.
“This group is arguably some of the most vulnerable people in the prison system,” Soble said. “We can’t erase the psychological and physical harm many of them have suffered because of their time in solitary, however we hope to spare our clients hundreds of years of additional prison time.”
The Illinois Department of Corrections did not respond to multiple requests for comment. But staff assaults are a persistent problem. According to data from department reports, there is an average of more than 50 per month in 28 corrections facilities statewide.
Many of those occur at Pontiac Correctional Center, a prison about two hours outside of Chicago, where people with some of the most serious mental illness and disciplinary histories are housed. When Pontiac prison officials seek criminal charges for assaults, the cases end up on Randy Yedinak’s desk. Yedinak, the Livingston County state’s attorney, chooses which cases to charge.
He said that victims also deserve their day in court. “Contrary to popular belief, correctional officers do not sign up for this type of behavior when they choose to wear the uniform. It is not part of their job to be physically assaulted, have urine or feces thrown on them or be spat upon. They don’t deserve it. Simply put — it is a crime,” Yedinak said.
But Soble said the best way to reduce the violence is to end the conditions that make it more likely prisoners will act out — like solitary.
“They’re not doing these things because they’re evil”
A report from the United Nations said the prolonged use of solitary confinement can trigger psychological suffering, especially for prisoners who already had experienced trauma or struggled with mental health conditions. The report found that in such cases solitary can amount to torture. And in Illinois, experts say prisoners in solitary frequently report depression, bouts of anger and feelings of impending breakdown. Some experienced hallucinations, and more than one even reported playing with their own feces.
Anthony Gay said he understands why staff, and people on the outside, may hear about prisoners throwing urine and feces and assume that they are monsters that need to be disciplined. Gay said he spent two decades in solitary, and he now advocates for its elmination in Illinois. He said people in solitary are so hungry for social contact that even a guard dragging them out of their cell can feel like a relief.
“They’re not doing these things because they’re evil. They’re not doing these things because they hate correctional officers. They’re doing these things because they’re miserable,” he said.
While he was locked in solitary, Gay said he would cut himself so he could have some feeling of stimulation. And that was the same reason he would act out against staff, sometimes throwing urine at them. He wanted to provoke them.
“When they beat you up, you feel alive,” he said. “When they spray you with mace and it’s burning your skin, you come to realize, yeah, you’re still human. You’re still alive.”
The Illinois House passed a bill, named after Gay, that would prohibt the state from isolating prisoners for more than 10 days in a six-month period. But the bill has since stalled in the Senate.
The Uptown People’s Law Center, a Chicago nonprofit legal organization that focuses on prison litigation, is also seeking to eliminate long-term solitary in Illinois. They filed a class-action lawsuit arguing that the current use of solitary violates the constitutional rights of prisoners.
Meanwhile, the Illinois Department of Corrections reports it has reduced the use of solitary, or what it calls “restrictive housing.” In October 2020, the state implemented new rules limiting how long someone could be kept in restrictive housing and outlining minimum guidelines for mental health care.
Anders Lindall, a spokesperson for AFSCME 31, a union that represents guards and other corrections staff, said when Illinois prisons do impose solitary now, it’s not in the kind of horrible conditions that some people might imagine with absolute sensory deprivation, and no contact with other prisoners or staff. He argued “a safe and effective system needs the ability to use corrective — not punitive — measures to encourage good outcomes and discourage bad outcomes.”
Soble with the Illinois Prison Project acknowledges the department has made progress in limiting solitary, but said even if solitary is reduced or eliminated, the state still needs to do something about the men facing extra years and decades behind bars because of the way the state was using isolation.
Getting people out
The Prison Project’s strategy is two-fold. The group is filing petitions for sentence commutations on behalf of prisoners with serious mental illness who are serving time for crimes they committed while locked up. Illinois Gov. JB Pritzker has the unilateral power to grant those commutations. Asked about the Prison Project’s efforts, a spokesperson for the governor simply said, “The governor regularly reviews requests for clemency and will continue to review requests as they are made.”
The union for staff said it does not generally take positions on sentencing commutations, but said any effective system must have tools to discourage bad behavior, including assaults on staff or other prisoners.
The second part of the Prison’s Project’s strategy is harder to follow because of complicated state rules.
When people are sentenced in Illinois, most are entitled to so-called good time credits that can cut their sentence in half. But those credits can be taken away.
That’s what happened to Knox. Not only was he getting criminally prosecuted for assault charges, but the prison was also taking away his sentence credits.
The threat of losing “good time” is supposed to deter prisoners from acting out. But Knox said solitary put him in such a dark mind frame that the punishment did nothing to discourage his violent behavior.
“I didn’t care about going home. … I had lost hope. I thought I was going to die in prison,” Knox said.
But while Knox was locked up, the Uptown People’s Law Center won a legal victory that required the Department of Corrections to improve access to therapy and medication. Knox said he was able to see a counselor, get on the right medication and leave solitary. He stopped getting so many tickets for lashing out against staff. But the punishment for his previous actions remained — years more behind bars.
The Prison Project got involved in Knox’s case. They wrote letters and advocated to have his good time restored. The prison gave him back three years of good time credits, according to Soble and in 2020, Knox went home. Soble said the Department of Corrections has new rules that make it easier for people to have their good time restored, something she praised.
Besides Knox, the Prison Project says eight of their clients were released after they advocated for the department to restore their credits. But the group says there is still a long way to go.
After going home, Knox got a job at a factory putting together COVID-19 protective gear. He talks to his therapist three times a week.
“I’m trying to make the best of it that I can,” Knox said.
But Knox hasn’t forgotten his friends that are still locked inside.
“A lot of them are still being denied adequate mental health treatment due to lack of staff, and they are still dealing with solitary confinement,” he said. “A lot of people are still suffering, you know, and it needs to stop.”
Shannon Heffernan is a criminal justice reporter. Follow her @shannon_h.