The Mental Illness Conundrum

By Harold Wilber

Most of the advocates for increased gun controls are disregarding the mentally ill in America.

Mental health issues are problems our nation's jails staff have been contending with for years. In 1971, while assigned as a custody officer at the Navy prison at Portsmouth, New Hampshire, I along with our staff psychiatrist and JAG officer (lawyer) visited the Massachusetts Correctional Institute for the Criminally Insane in Bridgewater, Massachusetts on Titticut Street. Several hundred patient-inmates were confined under appalling conditions there. In the large "smoke room" where smoking was allowed, there were four televisions up on opposite walls where the inmates could sit on long benches to watch. All of the televisions only flickered. Several inmates roamed the room in a trance talking and shouting to themselves and some wore football helmets so they would not injure themselves. The small clinic had bloody bandages on the floor, and a wing holding 80 inmates had to use "honey buckets" for toilets because there was no indoor plumbing. A staff member remarked about the progress being made with one elderly man because he was down to sexually servicing less than 10 inmates a night. Psychotropic drugs were controlling the population; professional staff was at a minimum. We were glad to leave and head north to our well-run prison.

The 1967 award-winning documentary film Titticut Follies initially shown only in Europe exposed the abhorrent conditions at Bridgewater. After court battles the film was released in the U.S., and the facility was closed. The film also created a major knee-jerk reaction with the closure of mental health institutions across the country. It was then assumed communities could provide better, more humane care for the mentally ill. Folly again for sure; communities did not receive the resources needed to do this, nor did the jails where those mentally ill not unexpectedly ended up.

Following my retirement from the Marine Corps, I worked as the Director of Detention and Community Control at the Broward County, Florida Sheriff's Office. There I learned that estimates place the number of mentally ill in jails at around 17 percent of their populations, and most of that number are also substance abusers. Nationally, the number of mentally ill persons behind bars is almost five times the number of patients in state mental health hospitals, according to the U.S. Justice Department.

Jail staff are not adequately trained and equipped to secure and care for someone so ill. Those mentally ill act out, offend, get arrested, go to jail and court, hopefully get some meds and treatment and are usually released shortly thereafter -- and are rearrested, sometimes within minutes. They are usually well known to police and it is not uncommon for jail staff to be on a first-name basis with those ill inmates that they truly do all they can for. But those same inmates leave our jails without support systems to sufficiently track them and care for them. So, those released don't take the three days of meds they may have been provided because they lost them, forgot or sold or traded them for dangerous drugs. And, again, sooner or later they are back in jail.

Recent tragic shootings in Colorado, Connecticut, Virginia and elsewhere have spawned ballyhoos for stricter gun control. While there may be room for some tightening of gun laws that comports with our Second Amendment, such outcry does not focus enough on the plight of the mentally ill in America. A simple fact of life is people have access to guns whether the people are good, bad, healthy or sick. So, it seems focus needs to be on people. And I maintain that bad people need to be confined, and those severely mentally ill need to be removed from society where they can be humanely treated and where they are not a threat to themselves or others.

History shows that all the world's people have a segment, albeit a small one, that just cannot function normally while free. That properly identified segment requires institutionalization with treatment for their own protection and the protection of others, any otherwise misguided notions notwithstanding. This can be done in a humane and cost-effective manner.

American jails have daily bed costs ranging from $50 to well over $100 in some jurisdictions. Most jails also house at great cost to taxpayers nonviolent criminals who don't need to be locked up to control their behavior. They can be placed in all kinds of restorative justice schemes where they pay back society for their misdeeds while keeping or getting a job. Accrued jails savings could then be used for needed mental hospitals. And finally, there can be unfathomed public cost avoidance as well as the absence of unimaginable tragedy caused by a deranged shooter that should have been placed in a mental institution for his or her own good.

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