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Poor national mental health policies have real, local effects

There used to be the occasional jokes in this area about taking someone to Milledgeville – which back in the earlier 1900s, most people knew referred to the state mental hospital in Milledgeville, Ga.

Those jokes wouldn’t work at all now. Obviously they wouldn’t be politically correct and, secondly, there are virtually no mental hospitals anywhere in America.

According to national reporting on the loss of state mental hospitals, in the 1960s through 1980s, the government/experts decided that mental hospitals were cruel, barbaric and the patients needed more freedom.

Rather than fix the problems – perhaps with more treatment, better conditions and consideration of those housed there - they more or less just shut down everything.

The government still houses quite a few psychiatric patients. Unfortunately for most, especially those without good insurance, they are housed in county jails and state prisons.

The summer 2018 issue of Esquire magazine reported that “nearly 400,000 of the 2.2 million prisoners in the United States have a psychiatric diagnosis.” As a comparison the article reports that state run psychiatric hospitals house only 38,000 people. 

Other commonly cited figures say that half of all prisoners in America are suffering from mental issues and for women prisoners it is thought the rate of mental illness is higher (possibly reaching 75 percent), according to a New York Post article in July of 2018.

The Esquire article went on to cite a statement from the National Alliance on Mental Illness - “In a mental health crisis, people are more likely to encounter police than to get medical help.”

According to the reporting, in 1955 government run hospitals housed 560,000 patients. In 1980 the number of mentally ill people housed in state hospitals had dropped by 80 percent.

This is not some big city problem that we are immune to in our small town. In an August 2016 story, the Progress reported that jailers here routinely cite lacking resources to handle a growing segment of mentally ill prisoners as a major problem to keeping good jailers.

Several jailers and senior officers told the Progress during an extended tour of the jail at that time that roughly 10 percent of their 140 average population has a mental issue severe enough that they are a challenge to deal with. And that number did not include any prisoner suffering temporary mental issues caused by drug/alcohol in their system or withdrawal effects.

Among the challenges faced by jail staff is that they can’t force a prisoner to continue taking already prescribed medication; nor can they diagnose or offer medication to those in jail.

Jailers at that time described the additional stress caused by mentally ill prisoners resulting from unprovoked attacks, thrown feces, and constant yelling and screaming.

Officers said they can often place an inmate with insurance into a private mental hospital, but there were few resources for a mentally ill patient with no means to pay for treatment.

The local jail can refer them to state hospitals but prisoners are often sent right back as there is such a scarcity of beds.

Not only is there a moral duty for America to stop considering our jails the proper place to stash mentally ill people, there is an efficiency/financial incentive to address this problem.

It’s worth pointing out that taxpayers already pick up the tab for housing mentally ill prisoners in terms of jail space, beds and the additional manpower. It’s not that a better system would necessarily cost more. It’s that we are using the wrong institution (jails) to handle a problem that is already widespread, unlikely to improve, costly, and dangerous to the prisoners and those who are charged with caring for them.

With our nation’s mental health, we’ve chosen short term expediency over working for a solution of how to handle mentally ill people who can not afford private care, and that needs to change.