Harrell 1

Camryn Harrell

Professor Barnes

English Composition II

14 April 2019

Treatment over Imprisonment

If it wasn’t for my addiction to true crime stories, I would be lost trying to find a research

topic that I’d actually be interested in learning about. The story of Dee Dee Blanchard’s death

put me through a whirlwind of questions. The flooding news articles and broadcasts made this

hard to miss and harder to comprehend the damage done to the people around her. Gypsy

Blanchard, Dee Dee’s critically ill daughter, had been charged with second degree murder after

planning her mother’s death and hiring her boyfriend to do it. As the story unfolded, the truth

came to the surface. Dee Dee had lied to everyone around her. Her daughter was actually

healthy, yet trapped. Dee Dee, Gypsy’s mom, manipulated doctors, family, and friends since her

daughter’s birth. Dee Dee had developed an extensive fantasy that her daughter was terminally

ill, suffering from cancer; however, little did others realize that Gypsy had actually caught on to

her mother’s lie, so she played along with her mom’s scheme. Even her mom was unaware that

she had been outplayed. Consequently, investigators concluded that Dee Dee actually was a

victim of Munchausen syndrome by proxy: “…a mental health problem in which a caregiver

makes up or causes an illness or injury in a person…” (“Munchausen Syndrome by Proxy”).

There were many questions raised to the surface, but my questions is: Who really belongs in jail?

Is it truly for the common good that the mentally ill are locked up in prison, or should they be

getting treatment to help their struggling minds? It is apparent that there are many mentally ill

individuals that become criminals; however, due to their vulnerability, behavioral problems,
 Harrell 2

suicide rates, and extra expenses, the mentally ill should be in inpatient care in hospitals or

outpatient care in local clinics for them to receive treatment rather than punishment.

Unfortunately, many mentally ill individuals became lost in the system once asylums

were closed down. To illustrate, in the article “Deinstitutionalization, It’s Causes, Effects, Pros

and Cons,” written by Kimberly Amadeo, featured in The Balance, the author informs the

general public of the shift between mental asylums to mental health centers, how it changed, and

why it changed. This article proves that the mentally ill have almost always been a “challenge”

to understand and care for, struggling with money, room, and safety measures. According to

Amadeo, deinstitutionalization lead to more rights given to the mentally challenged while

keeping them safe and comfortable. However, many people weren’t lucky enough to have the

severity for necessary hospital care, missing the mark and getting left with absolutely nothing.

Furthermore, she claims that in many cases, people with a serious mental illness would need kept

against their will in order to get proper treatment, even without the torture that came with the

mental asylums (Amedeo). Obviously and legally these local clinics aren’t able to hold people

against their will, and cannot offer inpatient care with the federal funding the institutions get, but

prisons can?

Additionally, studies show that the situation hasn’t really been resolved. For instance, at

the University of Pennsylvania, the Perelman School of Medicine studied deinstitutionalization.

They stated that “deinstitutionalization has really been transinstitutionalization. U.S. jails and

prisons have become the nation’s largest mental health care facilities…This results in a vicious

cycle whereby mentally ill patients move between crisis hospitalization, homelessness, and

incarceration” (Powers 204). The author highlights that these researchers rooted for medical

facilities to come back in order to properly treat them safely, without punishment. Ron Powers
 Harrell 3

goes on to explain in his book, “No one Cares about Crazy People,” that going back to asylums

is necessary to rid of the criminalization to the mentally ill (Powers 204).

After extensive research, it is evident that life in prison consists of a strict and structured

schedule full of both work and leisure, depending on the sentence and setting of each prison.

While structure has a positive effect on many mental illnesses, it is still prison, and at prisons

criminals are punished. Strict rules are hard on people who struggle with a mental illness; many

are unable to truly understand them and end up getting punished for it. Limiting visiting hours or

getting sent to solitary confinement is unfair for innocent people who cannot overcome these

struggles without help. It’s also just as unfair to the families of the mentally ill, who want to see

their son, daughter, brother, or sister. For instance, 64% of inmates in local jails experience the

symptoms of a mental illness, representing over 7 million people (Docherty, 1). Those 7 million

people are not criminals, they are misunderstood, and innocent. Why are we torturing and

punishing them?

People with a mental illness frequently need extra care, medication, and support, all of

which cost the prison money. The Treatment Advocacy Center points out how costly housing the

mentally ill really is. For example, “In Broward County, Florida in 2007, it cost(s) $80 a day to

house a regular inmate but $130 a day for an inmate with mental illness.” The author proposes

that medications, extra staffing, and even settling or losing lawsuits from the treatment of the

mentally ill in prisons all add to the price of the mentally ill being housed in state prisons

(Carrol). Additionally, suicide rates are spiking in state prisons, and the mentally ill contribute to

many of them. The author points out that “multiple studies indicate as many as half of all inmate

suicides are committed by the estimated 15% to 20% of inmates with a serious mental illness.”
 Harrell 4

(Carrol). Suicide is more likely to happen with mentally ill individuals, which continues to

provide evidence for taking care of the mentally ill, rather than isolating and punishing them.

Solitary confinement is a form of punishment used in prisons when inmates are unable to

follow their rules. Reveal News reports that although many people think only the most dangerous

criminals go to solitary confinement, but even if the guards are annoyed or disturbed by the

individual. they can be taken to solitary (Altan). The individual is taken to a small, dark room to

be left alone for what feels like a lifetime. Unfortunately, when those suffering from a mental

illness get overwhelmed, or just cannot understand the rules, they get broken and guards treat

them like any other criminal. They get locked up in a cell to sit alone, which isn’t the answer to

treat the mentally ill. Rather than punishing them, locking them up further, why isn’t America

helping these people get better, or just be able to cope with their problems?

People with a mental illness are very vulnerable, after the deinstitutionalization of mental

hospitals, the critical conditions were put in medical hospitals and others were left to figure it out

for themselves. Many don’t have family, money, or a home. Psychiatric News goes into depth on

the vulnerability of the mentally ill during police interrogations, the author shares an

interviewee’s report that “people with psychosis, anxiety, depression, or substance intoxication

or withdrawal are especially vulnerable” (Levin). Being placed in an intimidating environment is

uncomfortable, especially for an innocent person struggling with a mental disorder.

Safety measures must be taken into consideration when housing the mentally ill.

Murderers, rapists, and drug abusers are in prison, as they should be, but alongside with

vulnerable, mentally ill patients? There are guards in prison to keep peace throughout each day,

and keep each inmate following the rules. To the guards, however, everyone in jail is a criminal,

just like many people from the outside think. Subsequently, the mentally ill are being treated the
 Harrell 5

same as the murderer one cell over, which isn’t fair to them. To indicate just how vulnerable the

mentally ill are, Lisa Callahan shares in the International Journal of Forensic Mental Health,

“both male and female inmates with mental illness are more likely to be physically and sexually

abused prior to their prison admission” (Callahan 38). The mentally ill should not have to be

living with the abusers and attackers that made them the innocent victim that they are.

Prison guards didn’t go to medical school, or study how to calm a person suffering from a

manic episode, PTSD, or the voices in their head. Not that they aren’t equipped for their job, but

extra pressure and responsibility is put on guards when they already have enough to handle. The

staffing in state prisons is not equipped to care for or treat the mentally ill, although they are

institutionalized for that exact reason. Kevin Grabowsky discloses in an interview for the

Macleans News that “None of us are medical professionals as correctional officers and certainly

two days of training doesn’t do it.” Even the guards don’t feel confident doing their job because

of the incarceration of the mentally ill. The problem isn’t that they are institutionalized because

they need structure and daily care. The problem is the institution they are in is not adept for their

needs.
 Harrell 6

Roth, Alisa. Insane: America's Criminal Treatment of Mental Illness. Basic Books, 2018.

Alisa Roth dove into the criminal justice system to see what really goes on behind the

locked gates and closed doors. She shared through her book, “Insane,” how truly unfair the

criminal justice system is to the mentally ill. Roth admits that “Jails and prisons are among the

least therapeutic environments in the world,” and that correctional facilities are bringing the

worst out of the behavior of the mentally ill. The feedback from Alisa Roth’s book, “Insane,”

was astonishing. She drew in many people to bring awareness to the twisted ways of the criminal

justice system. In Roth’s conclusion to her book, she says, “We have known for more than two

hundred years that keeping people with mental illness locked up in jails and prisons does little

but make them worse. We know how to lock up masses of people. Now we need to figure out

how to treat them” (Roth, 275). Her argument is that we have gone through the cycle of

misplacing the mentally ill for hundreds of years now. America is trying to bring medical

advances in, when really the mentally ill just need out.
 Harrell 7

For many people, the situation the criminal justice system is in hasn’t been brought to

their attention, and awareness hasn’t spread vast enough. Without the information from Roth,

Powers, and several organizations, people think the mentally ill are safe here, in prison, where

they are criminalized and punished. Thankfully, many people haven’t seen other side of prison

doors, and they don’t want to. Without that information, however, those on the “outside” are

unable to stand up for what is right, because they have no idea how these people are being

treated.

Many are blinded by the fear of the mentally ill, allowing for them to be so lost in the

system. Many people would agree that institutionalizing the mentally ill is acceptable, but

without enough knowledge on the institutions the mentally ill are in, they don’t understand why

this institution isn’t right for them. Mental hospitals are few and far between, and in many cases

they’re outlawed. Therefore, the mentally ill have nowhere to go, and there aren’t many options

out there. Hospitals have limited beds, asylums closed down, but prisons are here to stay in order

to keep the few dangerous criminals separated from the rest of the general public. Additionally,

the societal fear of the mentally ill allows for them to be locked up. According to Saul McLeod,

in a Simply Psychology article, safety needs, the second tier of Maslow's Hierarchy of needs is

described as “protection from elements, security, order, law, stability, (and) freedom from fear.”

Human beings prioritize safety as a basic necessity, making the separation from society more

important than the ethics of locking up an innocent “criminal.” Few people think that the

individuals dealing with a mental illness deserve to live on the streets and have absolutely

nothing, but after making society uncomfortable in several instances, they desire to keep them

segregated.
 Harrell 8

Alternatively, organizations across the country have been created to raise awareness for

the problematic situation involving the mentally ill caused by America’s prison system. Three of

the largest being Mental Health America, National Alliance on Mental Illness and the Treatment

Advocacy Center. All three of these groups have informative websites that can educate anyone

of the general public to understand the importance and effects of the criminal justice system as it

is now. Some local counties have also taken steps to change the rules for the mentally ill housed

in prison. According to the Treatment Advocacy Center, Douglas County, Kansas has decided to

conduct research on the inmates with a mental illness in their local jail in hopes to decrease their

population of inmates. In the interview with Sheriff Jim Flory, he says,”...this issue goes well

beyond the county jail. We’re looking at this as a community issue.” The author presents that

those dealing with a mental illness are more likely to be in jail than a psychiatric hospital, and

the efforts made by Douglas County shouldn’t stop at that point. More efforts and research

measures should be made in order to see change.

What now, what can I do to change the system? Most importantly, getting some

background and researching what really goes on behind prison doors gives insight as to what this

is worth to fight for. Another option is donate money to any of the various organizations created

to bring awareness to the mentally ill being incriminated. Mental Health America, National

Alliance on Mental Illness, and the Treatment Advocacy Group are three great places to find

information, as well as people who want to support the same cause. Money isn’t the only way to

support these organizations, however, joining in on the movement is all it takes. Overall,

bringing awareness to as many people as possible is the best way to see change in the system.

What would life in a hospital or local clinic look like for a person dealing with a mental

illness? The biggest difference would be getting help rather than punishment, treated rather than
 Harrell 9

criminalized, and safe rather than confined, scared, or taken advantage of. The structure given to

each inmate in prison is important to continue in facilities housing the mentally ill. However, the

environment will shift when they are less afraid, no longer blamed, and treated like innocent

humans again. The mentally ill just don’t belong in prisons; it’s unfair, unsafe, and unethical. No

one should be punished for things that are out of their control, and if they are unable to defend

themselves, they only get lost in the system. It is important that steps are taken in the direction

opposite of criminalization. The people that need help should get their help, just as the people

who need to be punished, should get their punishment, the two don’t overlap. Overall, with the

state the mentally ill are in, their vulnerability and unfair treatment is not right, and they should

be moved from prisons to treatment as soon as possible.

 Harrell 10

Works Cited

Altan, Daffodil J., and Trey Bundy. “For Teens at Rikers Island, Solitary Confinement Pushes

Mental Limits.” Reveal, 29 Nov. 2018,

www.revealnews.org/article-legacy/for-teens-at-rikers-island-solitary-confinement-

pushes-mental-limits/.

Amadeo, Kimberly. “Learn About Deinstitutionalization, the Causes and the Effects.” The

Balance, 24 Jan. 2019, www.thebalance.com/deinstitutionalization-3306067.

Carroll, Heather.“Serious Mental Illness Prevalence in Jails and Prisons.” Treatment Advocacy

Center, 2018, www.treatmentadvocacycenter.org/evidence-and-research/learn-more-

about/3695.

Docherty, John. “NAMI.” Creating New Hope For Mental Illness And The Criminal Justice

System, 20 Oct. 2017, www.nami.org/Blogs/NAMI-Blog/October-2017/Creating-New-

Hope-for-Mental-Illness-and-the-Crimi.

Healthwise, Staff. “Munchausen Syndrome by Proxy.” Munchausen Syndrome by Proxy

Michigan Medicine, Sept. 2018, www.uofmhealth.org/health-library/hw180537.

Levin, Aaron. “Mentally Ill Individuals More Vulnerable in Police Interrogations.”

Psychiatric News, vol. 47, no. 24, 2012, pp. 12–12., doi:10.1176/appi.pn.2012.12b16.

Maxwell, Lynne. “No One Cares About Crazy People: The Chaos and Heartbreak of Mental

Health in America.” Library Journal, vol. 141, no. 20, Dec. 2016, p. 110. EBSCOhost,

search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=120470079&site=ehost-live.

Press, The Canadian. “Prison Guards Not Trained to Deal with Mentally Ill: Union.”

Macleans.ca, 30 July 2014,

 Harrell 11

www.macleans.ca/news/canada/prison-guards-not-trained-to-deal-with-mentally-ill-

union/.

Roesch, Ronald. “The International Journal of Forensic Mental Health.” International

Journal of Forensic Mental Health, vol. 8, no. 1, 2009, pp. 38–28.,

doi:10.1080/14999010903109935.

Roth, Alisa “Insane: America's Criminal Treatment of Mental Illness.” Basic Books, 2018.

“INSANE America’s Criminal Treatment of Mental Illness.” Kirkus Reviews, vol. 86, no.

3, Feb. 2018, p. 391. EBSCOhost,

search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=127646706&site=ehost-live.

“Seeking Better Solutions for Inmates with Mental Illness.” Treatment Advocacy Center,

25 Mar. 2015, www.treatmentadvocacycenter.org/fixing-the-system/features-and-

news/2799.