“Sometimes its easier to get drugs in prison than it is to get a cell phone.”
That’s according to a former client of mine. When I asked him why he thought drug use was so rampant in jails, his answer was pretty poignant:
“If you can’t get the drugs you need, you’re stuck with the ones you can find. You’ll find something.”
On May 23, 2014, Daniel St. Hubert, a man with a history of schizophrenia and violence induced by mental illness, was released from prison—without medication, without resources, and with an acknowledgment that it would be 2-3 weeks before he could see a doctor. Within a week, he savagely stabbed two young children in an elevator, killing a 6-year-old boy and seriously injuring a 7-year-old girl.
When we think of criminal justice and mental illness, we often think of stories like this. We think of Adam Lanza and his unthinkable attack on small children at Sandy Hook Elementary. We think of James Holmes and the shooting at a movie theater in Aurora, Colorado. We think of Adacia Chambers, who plowed her car into a crowd of parade-goers in Stillwater, Oklahoma.
Stories abound of people who are unable to get adequate mental health treatment, a failure that can result in horrific tragedy.
But the truth is, these stories are few and far between in comparison with more pervasive failures for sufficient mental health care in the realm of criminal justice. While stories of unthinkable violence against innocent people grab headlines, suffering due to a lack of mental health care in the criminal justice system plays out much more quietly—through broken homes, children in foster care, a cycle of recidivism, drug addiction, and jail suicides.
How often do you hear about the inmates sitting in jails and prisons across the United States, passing the time, high as a kite? You don’t. But it’s real. I’ve heard it from plenty of clients: you can get whatever kind of drug you want while in custody. All you have to do is ask (and barter). Most are trying to mask the pain of being locked in a cage. Others are trying to medicate the thoughts and voices that led them to the cell in the first place.
Just how big of a problem is this? According to the National Alliance on Mental Illness (NAMI), people in a mental health crisis are more likely to encounter police than to get medical help. This results in the arrest of nearly 2 million people with mental illness each year.
These individuals are booked into jail, which often exacerbates whatever mental illness they already experience. Imagine you suffer from paranoia. An arrest will only feed into your state. If you have depression or anxiety, being booked into jail would only amplify those feelings. Even if your mental illness is recognized by the arresting agency, there is little hope you’ll receive the medical and mental health care you need while incarcerated.
You’ll likely just get a few ibuprofen and a “let me know if that helps.” The nurse won’t be around for another week or two, so most prisoners resort to illegal drugs inside the jail walls to self-medicate the issues they brought from outside.
In fact, people with mental illness who are jailed tend to stay behind bars longer than their counterparts without mental illness, and they are at greater risk of victimization during their stay. Often, denied adequate medical and mental health care, and facing added stressors from incarceration, their conditions deteriorate dramatically while in jail.
How else does substance abuse and addiction interact with mental health in prisons? According to the National Association of Drug Court Professionals (NADCP) up to 80% of inmates abuse drugs or alcohol, with about 50% of all jail and prison inmates clinically addicted. And more than half—60%―of all people arrested for most types of crimes test positive for illicit drugs at the time of their arrest.
And according to the National Institute on Drug Abuse, as many as 6 in 10 people who use illicit drugs also have a co-occurring mental disorder. Unfortunately, many of those booked into jail for drug crimes or drug-related crimes (including theft, prostitution, public disturbance, DUI) are examined only as far as the drugs, without further care or treatment for the underlying mental health issue.
So, you have a person with mental illness who also self-medicates with drugs. During a behavioral episode or after committing a crime related to substance abuse, he or she is booked into jail. In the event that he or she receives any type of treatment during incarceration, it is likely focused on the drug abuse, rather than the mental illness that prompted the abuse.
As most inmates will tell you, it is often easier to get drugs in jail or prison than it is to get them on the streets. Most trade their commissary for whatever they can get. A few cups of noodles might land you a joint or a couple of pills. If you have family willing to send you a prepaid debit or gift card, then you can really wheel and deal. Meth, heroin, coke...its all available.
The NADCP reports that 60-80% of drug abusers commit a new crime—typically drug-driven—after release from prison, and 95% return to drug abuse—an almost 100% failure rate.
Mental health is at a crisis in the United States, and leaving the criminal justice system as the de facto mental health care provider is an abysmal injustice for those with mental illness. This leads to a revolving door of incarceration and release. Drugs on the outside lead to drugs on the inside which lead to drugs on the outside...
It is a vicious cycle. Our prison systems have to start addressing mental health more adequately. For those with mental illness, law enforcement shouldn’t be the first line of defense. Mental illness deserves treatment, not punishment.