Our jails and prisons are filled with mentally ill inmates and many of them are kept in solitary confinement, a form of punishment that some criminal justice experts and the United Nations describe as torture.
Tuesday, Dr. James Gilligan, clinical professor of psychiatry in the School of Medicine and adjunct professor in the School of Law at New York University, told Democracy Now that the mentally ill are being treated worse than animals.
"Zookeepers are not allowed to keep zoo animals in the kind of housing that we put human beings in," Dr. Gilligan said. "We have created the situation; it is called a self-fulfilling prophecy: We say these are animals, they are going to behave like animals, then we treat them so that they will."
As Mother Jones and others have reported, the mental health care system in America has steadily declined since the 1980s. Funding for treatment has dried up, at the same time the prison population has spiked.
The result, Gilligan said, is that the nation's prisons and jails have become America's mental health hospitals.
And many of the incarcerated mentally ill wind up in solitary confinement.
According to Human Rights Watch, based on available data, an estimated one-third to one-half of inmates in isolation had some form of mental illness.
"The biggest mental hospital in the country is the Los Angeles County Jail; the second largest is Rikers Island," Gilligan said. "If we’re going to put the mentally ill there, we should turn it into a mental hospital, because that’s what these people need."
Instead, Gilligan said "we put the mentally ill in solitary confinement. For many, that became the default placement. And, you know, the United Nations and the European Court of Human Rights both have declared prolonged solitary confinement to be a form of torture. And it clearly is. It’s psychological torture. It drives people crazy and makes them suicidal."
Solitary makes it especially difficult for mental health practitioners to do their jobs, according to a paper published this year in the Journal of the American Academy of Psychiatry and the Law:
Mental health professionals are often unable to mitigate fully the harm associated with isolation. Mental health services in segregation units are typically limited to psychotropic medication, a health care clinician stopping at the cell front to ask how the prisoner is doing (i.e., mental health rounds), and occasional meetings in private with a clinician. Individual therapy; group therapy; structured educational, recreational, or life-skill-enhancing activities; and other therapeutic interventions are usually not available because of insufficient resources and rules requiring prisoners to remain in their cells.
Prison officials have said solitary is a crucial tool that helps guards maintain order and provide a safe environment in often overcrowded facilities. They also say the practice is for prisoners' own good, to keep them from being harmed by other inmates, or harming themselves.
But the tide may be turning against the practice, at least when it comes to the mentally ill.
In February, USA Today reported that a Senate Judiciary panel recommended that solitary confinement be banned for juveniles, pregnant women and the mentally ill.
The recommendation came despite support for the practice from Eric Young, president of the American Federation of Government Employees' Council of Prison Locals, which represents federal prison officers,
"We must be able to restrict and restrain inmates before their behavior escalates," Young told the panel. "We cannot have staff and inmates being targeted for assaults and certainly cannot allow anyone to be murdered without consequence."
But others who testified in front of the panel said solitary itself can be deadly.
"Being in that environment for 23 hours a day will slowly kill you,'' said Damon Thibodeaux, who spent 15 years in solitary confinement on Louisiana's death row before being exonerated. "Mentally, you have to find some way to live as if you were not there. If you cannot do that, you will die a slow mental death and may actually wish for your physical death, so that you do not have to continue that existence.''