If we call the criminal justice system in the US the largest facility that caters mentally ill patients, it won't be a statement much disputed. One of the largest numbers of mentally ill patients in the US is catered in the jails and prison facilities, instead of mental health institutions. There are large numbers of estimates regarding the inmates in prison that have mental illnesses. According to some researches, of the total number of patients in the US criminal justice system, about 14 percent of male inmates suffer from some kind of serious mental illness, as opposed to 31% of females. (Epperson et al. 2014)
The current mental health system has significantly declined in relation to the one that was prevalent in the country from the 1850's onwards to the 1950's. There has been a reversal to the pre 1850's era. It seems with the large number of mental illness patients being packed into prisons and jail cells instead of being provided with proper psychiatric treatments in mental hospitals.
The strategy of emptying the mental hospitals in America without taking into account the need for the discharged patients to receive proper care and treatment elsewhere has proved to be a glaring disaster. Half of the patients that have been discharged by the mental health systems have either ended up homeless or in prison cells. This can be termed as nothing short of tragedy (Frances, 2013). This is not a disaster that had happened only once; it is one that continues to be in motion. Many states in the US are continuing to close down psychiatric beds in hospitals, with most of the current administrators of mental health programs, ignorant of the current state.
When we look at the current state of the mental health care system, it seems as if there is a lack of ideas for implementation and correction of the problems at hand. This article sets out to outline a few changes that need to be made in the policies of the current health care system to be able to make the most of the prevalent situation. Here is a list of few changes and solutions to the existing problems of the mental health system.
Inculcation of Mental Health Courts into the Legal Administrative Framework
The US is one of the few countries that have health and more specifically mental health courts. The use of these mental health courts need to be given a greater deal of autonomy and area of practice to work in. It should be made compulsory for every person leaving a mental hospital to appear before the court and be able to choose between going to jail or following a set treatment plan. This means that the judges and the courts would then become the primary authority in this regard. This would allow the fate of the patients to be decided not on the basis of economic considerations or administrative feasibility, but on the concept of fairness. Studies have suggested the affectivity of the use of mental health courts (Moore & Hiday, 2006) (Lamb & Weinberger, 2008).
Changes in the Federal System of Funding
The current system of mental health is one of the primary reasons for the funding and resource issue being faced by the mental health system today. The largest sources of these funds to the states come via Federal Medicaid. Medicaid imposes a number of restrictions on of the states from using the Medicaid funds for the betterment of mentally ill patients. This is one strategy that needs to be revised. The current strategy provides incentives to the state not to encourage the proper treatment of mentally ill patients but to rid the hospitals of them at the earliest. One of the most major shifts in the government's policies in this regard would be to fix the system of Medicaid, particularly the restrictions that it places on usage of its funds on mentally impaired patients.
An upheaval in the Treatment Laws
Some reforms are needed to be made by the states in their mental health system laws that allow for a greater number of treatment interventions. The reforms in law need to be made in a way that allow for the interventions in treatments to be made with regard to standards of the treatment. This would allow the individuals that are suffering from mental illness to be able to get treatment before they get involved in a dangerous situation or commit a crime.
It is appropriate to say that the days of reminiscing on the past seem to have passed, and if there is any chance of revisiting the good old days, it is needed that we work towards it today for the better future.
• Torrey, F., Kennard, A., Eslinger, D., Payle, J., & Lamb, R. (2010). More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States. National Sheriffs Association, 2(3), 1-20. doi:-
• R. H. Lamb, L. E. Weinberger, Mental health courts as a way to provide treatment to violent persons with severe mental illness, Journal of the American Medical Association 2008;300:722-724
• M. E. Moore, V. A. Hiday, Mental health court outcomes: a comparison of re-arrest and re-arrest severity between mental health court and traditional court participants, Law and Human Behavior 2006;30:659-674
• Matthew W. Epperson, Nancy Wolff, Robert D. Morgan, William H. Fisher, B.Christopher Frueh, Jessica Huening. Envisioning the next generation of behavioral health and criminal justice interventions.International Journal of Law and Psychiatry, 2014; 37 (5): 427 DOI:10.1016/j.ijlp.2014.02.015