Wasted minds

By Michelle Chen May 07, 2009

The debate over the public cost of prisons has focused largely the drain on taxpayer funds and social services. Now there’s evidence that it may be costing us our sanity, too. An article in the May/June issue of Health Affairs notes that while access to psychiatric and inpatient mental health care has generally improved, “Access to care among those with mental health impairments appears to have declined, and we estimate that because of continued increases in incarceration, at least 7 percent of the population with serious and persistent mental illnesses are incarcerated in jail or prison each year.” In other words, mental health care is improving for the country as a whole, but not so much for the swath of the population condemned to wrestle with their psychological problems behind bars. According to 2005 federal data, the majority of prison and jail inmates had exhibited a mental health problem, including major depression and psychotic disorders. Compared to non-mentally-ill incarcerated people, inmates with mental health problems had higher rates of past substance abuse and homelessness. Yet only one third of state prisoners received treatment while inside. Outside the prison system, communities deeply impacted by criminal justice are vulnerable to cracks in the mainstream mental health system. Other research has identified barriers such as culturally insensitive treatment providers, patient mistrust, and language barriers, which underscore the need for comprehensive, culturally competent facilities serving communities of color. Like the criminal justice structure, certain mental health issues have an acute impact on the Black community. From 1980 to 1995, according to a report published by the Morehouse School of Medicine, the Black male suicide rate soared—a phenomenon that researchers attribute to racism, community violence, and a lack of diversity among mental health care workers. In the confluence of race, incarceration and mental health, different stressors and crises mutually feed off each other: socioeconomic deprivation could breed psychological instability and vice versa. Yet in the cause-effect loop, institutionalized racism stands out as an insidious catalyst. In a study on fifth-grade public school students published in the May issue of American Journal of Public Health, researchers revealed a tragic response to perceived injustice:

“Children who reported perceived racial/ethnic discrimination were more likely to have symptoms of… depression, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. An association between perceived racial/ethnic discrimination and depressive symptoms was found for Black, Hispanic, and other children but not for White children.”

Mental health disparities seem to fit perfectly with a social system that perpetuates vast inequalities, irrational social policies and intransigent prejudice. It’s the definition of insanity. May 7 is National Children’s Mental Health Awareness Day. Image: "Nightmare of Justice," Anthony Papa