Mental Illness, Women and the Criminal Justice System

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Mental Illness, Women and the Criminal Justice
System

• Tina Riveros

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• Thousands of mentally ill are left untreated and
  unhelped until they have deteriorated so greatly
  that they wind up arrested and prosecuted for
  crimes they might never have committed had they
  been able to access therapy, medication and
  assisted living facilities in the community.
  Mental health professionals told Human Rights
  that it is next to impossible to get their
  clients admitted to hospitals or treatment
  programs until after they have deteriorated to
  such a point that they have already committed a
  crime.1
• 1 Human Rights Watch

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Presentation Outline

• Introduction self and topic
• Statistics
• Mental Illness
• Why prison? Purpose?
• The truth about prison
• Rehabilitation? How?
• What can be done

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Introduction

• Myself
• My topic

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Lets look at some statistics

• Around 60 of women in prison are parents, with
  30-40 being sole carers. The majority of women
  in prison have some form of problematic
  relationship with drugs and/or alcohol and have
  been incarcerated for non-violent offences, and
  mostly drug-involved offences.
• Offenders with mental health needs (around 30)
  and intellectual disabilities (around 12) are
  much more likely to have their needs effectively
  met in the community environment. The experience
  of imprisonment, not surprisingly can often
  worsen existing mental health conditions. People
  with intellectual disabilities and people with a
  mental illness are especially vulnerable in the
  prison environment.

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• A report was made in 2003 regarding mental
  illness in prison.
• It was found that 45 of reception inmates and
  38 of sentenced inmates had suffered a mental
  disorder in the past 12 months (characterised as
  a psychosis, affective disorder or anxiety
  disorder).
• When a broader definition of any psychiatric
  disorder was used it was found that 74 was
  affected.
• The study also reported that female prisoners
  have a higher prevalence of psychiatric disorder
  with approximately 90 of female reception
  prisoners having experienced a mental disorder in
  the 12 months prior.1
• 1 Berry, C., Mental Illness in NSW Prisons,
  Health Policy and Advocacy, Public Interest
  Advocacy Centre page 2

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• 1995-2002 58 increase in imprisonment rate for
  women in Australia
• The imprisonment rate is the number of prisoners
  on 30 June per 100,0000 estimated resident
  population at 30 June aged 17 and over
• 2002 1,484 women in prison

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• Of the roughly 15,000 people with major mental
  illnesses in Australian institutions in 2001
  around one third were in prisons.1
• In New South Wales sixty-four per cent of
  offenders released from prison on parole
  re-offend within two years of release2.
• In our prison system at the moment we have 1.5
  mental health workers for 3500 prisoners. Prisons
  have become the de facto psychiatric units but
  with not mental health professionals.3

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Victorian Prisoner Health Study

• 74.9 of prisoners who had ever injected drugs
  reported injecting drugs while in prison.
• Research last year, found that in the last decade
  in Victoria, there had been a 138 increase on
  prison expenditure, the equivalent increase for
  the states mental health services was only 88 .
• 36 of the prisoners who were surveyed had been
  told that they had a mental illness.
• 15 of the prisoners questioned reported that
  they were currently receiving medication
• More than 30 of the prisoners questioned had
  attempted suicide.

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What is mental illness

• The term mental illness is very broad. It covers
  a diverse range of health conditions relating to
  someone psychological state. Depression and
  schizophrenia are some of the better known
  examples of mental illness. Definitions are a
  little fluid. They have changed frequently over
  time and are influenced by various social and
  cultural trends. Bipolar Disorder

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• Schizophrenia
• Borderline Personality Disorder
• Depression
• Anxiety
• Bipolar Disorder

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• The DSM describes a mental disorder is
  conceptualised as a clinically significant
  behavioural or psychological syndrome or pattern
  that occurs in an individual and is associated
  with present distress (e.g. a painful symptom) or
  disability (i.e. impairment in one or more
  important areas of functioning) or with a
  significantly increased risk f suffering death,
  pain, disability, or an important loss of
  freedom. In addition this syndrome or pattern
  must not be merely an acceptable or culturally
  sanctioned response to a particular event, for
  example the death of a loved one. Whatever its
  original cause, it must currently be considered a
  manifestation of a behavioural, psychological or
  biological dysfunction in the individual.

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Purpose of Punishment

• There are five possible purposes to the
  punishment of criminals 1.
• 1. Incapacitation A felon in prison cannot
  commit crimes while imprisoned. An executed felon
  cannot commit a crime ever again.
• 2. Deterrence The threat of punishment deters
  people from engaging in illegal acts.
• 3. Restitution The felon is required to take
  some action to at least partially return the
  victim to the status quo ante.
• 4. Retribution The felon harmed society
  therefore society (or the direct victims) is
  entitled to inflict harm in return.
• 5. Rehabilitation The punishment changes the
  felon in order to make him a better citizen
  afterwards. (The punishment can include mandatory
  vocational training, counseling, drug treatment,
  etc.)

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Prison Myths

• Free food
• Free accommodation
• You get paid
• Watch TV all the time
• Get an education for free

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Scotts Case
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Prison Facts

• violence
• rape
• isolation
• development of mental illnesses
• suicide
• inadequate responses to mental health issues

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Rehabilitation Biggest Myth

• Sexual violence
• Availability of drugs
• Seclusion

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What can be done?
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(No Transcript)
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• Improve community Mental Health Service.
• Have a court liaison service.
• Court Assessment service Prison based services
  reception screening, O.P., inpatient units
  acute and long stay, vulnerable prisoner units,
  suicide prevention teams.
• Development of more effective institutions

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• 5. Separate services for the seriously
  personality disordered.
• 6. Hostel supervised accommodation.

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• We need more appropriate institutions
• We dont want High Security Perimeter 5.2m wall
  with anti-grappling fronds, electronic
  surveillance with movement detectors within 5m of
  wall.
• We dont want isolation.

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• Conflict between Care Containment
• Design which minimises the walls visibility.
• Internal hospital environment.The building
  design is hospital not prison based. Patients
  not locked in room, (except short term
  seclusion). Views, open space, changing
  vegetation, domestic standard construction.
• Education and recreation blocks community
  standard.
• Therapeutic rather than Custodial culture.

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• SECURITY
• CUSTODIAL THERAPEUTIC
• Observe (from office) Interact (in unit)
• Reward conformity Reward engagement and
  initiative
• Emphasise behaviour Emphasise psych adjustment
• Oriented to immediate goals Oriented to long
  term goals of
• of institutional functioning good social
  and interpersonal functioning in the
  community

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• CUSTODIAL THERAPEUTIC
• Unified approach and Multiple
  Professional
  only one
  approaches and
• perspective (authoritarian) perspectives
  (negotiated)
• Physical structure Therapeutic
  interventions
• constrain behaviour
  social expectations
• constrain unwanted behaviour
• Ultimate goal control Ultimate
  goal effective functioning without antisocial and
• self damaging behaviours.

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• Combining high, medium and low security in
  environment of rehabilitation gives patients and
  staff sense of progress.
• Prisoner patients acutely ill, rapid response,
  regularly assessed for progress and monitored for
  prospect of gradual community involvement once
  discharged must be more to the service
• Staff able to move between aspects of service.
• Presence of students.
• Mullen, P., Developing Forensic Mental Health,
  Monash University