Opinion: Prison crisis also a mental health crisis
Kansas faces a prison crisis of crowded facilities and escalating costs to taxpayers. Fixing that requires addressing mental health and the grim reality that our approach to the mentally ill is often to imprison them.
In fairness, America has evolved on this issue. Historically, states often forced the mentally ill, especially the poor, into state-run institutions where they faced involuntary sterilization. In Kansas, from 1913 to 1961, the state sterilized over 3,000 individuals, mostly with mental illnesses.
In the 1960s, states started to deinstitutionalize the mentally ill, shifting the care burden to families, nursing homes or other community-based settings. But states often failed to follow through on promises to fund these alternatives. This meant that more people with mental illness lacked access to adequate care, which often resulted in homelessness and incarceration.
As the state mental health apparatus withered in Kansas, the burden of care shifted to local communities that varied in their ability to meet that challenge. In many communities, county jails became the default mental health providers, and law enforcement officers increasingly became first responders to mental health crises.
Kansas also started imprisoning more people with mental illness. In 2018, the Kansas Department of Corrections reported that 33% of the nearly 10,000 inmates in state prisons were diagnosed with serious to severe mental illnesses, and 65% had some degree of mental illness. By comparison, the department reported that in 2006 only 38% of inmates were mentally ill.
Compounding that problem, experts show that mentally ill offenders are more likely to receive extended sentences and other punishments in prison due to behavioral incidents, and many return post-release because of incidents explicitly related to their illnesses.
Kansas also faces the challenge that companies contracted to provide prison services have often failed to meet contractual obligations. Local media reported earlier in 2019 that Corizon Health, which the Sam Brownback administration hired to provide health services in Kansas prisons, had failed to provide adequate staffing and medication to cover mental health needs of prisoners.
Are there solutions?
First, Kansas has a patchwork of mental health services — and strong mental health advocates — that can help address the issue. Those providers need policy and financial support from local, state and federal policymakers.
Second, some Kansas communities have trained law enforcement on defusing mental health crises. But how many do this and the effectiveness of that training is uncertain.
Third, as some politicians recognize, prison alternatives merit consideration. Other states have explored criminal justice reforms such as mental health courts, pretrial diversions that emphasize supervision and treatment over prosecution, and expanding services for offenders post-release to avoid reentry. Adapting those reforms to Kansas is worth exploring.
Fourth, some states have started reverting privatized prison services back to state functions. Some states have found that implementing services like mental health care effectively themselves is cheaper than contracting with corporations that require additional oversight and that may botch program implementation in ways that increase state costs.
Yes, this costs money. But, the system now incurs great costs and sets many mentally ill Kansans up to fail. For both politicians and citizens, it is often easier to say that we care about mental illness, but harder to act on that financially. If we had cared financially decades ago, today’s prisons might not be leading mental health providers.
— Patrick R. Miller is an associate professor of political science at the University of Kansas.