May 12, 2015

By Ron Honberg

Human Rights Watch released a report today, Callous and Cruel, that describes in chilling detail the degree to which “unnecessary, excessive, and even malicious force” is used in jails and prisons throughout the U.S. to control inmates with serious mental illness such as schizophrenia and bipolar disorder.

Report cover: image of Paul Schlosser III, being pepper sprayed in
a screenshot from video of the incident via: Human Rights Watch

For some inmates with mental illness, these abusive tactics result in serious injuries or even death.  In virtually all cases, these tactics cause extreme psychological distress and often a worsening of symptoms that leave individuals unable to function in correctional settings and wholly unprepared to successfully reenter communities after incarceration.

Human Rights Watch engaged in extensive review of court cases and interviewed more than 125 current and former correctional officials and a variety of experts in compiling its report.  The report documents use of tactics against individuals with serious mental illness such as spraying them with painful chemicals, shocking them with electric stun guns, and strapping people in restraint chairs or beds for days at a time.   It also documents severe physical beatings that have resulted in serious injuries or deaths.

Long term solitary confinement or other forms of “administrative segregation” are used frequently to control and manage inmates with serious mental illness.  It is well established that long term isolation causes severe psychological distress with individuals who do not have pre-existing mental illness.   For people with pre-existing mental illness, long term isolation can be akin to torture.

How did we get to this shameful point in our history?   The answer is not hard to find.   It is well known that the lack of appropriate mental health services and supports has contributed significantly to the “criminalization” of people with serious mental illness.

Jails and prisons have been characterized as “de-facto” mental health treatment facilities.  However, this term is a misnomer.  Jails and prisons are designed to punish people, not treat them.  And, correctional officers, who have very difficult and stressful jobs, are not trained to de-escalate psychiatric crises.  In these settings, the response to any sort of aberrant behavior is typically punitive, not therapeutic.

The report contains a number of policy recommendations for improving the response to individuals with serious mental illness who are incarcerated, including:

  • Ensuring that jails and prisons adopt policies and standards pertaining to the use of force, including alternative strategies for addressing the “unique needs and vulnerabilities of prisoners with mental disabilities.”   One option that should be strongly considered is CIT for Corrections, a program that trains correctional officers on how to de-escalate crises and prevent the use of force.  These have been adopted in several states, including Indiana, Pennsylvania and North Carolina.
  • Prohibit the use of solitary confinement for persons with serious mental illness and other mental disabilities who are confined in jails and prisons.  Certain states have moved in this direction, including Maine, Colorado and Mississippi.
  • Reduce the numbers of people with serious mental illness who are incarcerated in jails and prisons.

Ultimately, the best way to address this tragedy is by eliminating the unnecessary incarceration of people with serious mental illness who need treatment and services, not punishment.  There is currently legislation pending in Congress that could help.   The Comprehensive Justice and Mental Health Collaboration Act (S. 933 in the Senate, HR 1854 in the House of Representatives) would provide resources to communities and states for law enforcement and correctional training, jail diversion and community reentry programs.  You can advocate for passage of this important legislation by taking action on

NAMI is also engaged in a new project called Stepping Up with the Council of State Government’s Justice Center, the National Association of Counties, the American Psychiatric Foundation, the Major Sheriff’s Association and other law enforcement and mental health organizations.  The goal of the Stepping Up initiative is to reduce the incarceration of people with serious mental illness in jails throughout the U.S.

The “Cruel and Unusual” report is a vivid and disturbing expose of how shamefully we have neglected people with serious mental illness in the U.S. We would never tolerate such neglect of people with heart disease, cancer, diabetes, or Alzheimer’s Disease.  It is time to stop this shameful mistreatment and respond to people with mental illness with respect and compassion.

Ron Honberg, J.D. serves as the National Director of Policy and Legal Affairs at NAMI, the National Alliance on Mental Illness. Mr. Honberg oversees NAMI’s federal advocacy agenda and NAMI’s work on legal and criminal justice issues. Follow Ron Honberg @NAMIPolicyWonk.

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