CRIMINAL TREATMENT
Ivins, Molly
CRIMINAL TREATMENT The jails become holding tanks for the mentally ill BY JACK WAX When Francis Carol Doerr Cardinal was picked up by the police, she was wearing a one-piece purple swimsuit and...
...City and county jails, in fact, are becoming the poor man's—and woman's—mental-health center...
...To one of the guards, she called, "You're the first man ever to make love to me...
...When conditions of a county jail amount to punishment of a pretrial detainee," says her lawyer, Lawrence Altman of St...
...County, court, and jail officials meet periodically with mental-health officials...
...It took the prosecutor only a few days to dispose of the case...
...Because jail officials couldn't get her to cooperate, they put her in restraints...
...I just got me a nut...
...Cardinale was obviously in need of psychiatric care...
...People want anyone who is a troublemaker, and that includes the mentally ill, out of the way," she says...
...They're just finding their way into jails and prisons...
...Holcomb's study demonstrates that in Missouri, the mentally ill are seventeen times more likely to be arrested than other people...
...There's an obligation for state and local authorities to provide care for the mentally ill that they find within their facilities," Koren continues...
...When her jailers gave her water to drink, she threw it on herself to cool the imaginary burn...
...Officials at the Dade County Jail told The Miami Herald that about 30 per cent of the 1,400 inmates receive psychotropic medication—drugs used to calm the severely disturbed...
...Throughout the country, the number of mentally ill people behind bars is increasing, and there's no sign that the trend is turning around, according to Carol Shapiro, executive director of the National Coalition for Jail Reform...
...But, while some jails provide more care than others, keeping the mentally ill out of jail is better than treating them there...
...It doesn't take much to land them in jail...
...They should be treated, not punished...
...They need to be getting help...
...She had a history of chronic mental illness and recent bouts with psychosis...
...Francis Cardinale will have her day in court in November...
...Patients who faced lifelong struggles against their illness were steered out of institutions...
...Koren of the ACLU puts it this way: "The problems have shifted from the mental-health sector to the criminal-justice sector...
...Case after case talks about this...
...With suicidal inmates, anything that can possibly harm them is taken away...
...Some communities are attempting to cope...
...He was jailed six months for hawking a handsaw...
...When a guard discovered him with Cardinale, he said, "You're too late...
...She babbled about being able to see through crystals and pearls...
...Stone, jail supervisor, estimates that 10 to 15 per cent of the inmates show some signs of having emotional problems, though he says few are extremely disturbed...
...It's not a crisis situation in the eyes of the typical jail administrator," says Hardy Rauch, who directs the correctional standards program of the American Correctional Association...
...Confused, frightened, and sometimes belligerent, many don't even know why they have been arrested...
...I think that's part of an Eighth Amendment claim that one could make about most jails in the United States," he says...
...City and county jails have always had their share of them...
...The exact number of mentally ill inmates isn't known, but estimates and research on several of the nation's 3,338 jails indicate a serious problem...
...New community-based programs would take care of them...
...In Columbia and elsewhere, coalitions have been formed to untangle this problem at the local level...
...While Francis Cardinale was in the Boone County Jail, she told another inmate she thought she was in a basement, locked up...
...Forced into a leather waistband with loops that held her hands down, she was taken to a cell wrapped in a blanket...
...They don't need to be in jail," he says...
...In the 1960s, the push was on to move chronic mentally ill patients out of state hospitals and into the community: "Deinstitutionalization," it was called...
...Los Angeles also has a mental-health center within a jail...
...They may also commit suicide just because they're disoriented when locked up in a cell by themselves...
...Some jails offer therapy behind bars...
...CRIMINAL TREATMENT The jails become holding tanks for the mentally ill BY JACK WAX When Francis Carol Doerr Cardinal was picked up by the police, she was wearing a one-piece purple swimsuit and a pink shirt...
...If she wins her case against Boone County, she could be awarded $1 million in damages...
...She shouted, "Men are on top of me," and "You're killing my baby...
...She told one inmate the suit was cutting her and that the fluorescent lights were burning her body...
...Naked and temporarily safe, they are, says Stone, kept under close observation...
...But the programs, for the most part, never got off the ground...
...Cardinale was thirty-six years old, and she was having a tough day...
...Cardinale is not the first mentally ill person to be jailed...
...In Baltimore City Jail, mentally ill inmates are treated on-site...
...Officials at Cook County Jail told the Chicago Tribune that on any given day, 500 to 700 of the 4,600 inmates need some type of mental-health care...
...Clothes and mattresses are stripped from their cells...
...More than twenty years after the exodus from the state hospitals began, the number-one goal of the National Association of State Mental Health Directors is to improve community services for the chronic mentally ill...
...A therapeutic community—a sort of mental-health center within a jail—has been formed...
...Treating the mentally ill is not a strong point of jails, and those in isolated rural areas, where the nearest psychiatrist might be seventy-five miles away, are not alone in this weakness...
...When people who have a chronic mental illness are on the streets," says Bill Holcomb, "they are always at high risk of being arrested...
...The Boone County Jail is less than five miles from a community mental-health center...
...It's totally inappropriate for these people to be housed there...
...At the Boone County Jail where Francis Cardinale was sexually assaulted, Lieutenant O.J...
...Several months later, Buck was tried Jack Wax, a free-lance writer specializing in health issues, lives in Columbia, Missouri...
...Very often, mentally ill people are victimized in jail," says Shapiro...
...and convicted of first-degree sexual assault and sentenced to seven years in prison...
...In the meantime, Francis Cardinale was raped...
...Mental health is certainly a concern of the people who run jails, but it isn't the only one...
...Louis, "there is a violation of Fourteenth Amendment rights...
...Another of Holcomb's clients was arrested for trying to sell some of his parents' property...
...That was July 19, 1985...
...In most states, you must be imminently dangerous to yourself or others [to be treated against your will...
...In the holding cell, she kept taking off her swimsuit...
...They're looked upon as a nuisance...
...She was taken to the Boone County Jail in Columbia, Missouri, for possession of marijuana and was placed in protective custody...
...But Cardinale, who has sued Boone County, is still waiting for her day in court...
...But psychiatric help costs money, and mental-health programs are not a high priority of policy-makers...
...Before the center opened, mentally ill arrestees wound up in jail or hospital emergency rooms...
...But even then, her family will have no guarantee that she won't be arrested again and slapped in jail...
...With little money and less ability to deal with mentally ill inmates, jails have a difficult time coping with their problems...
...To have the mentally ill in jails and prisons isn't new," says Bill Holcomb, a psychologist at Mid-Missouri Mental Health Center who recently did a study for the National Institute of Mental Health on the criminal records of mentally ill people...
...Police can take individuals whose behavior is bizarre or dangerous to a thirty-six-bed psychiatric emergency center for evaluation or treatment...
...Researchers call the new trend of jailing the disturbed "the criminalization of mental illness...
...It seemed like a good idea...
...She had to wait three days to get it...
...ACA standards require jails to arrange for emergency care with hospitals, Rauch says, but the standards are voluntary unless a court mandates their observance...
...So there are more people on the street who can't take care of themselves but can't be involuntarily treated...
...Once behind bars, the mentally ill become the responsibility of the jail that holds them...
...He was arrested for trespassing...
...It, or a nearby state hospital, sometimes accepts inmates for evalution...
...Aside from deinstitutionalization, changes in commitment laws have also helped to load the jails with emotionally disturbed prisoners...
...Civil commitment laws have become very restrictive," Holcomb says...
...And mental-health workers at the San Luis Obispo County Jail in California reported, in the Journal of Offender Counseling, that 6 to 15 per cent of the inmates on any given day are obviously psychotic—out of touch with reality and possibly hallucinating...
...Told to leave and not come back, he returned the next day and banged a quarter on the counter...
...On the outskirts of Philadelphia, Montgomery County Emergency Services links area police departments with mental-health services...
...The Eighth Amendment prohibits cruel and unusual punishment...
...Instead of treatment, however, the swelling ranks of mentally ill inmates more often face neglect by jail officials and abuse by other prisoners...
...It's the same people...
...We provide an alternative to incarceration," says Naomi Dank, the program's executive director...
...When no treatment is available, the mentally ill in jails like Boone County's face primitive conditions...
...Holcomb says he had one client who became loud in a bar...
...Later, when called on to testify, a guard recalled that Cardinale was combative, verbally aggressive, and incoherent while in the holding cell...
...We feel it's not appropriate for the mentally ill to be in jail...
...People are being arrested for minor offenses, and they can be detained in jail for a long time...
...Ralph Buck, the occupant of the next cell, bashed through the wall...
...But other times they are full...
...Jail inmates aren't getting the mental-health treatment they're entitled to, according to Ed Koren, director of the National Jail Project of the American Civil Liberties Union...
Vol. 51 • October 1987 • No. 10
