Are Massachusetts Prisons Becoming the New Asylums?

Prisons are designed to keep those convicted of a crime locked within secure walls—not to take the place of mental-health facilities. But over the past decade, that’s exactly what has happened. Some experts point the finger at finances; others at the closure of mental hospitals in the state. In any case, almost 25 percent of Massachusetts state prisoners are now classified as “open mental health cases” by the Department of Correction (DOC).

While a recent study by The Wall Street Journal puts the Bay State in the middle of the pack, nationwide, the Massachusetts DOC paints a bleak picture. An eye-popping 2,502 of 10,218 state prisoners were diagnosed with some form of mental illness for which they were receiving treatment in 2012, according to a DOC study from that year. June Binney, the Criminal Justice Project Director of the National Alliance on Mental Illness of Massachusetts (NAMI Mass.), said in an email that she thought the numbers were even higher in 2013. “… [The] extent to which we tolerate the criminalization of people with mental illness is shameful,” she said.

Both Binney and attorney Robert Fleischner, of the Northampton Center for Public Representation, pointed out that Massachusetts is spending money after the fact rather than before people get to prison. On average, it costs $46,000 for a state prison bed but even more to house the mentally ill, they said, due to costs of mental health services. “Some people are arrested for things that might not happen if there were appropriate services,” Fleischner said. He noted that many state agencies, like the Department of Mental Health, have taken a hit, and community-health services for the mentally ill have gone unfunded in these times of tighter budgets.

Another factor that has added to the uptick in the mentally ill behind bars is poverty itself, and what Binney called “… the transient lifestyles of many people with serious mental illness, which bring them into contact with the police.” In 2012, of the 2,502 Massachusetts prisoners with mental-health issues, more than 825 had what are classified as serious mental illnesses such as psychosis or other diseases incurring severe breaks with reality. A report by NAMI Mass., co-funded with the Association for Behavioral Health, found that people suffering from mental illness are at a greater risk of arrest than the general population, and that “arrest and detention have become an alternative to mental health treatment.” Plus state prisoners with any diagnosis of mental illness average a sentence 12 months longer than other lawbreakers.

Unfortunately, a quick fix to this problem is unlikely, but some organizations and lawmakers are trying to make changes. This month, NAMI Mass. is initiating “A Crisis Intervention and Diversion Project” to train police officers in 351 towns across the state in issues regarding mental illness. NAMI Mass. is also working with the judiciary to seek money to expand mental-health courts. Binney said diverting the mentally ill to such courts is another way to assure they will get treatment without doing time.

On the legislative side, Newton Rep. Ruth Balser has a bill in the chute that seeks to make permanent the changes enacted after a lawsuit was brought against the DOC as a result of suicides in our prisons. Settled in 2012, it required statewide, systemic reforms during a three-year period to change the confinement of prisoners with serious mental illness. Fleishner, who was part of a team representing the plaintiff, is monitoring implementation of the reforms. He said what has improved substantially is that, instead of sending people with mental illness to segregation when they act out, there are specialized units in place at two prisons as well as a mental-health classification system. If Balser’s bill becomes law, it assures these changes don’t disappear in 2015.

But maybe the best solution is to make it a priority to fund programs that treat the mentally ill before they commit crimes—and add to an expensive prison system that’s already bursting at the seams.