By Clara Miller
What is always perplexing to me is the inability of our country to treat mental illness as an illness rather than as a personality shortcoming. Historically, we have viewed those struggling with mental illness as a secret to keep buried, rather than an illness to treat. While some federal and state administrations have tried to enact sensible legislation to help people with the illness, most have fallen woefully short.
In 1963, weeks before his assassination, President John F. Kennedy signed the Community Mental Health Act. That legislation’s purpose was to build treatment centers throughout the United States with a goal of treating citizens with a mental illness while they continued to work and live at home. Unfortunately with the death of JFK, the funding needed for the initiative to be successful was never fully realized and the treatment of mental health was again put on a shelf in Washington. In 1981, President Reagan signed the Omnibus Budget Reconciliation Act, which established block grants for the states to provide mental health care, but further cut federal spending by 30 percent, thus creating another decrease in funding for mental health. In the aftermath of the 2008 recession, states were again forced to cut over 4 billion in public health funding and mental health was seen as a second tiered funding priority, so again, mental health treatment funding was cut when state budgets became strained. Since mental illness is not viewed in the same way as other illnesses, many insurance plans either do not cover mental illness treatments or cap the expenditures to make treatment difficult to afford for most American families.
With such large cuts in funding by federal and state governments, prisons and nursing homes have become a means of warehousing the mentally ill, especially those from lower income families that do not have adequate insurance for long-term treatment options. Most prison systems do not have an adequate treatment program and in some cases, no treatment program at all. According to the Bureau of Justice Statistics from 2006, individuals with mental health needs make up a large proportion of the prison population. An estimated 56% of state prisoners, 45% of federal prisoners, and 64% of jail inmates have mental health problems. Not only do prisons or jails offer little in the way of treatment options, they often turn to the use of solitary confinement for the mentally ill inmates, claiming it is necessary to curb violence in their institution. Lack of funding for treatment and the use of solitary confinement in prisons is counter-intuitive to what should be the goals of our democracy.
Mental illness, left untreated, is associated with high recidivism rates as well as increased rates of disciplinary actions in prison. By not treating the illness itself, we will continue to strain the prison and judicial system at a cost that is higher than treatment, especially long term. Wouldn’t it be wiser to fund treatment which will eventually create a productive and safe citizen rather than a person that will be in and out of prison for his or her entire life? Not only would it be wiser, it would be the most cost effective as treatment could and should reduce the prison population, make it easier for law enforcement to do their jobs and do more to create a productive tax-paying citizen.
It is time for Americans to see mental illness as the disease it is and fund treatment options to help our fellow Americans. We can pay it now, or pay more later.