Severe Mental Illness and the Death Penalty

In Dee Hibbert-Jones & Nomi Talisman’s film, Last Day of Freedom, Manny Babbitt’s childhood traumatic brain injury goes untreated, and when he returns from the war in Vietnam with his poor mental health severely exacerbated, he continues to go untreated, is left to fend for himself, and kills a 78 year old woman. After a lifetime of distress, in an acute state of distress, Manny commits a terrible crime, and his fate is sealed along with his victim’s. He is sentenced to death and executed by the State of California by lethal injection. The film’s heartrending atmosphere of tragic inevitability stems from its depiction of the well-trodden pathway that leads from untreated mental illness to criminalization in America.

The Equitas Foundation works nationally on the intersection of mental and behavioral health and the criminal justice system, with the aims of 1) supporting access to treatment and improved mental and behavioral health outcomes, 2) reducing incarceration, and 3) increasing public safety and prosperity. We are pleased to be supporting this week’s National Summit on Severe Mental Illness and the Death Penalty at Georgetown University in Washington, D.C. As states and as a nation, we need to identify people with mental and behavioral health vulnerabilities as early as possible and provide immediate access to appropriate care—not neglect people at every stage and then punish and execute them when their behavior becomes a threat to public safety and claims victims.

Putting aside the moral issues associated with state-directed killing, the death penalty in America has been declining in popular support since 1971, in part due to the public’s increased awareness of the fallibility of the process, and the outsized cost of the death penalty in the US each year—far above that of lifetime imprisonment without the possibility of parole. Executions have also largely dropped off due to litigation, cost, and international pressure that has resulted in diminishing supplies of lethal injection drugs.

In their new book, Courting Death: the Supreme Court and Capital Punishment, Carol and Jordan Steiker argue that capital punishment is unconstitutional in its capricious and unjust application. Use of the death penalty is racially biased and is disproportionately applied to people with severe mental illnesses. One 10-year study in Philadelphia found that African American defendants were 3.9 times more likely to receive the death penalty than other similarly situated defendants. All death row inmates surveyed in another study had experienced adverse childhood experiences, which are also profoundly predictive of early death, future mental illness, and lifetime onset of numerous other conditions and maladies. According to Mental Health America, at least 20% of inmates on death row have a serious mental illness.

Treatment for mental illnesses, especially at an early age or upon initial acute onset, is very effective…which underscores the tragic systems failure of criminalizing and killing the mentally ill. Children with disruptive tendencies or mental illnesses who receive special attention show the capacity to recover from childhood traumas before they are locked into an unhealthy path. Reductions in violence and criminality have even been linked to treatments like cognitive behavioral therapy and other trauma-informed interventions for incarcerated adult populations. Sadly, Americans affected by severe mental illnesses have borne the brunt of the failures of our communities to address their needs as vulnerable populations from a young age.

The poor are twice as likely to live with mental illness. Poverty, compounded with factors like homelessness (30% of homeless Americans have severe mental illness), substance use disorders (people with mental illnesses are more likely to use drugs), and lack of access to treatment (only about 50% of people with severe mental illnesses receive treatment) puts this population and the general public at risk. According to the Treatment Advocacy Center, 7% of homicides, 20% of law enforcement officer fatalities, and up to 50% of mass homicides are associated with untreated severe mental illness.

Not enough was done to prevent the colossal tragedy of Manny Babbitt’s untreated illness, terrible crime, and state-directed extermination. We the People of the U.S. are guilty on each count. Interventions should have been made available sooner.  We have lulled ourselves into complacency with the word “system”—and weakly struggle to reform our educational, health care, and criminal justice “systems”–but these “systems” that we have, evaluated in terms of their effectiveness in providing support for the most vulnerable, might reasonably be mistaken for systems designed to produce negative outcomes for those who’ve experienced trauma and to punish people harshly for behaviors that can be predicted and prevented.  The state exists to promote the general welfare and facilitate progress toward more perfect union, not to neglect, fail, and execute its most vulnerable citizens, especially those experiencing mental illness. The United States has banned the execution of vulnerable populations like children and the developmentally disabled. The time has come for us to spare those with severe mental illnesses from this cruel and unusual punishment.

On December 6 and 7, Equitas Foundation, in collaboration with the American Bar Association Death Penalty Due Process Review Project and Georgetown University Prisons and Justice Initiative, will convene experts and advocates from across the country at Georgetown University in Washington, D.C., to accelerate the achievement of severe mental illness exemption from the death penalty, state by state.  Visit our webpage on this event.

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