A new mental health jail vs. community mental health treatment

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Excerpt from the piece by psychiatrist Dr. Terry Kupers, Equitas National Advisor.

The problems with mistreatment of inmates with mental illness at Los Angeles County Jail, and the decision by the Board of Supervisors that Men’s Central Jail must be demolished, present Los Angeles with an important choice between two different approaches.

One is to build a large “mental health jail.” The other is to “divert” a significant proportion of individuals with serious mental illness away from jail and into closely supervised community treatment and rehabilitation programs.

The emphasis on rules and punishments in jail is contrary to what is needed to create a treatment milieu for individuals with mental illness.  Consider a patient who is so depressed that he does not want to leave his cell to participate in treatment or recreational programs.  If a depressed or psychotic jail prisoner remains in his single cell for a long time –isolation and inactivity that will almost certainly worsen the mental illness – officers leave him be, figuring that is best for the smooth-running of the jail.  In community treatment facilities, if a patient opts to stay in her room, a member of the staff will try to persuade her to come out of her room and join in the activities.  The difference is enormous.  Self-imposed isolation is a troublesome symptom of depression and psychosis.  The individual with serious mental illness who stays in his jail cell will not benefit from treatment while the patient in the community program will benefit maximally.

A plan to build a new “mental health jail” is doomed to failure, while enhancing resources for treatment in the community promises better treatment outcomes and lowered recidivism.

Terry A. Kupers, M.D., M.S.P. is a  Professor at the The Wright Institute. He is the author of Solitary: The Untold Story of Supermax Isolation and How We Can Abolish It (Univ. of California Press, 2017)

From The Daily News.

Read the full article here.

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