
The costly criminalisation of the mentally ill - qingu
http://www.economist.com/news/united-states/21582535-costly-criminalisation-mentally-ill-locked
======
phren0logy
I am an HN regular, and a forensic psychiatrist. Every day I work with
mentally ill people who have been charged with crimes. I don't have much to
add here except to say thanks for taking an interest.

The mentally ill and the incarcerated are two of the most deeply marginalized
groups in our society. It's nice that someone outside of our world is thinking
about them.

~~~
gruseom
Well, I wish you would add more. You'd surely have more of value and
experience to say than almost anybody here. But I hope that doesn't sound
demanding--I really appreciate your comment.

~~~
phren0logy
I'd be happy to say more, but probably the most important thing people can do
is read the article. Lack of adequate services for the mentally ill is a huge
issue. In the absence of services, they often end up behaving oddly enough for
someone to call the police, leading to arrest. More and more often we see
families who are relieved that their loved ones are arrested _just to get
access to treatment_.

That seems like a real shame, and often their needs are a bad fit for the
correctional system. I work in a forensic hospital, and most of our patients
come from jails. They often do not get very good care there. Private hospitals
are largely closing their psychiatric units, because they don't make money.
More and more, state or county funded hospitals and clinics are the last stop,
and those (as mentioned in the article) are popular targets for defunding when
the budget gets rough. It's a bad situation.

At any rate, I'll check in again in the morning if anyone else has more
questions.

~~~
grahamburger
My aunt is in that situation. She is severely mentally ill and homeless. She
was in a shelter until a few months ago, no one has heard from her since. No
one else in the family can afford to get her treatment, and she wouldn't
comply even if we tried - she doesn't know she's mentally ill, she thinks her
delusions are reality. We would all be relieved if she landed in jail as long
as it came with some treatment. She is very intelligent, though, and she is
not using drugs or alcohol, so she may never get herself in enough trouble to
land in jail.

Committing people to treatment against their will sounds like a bad idea just
begging for abuse, but what else can we do? In what world could she actually
be taken care of? I don't know the answer.

~~~
phren0logy
Involuntary commitment is the reality for many people. Sometimes the delusions
recede enough that they recognize they are ill.

I would encourage you to look for a support group for family members.
Sometimes it helps to know other people are struggling with the same issues,
and see how they cope with those issues when there's not a solution.

------
auctiontheory
I see many comments here about developers upset about being treated as "just a
developer."

Well, if you want to be respected as more than "just a developer," you'll need
to understand more about the real world. Specifically people.

If that doesn't convince you, look at it this way: healthcare is a huge,
growing, and technologically behind-the-curve industry. It offers a huge
market for your services. Mental healthcare needs better solutions.

Also, I have met my share of severally mentally disturbed developers. So this
could be any of us we're talking about.

~~~
eshvk
Agreed. I don't mean to construct a strawman here. However, it surprises me
how this is not relevant. Code doesn't exist in vacuum. Ultimately, software
engineering is about applying yourself to solve real world problems. Including
mental health care. No one crawled out of the woodwork when 7 cups of tea
announced their product. Yet the opposition for this is surprising. How does
one understand and solve a problem like that unless one is aware of one's
society? An interesting problem requires discovery. That requires awareness of
the world.

------
ceautery
"...taking something without paying at Wholefoods Market; but when two
security guards came after her and she thought they were attacking her, she
fought back. This led to a felony charge for robbery."

I'm very curious about Melissa's case now. Shoplifting ain't felony robbery,
obviously, and over-aggressive security staff have been known to injure or
kill people[1][2], so "thought they were attacking her" is a legitimate
concern.

[1] - [http://azstarnet.com/news/local/crime/ex-guard-convicted-
sho...](http://azstarnet.com/news/local/crime/ex-guard-convicted-shot-
paralyzed-shoplift-suspect/article_194c01f7-2d05-5f64-ab89-f3eb506c408d.html)
[2] - [http://jezebel.com/5967072/woman-shot-dead-by-walmart-
securi...](http://jezebel.com/5967072/woman-shot-dead-by-walmart-security-
guard-on-suspicion-of-shoplifting)

------
droithomme
The article uses a woman as an example and gives her crimes as: "trespassing,
prostitution, drugs, disorderly conduct, petty theft, drinking in public".

The petty theft is later discussed as theft from a supermarket, probably of
some small food item.

As to the others, why should any of them be imprisonable offenses? Drinking in
public? Drugs? Prostitution?

Trespassing is not breaking and entering, which is reasonable as an
imprisonable offense. Shouldn't trespassing be an infraction with a modest
fine?

Back to that food item she took from Whole Foods. In a fabulously wealthy
nation, how is it that she has come to need to shoplift food to be able to
eat. Is that not a failure of the society as a whole?

The proposed answer in the article is to have them committed by some sort of
court order and place them indefinitely in a "secure nursing home" facility
with an ankle bracelet. That's likely to be more costly than prison since it
requires round the clock medical care, and is no better than a prison since
they are locked up.

I propose a better solution. Decriminalize all of these things, leave this
woman alone, and save the $719,436 it cost to imprison her for minor and non-
offenses.

The article also makes the claim, "If someone decides he wants to walk around
naked, or cannot give his name to a police officer, the likelihood is that he
will end up in jail." If police are arresting people without probable cause or
even reasonable suspicion, then it is the police that are acting illegally
here. You are not required to identify yourself to any police officer just
because he asks, and if he asks without reasonable suspicion or probable cause
(it depends on the state which one is the threshold), and you refuse to state
your name, then he can not arrest you for that sole reason. If he attempts to
do so, it is false arrest, and you have the right under the law, upheld by the
supreme court, to use any necessary force to resist illegal arrest.

Regarding walking around naked, that is permitted or tolerated in some areas
such as nude beaches. There are also issues where people ask why it is that it
is legal for men to go topless, yet is criminal for women to go topless?
Should not the law apply equally to both men and women? That is a reasonable
question and there is no answer that justifies this discrimination that is not
intrinsically sexist. Is that what we want? What is so wrong with even total
nudity? There is an old man in Barcelona who is well known for going about
completely naked, wearing only his tattoos, pierced foreskin and often a full
erection. The police do not bother him.

[http://chrisrako.blogspot.com/2007/05/naked-man-of-
barcelona...](http://chrisrako.blogspot.com/2007/05/naked-man-of-
barcelona.html)

Has Spanish society collapsed as a result? Is it obvious he should be in
prison as The Economist advocates as common sense?

Or consider the Jainists, many of who walk about India naked because of their
religious beliefs. Are they criminals as well?

[http://s781.photobucket.com/albums/yy95/phuongvien_bucket/Do...](http://s781.photobucket.com/albums/yy95/phuongvien_bucket/Doc1.jpg)

I propose that public nudity and refusing to give your name to police when
they have no cause to ask it are both fundamental rights of man and that any
society which denies these rights is tyrannical and any person who denies
these rights is an enemy of humanity.

~~~
smtddr
_> I propose that public nudity and refusing to give your name to police when
they have no cause to ask it are both fundamental rights of man and that any
society which denies these rights is tyrannical and any person who denies
these rights is an enemy of humanity._

Whoa, whoa, whoa.... whoa. I like to think of myself as open-minded but I'm
not ready for that just yet. That being said, San Francisco apparently has no
punishment for being nude in public and yet I've only seen nudity in public
twice in the 6 years of having a full-time job there. So maybe it should be
removed from the law and most people will continue to cover-up out of personal
modesty.

~~~
flumbaps
Honestly, I think if public nudity was common, no-one would care about it.
When you go to the beach and see people in swimming costumes, there isn't
really much left to the imagination. You can already pretty much figure out
what they look like naked, but no-one cares, we're all used to it. Society
just places a weird importance on nipples and genitals. But just women's
nipples. Even though men's nipples kind of look the same anyway. You could
take a swimsuit catalogue and cut the nipples off the men and glue them onto
the women and turn it into porn.

If you think about it, we're just animals. It's really crazy that we can't
just walk around in our natural state freely because we tend to feel really
weird about looking at other members of our own species.

What if I've got it backwards and other animals are just as prudish? When a
dog is barking at another dog, maybe he's really saying, "hey, check out this
weirdo - he's naked! Get the hell out of here, you pervert!"

~~~
sunglasses
"swimming costumes"... are you British? :)

But yes, this apprehension of nudity is something I've always found so
bizarre. Why is seeing skin of our species such a big deal? At what point of
our social evolution did it evolve that way (because the idea of clothing is
pretty universal to humans).

~~~
Symmetry
The idea of clothing isn't quite universal, but nearly so. Still, we're
something of an outlier in how serious our nudity taboo is. As far as I can
tell most cultures are ok with women going around topless and most think that
it's ok for men and women to see each other naked when bathing, though I guess
Hollywood is changing that.

------
Roboprog
I was on vacation last week, went to the Puget Sound area in Washington.
Downtown Seattle has the usual homeless people wandering around like most
cities in the U.S.. We went to Victoria BC in Canada one afternoon. No
homeless beggars threatening the pedestrians. Crazy Canadians and their
healthcare system, getting the mentally ill off the streets.

~~~
refurb
So you're comparing a major US city of 3.4M people (greater Seattle area) to a
small Canadian city of 344K (greater Victoria area)?

I've lived in several major Canadian cities during my lifetime and the
homeless problem is huge, particularly in Vancouver. Universal healthcare
doesn't do much if the person refuses treatment.

------
emiliobumachar
"SINCE 1994 Tracey Aldridge has been arrested 100 times, jailed 27 times for
more than 1,000 days and spent a total of eight years in prison."

The math does not add up. There were not 27000 days since 1994. Did I
misinterpret something?

~~~
wtracy
I assume that means 1000 days total, not 1000 days per incarceration.

------
DanBC
The article doesn't mention the diagnosis of "Personality disorder". This is a
difficult and controversial diagnosis, but it's important for this kind of
article.

We'll hear about people who don't take their meds (this thread has such
comments) but these people aren't the main problem. People with a probable
diagnosis of PD are the problem.

Some numbers from the mostly rural UK county of Gloucestershire:

Population is roughly 800,000 people. There are about 4,500 people on the
books of specialist MH services at any time. There are about 2,000 people with
a probably psychotic illness. There are about 2,500 people with a probably
mood disorder. There are between 20,000 and 30,000 people with a probable
personality disorder.

Looking at the psychotic and mood disorders, and putting it very simply, you
hospitalise for a short time while you stabilise the illness and sort out the
meds. Then you release the patient back to the community with intense support
from community workers (daily, weekly, monthly visits). You give an easy route
back into services when these people need it. You also provide vocational
support - help people back into work and to integrate back into society.

Now look at what happens to people with a personality disorder. There's no
real treatment. This used to mean they were specifically excluded from
treatment - turned away from specialist MH services. That doesn't happen
anymore, but there's not much that can be done. And behaviours are often much
closer to "bad" than "mad", and so criminal justice is involved a lot more
than MH services.

Here's a harrowing Grauniad article
([http://www.theguardian.com/society/2008/mar/30/prisonsandpro...](http://www.theguardian.com/society/2008/mar/30/prisonsandprobation.mentalhealth))
(contains description of self harm and suicidal behaviour)

> _On the day Diane Kent set herself on fire in her cell at Low Newton prison,
> County Durham, two months ago, she had already tried to hang herself twice
> and asked a prison officer to take away her lighter because she was scared
> of harming herself. According to incomplete prison records, her request was
> refused._

This woman's burns were so severe she was kept in a medically induced coma for
5 weeks.

Women who attempt suicide by arson are sometimes put in prison
([http://www.oxfordmail.co.uk/news/8389188.Woman_locked_up_for...](http://www.oxfordmail.co.uk/news/8389188.Woman_locked_up_for_arson_suicide_attempts/))
for endangering life.

Here's another example, again traumatic reading.
([http://www.theguardian.com/society/2008/feb/03/prisonsandpro...](http://www.theguardian.com/society/2008/feb/03/prisonsandprobation.mentalhealth))

And this is in the UK where we have much better services than the US. God only
knows what it's like over there.

------
ZeroGravitas
How about all reporting of sentences including a) the cost of the trial, and
b) the cost of the sentence?

------
WestCoastJustin
Great example of something that does not belong here. A social political issue
with absolutely _zero_ to do with tech or hacker news! Why is this getting
upvotes?

~~~
gruseom
I believe you're wrong here. HN is not just about tech. It has always had room
for substantive articles about anything interesting. Is this article
substantive? I'd say it's surprisingly so, for such a short piece. It contains
a mix of anecdote, data, and history. I learned three or four things I didn't
know, and I've read occasional stuff on this issue in the past.

The graph alone is worth the visit.

~~~
yareally
Economist is also a quality news source. I'd rather have articles from the
Economist make the front page over sensationalist/uninformed tech articles
from The Register or similar sites that lack substance.

