Free Writing Exercise with student considering housing and mental health policies

 In almost every class I have taken in the social work department, a topic that has come up has been homelessness and mental health. The idea of homelessness still baffles me and raises so many questions. I think the problem with homelessness in the United States is that it is a multi-faceted problem. There is not one issue that we can pinpoint as the source of the problem. There are so many different factors that go into homelessness. The one factor that I feel we really need to hone in on is mental health. The mental health crisis in America has and will continue to be an issue unless we actually work to create and reform a good mental health care system in our country. Too often, people do not get the help that they need, and they end up on the street. The documentary we watched titled Bedlam was a great representation of the connection between mental health and homelessness. I do not remember exactly what the statistic is for people who are homeless and also suffering from a mental illness, but I know that number is way too high. Instead of putting those who suffer from mental illness on the street to fend for themselves, they should be receiving supportive care to help them live a normal life. 

Because persons with serious mental illness or substance use disorders tend to have a lot more difficulty getting out of homelessness, they tend to remain homeless for a longer time.  Thus, if someone is doing a point-in-time count of unhoused persons, and they are looking at people on the streets and in the emergency shelters, they will find most of the persons they see have mental illness problems and/or substance use problems.  However, if you look at al the people who come in contact with homeless services over a year, or you count unhoused persons including persons in transitional shelters and persons staying with friends or family in informal arrangements (sleeping on cots, couches, or in sleeping bags on the floor), you would find that a smaller fraction of those who experience homelessness in a year do so with a mental illness or substance use disorder. The census of persons suffering from homelessness in Springfield, Illinois typical counts about 25% of the persons as having a serious mental illness. Typically, the serious mental illness count is between 70 and 90, and the total count is around 320 to 350. You have to remember that this is a point-in-time count, so it will overrepresent persons who experience chronic homelessness, which means it is over-representing persons with serious mental illness.

I think most people accept that we may have frictional homelessness, where an individual or family is evicted, hasn't a friend or family member with whom they can stay, and so they must use an emergency shelter.  However, without a serious addiction or mental illness, most of these people can, with support and help from case workers, social workers, employment services, and housing services, be back in an apartment within a month or two, and then be paying the rent for their apartment with money they earn (or at least paying a substantial share of their monthly rent with their own money) within a few more months. So, if we have a certain number of unhoused persons in our community, but the case records show that everyone who shows up in an emergency shelter is housed within eight weeks, then I think that would be a situation that we would call a “functional end of homelessness” and an end of chronic homelessness. 

I think the documentary Bedlam showed that there are not a sufficient supply of mental health professionals, mental health day clinics, mental health oriented supportive housing, or residential facilities catering to persons with serious mental illness. The documentary also showed there is an insufficient supply of affordable or subsidized studio apartments where persons suffering from chronic health and mental health problems could stay, whether they are able to pay the rent or not. 

Another problem with homeless people who have psychiatric problems is incarceration. Too often, those experiencing a mental health crisis will be thrown into a prison without getting the adequate help they need to improve their mental situation. They are not given proper care and their behavior does not change because of this. Putting a mentally ill person in prison instead of a mental hospital is only hurting them. I feel like the culture and taboo around the idea of mental health is improving, but only for certain diagnosis’. For example, I feel as if the discussion around depression and anxiety has been more normalized, but the “heavier” diagnosis’ such as BPD and schizophrenia still have an overwhelmingly negative stigma around them. In reality, people living with these kinds of psychiatric disorders are the ones who need the most support in our world. I cannot imagine how truly terrifying it must be to live in a delusional reality that is not real to anyone besides yourself. That must be the most isolating feeling someone can experience. 

In a given year, maybe 6% of people will have some serious symptoms of a depressive disorder, and maybe 10% will be dealing with an addiction.  If we include the immediate families of all these people, I'm sure we're looking at about a quarter of the population either experiencing depression or addiction directly or through a close family member or intimate friend. That's about 85 million Americans with experiences with those sorts of problems.  With psychotic disorders, we might have 0.3% to 0.4% experiencing schizophrenia or something related to it, and maybe 1% of the population lives with someone suffering from such a disorder.  So, that's about 4 to 5 million Americans either living with a psychotic disorder or having a close family member or intimate friend who is dealing with a psychotic disorder. 

We have room in our prisons and jails for a couple million incarcerated persons.  There are about a million persons with psychotic disorders.  With medication and family and public support, probably 600,000 to 700,000 of those persons with psychotic disorders can live fairly independently and have nearly normal lives, with friends and family visiting them.  They may need to live modestly, as most of them will not be able to hold employment, but they won’t need to live in a state hospital or a locked mental health facility, and they certainly would not need to be incarcerated. However, I think about 400,000 to 300,000 persons with psychotic disorders probably are not responding well to medications, or they do not have social supports and families who have the time and money resources to take care of them. We certainly have not made it a priority to help these hundreds of thousands of persons get into safe and secure long-term living facilities where they would receive the support they need to live safely.  Tens of thousands of these people will end up incarcerated, and it seems to me that over half of them are living in desperation on the streets and in emergency shelters.

In an ideal world, we would have a mental healthcare system setup that is universal and effective. Everyone in the United States needs access to mental healthcare whether that is in person or online through telehealth. If we could provide services free of charge for everyone, I feel as if a lot of lives could be saved/improved. It also needs to be able to provide services such as everyday therapy to drug rehabilitation. Having a wide array of services means that the system would need to have all kinds of professionals on teams to work with people. I also feel as if we should do regular screenings for mental health and certain conditions and start these very early on in life. When intervention can happen early in life, the disease can be managed, and this will improve the person's life as they continue on into adulthood. We also need to be able to provide good hospital spaces and halfway houses for those who need more attention than others. Some people cannot live through their lives by themselves if they have a very serious diagnosis. We need to be able to provide safe spaces for people so they do not end up on the streets. The last place someone with schizophrenia should be is homeless on the street. Overall, I feel like the general attitude towards mental health and mental health crises needs to change. There are so many people who still do not really believe in mental health, my own father is included in this. To be able to move forward as a society and continue research, people need to have an open mind that mental health crises are very real and can be harmful if they are left untreated. While I do feel like we are making some progress, we still have a long way to go before we can formulate a good mental healthcare system that works for everyone, especially the most unfortunate of our population. 

I believe the costs of regular screening of everyone aged 18 to 30 for prodromal symptoms of schizophrenia and then providing intensive cognitive therapy to everyone who seems to be developing the prodromal symptoms would be expensive, but would prevent so many fully developed cases of schizophrenia that the net costs would be less than the current situation where we allow schizophrenia to develop, even though we have methods that can usually prevent it.  Likewise, we are clearly putting too little investment in the sort of psychological and social training that would prevent addictions.  And, obviously, we are not investing sufficiently in treatment for addictions and mental illness. A city such as Springfield with about 110,000 inhabitants ought to have fewer than 1,000 persons with schizophrenia (probably slightly fewer than 500 persons with schizophrenia). With about ten full-time caseworkers we could do a lot for the 200 to 300 of those persons who would need lots of supports and help with securing and maintaining themselves in safe and dignity-enhancing housing. Salaries and benefits and administrative support for about 10 full-time mental health professionals would be less than $1.5 million.  It seems to me that for every 100,000 persons in a county or city, the county boards or city councils out to budget about $2 million for local mental health services (to supplement state and federal and public health and private mental health care).  The expense of $2 million per 100,000 residents ought to just be a normal budget item for local governments, just like the expense of providing 2.4 sworn police officers for every 1000 residents, or a certain standard amount for libraries, fire protection, and public works. 

I also think local governments ought to create parastatal (private non-profit organizations that are governed by rules established by the elected government and with directors who are appointed by elected officials) housing development corporations that would work with planning and economic development offices at the city our county level to regularly increase the supply of social housing.  That is, the government ought to set up some non-profit housing corporations that build new housing or renovate and improve existing housing so that there is an ever-increasing supply of non-profit housing available in the local housing market. When bonds or mortgages are being paid off, as no profit is being taken, the rents in such housing would typically be 5% to 10% lower in cost than in the private sector.  Once mortgages or bonds are paid off, so that the only need for rent is to pay into escrow for maintaining the physical structures, paying for insurance, and paying property taxes, the costs of rent on such non-profit properties would drop to about 30% to 40% below private market rental rates.  Once 20% to 30% of rental housing in a community was being run by the non-profit housing corporation, private sector rents would also decline steeply because of competition for residents.  Even in Springfield, Illinois, where housing costs relative to median incomes are some of the most affordable in the nation, this sort of non-profit housing development corporation is needed so we can increase our supply of affordable housing by about 1,000 units.  In unaffordable places like the major cities of the west coast or the northeast, such housing development corporations are absolutely necessary, and it's shocking to me that allegedly progressive or liberal city administrations in those cities are not creating such entities or funding them sufficiently to have them significantly increase the supply of public housing.  There are models people could examine to see how this can work: Singapore, Hong Kong, Vienna, The Netherlands, Denmark, etc.  

Education Programs in U.S Prisons

 The current United States’ prison system has led to mass incarceration and a very high recidivism rate. Mass incarceration refers to the U.S having the highest incarceration rate in the world, and has led to a prison population growth of five hundred percent over thirty years. Including those in local jails, there are more than 1.9 million Americans incarcerated today. The United States also has one of the highest recidivism rates in the world. In a ten-year study done to measure re-arrest recidivism for persons released from state prisons, over eighty percent of people who had been incarcerated were arrested again before the end of the study. There is a saying often heard when talking about prisons that refers to prisons as schools for crime. With all of this in mind, the question of how to end mass incarceration and the high recidivism rate in the U.S must be answered, or at least we must be blaringly loud in asking this question of our elected officials. I believe that providing education and vocational training programs within prisons is an important and necessary (but not sufficient) good first step. 

Not only do I believe that educational programs in prisons would be beneficial from my own morals and worldview, but the statistics support this idea as well. Researchers have found that inmates who participate in educational programs while in prison have forty-three percent lower odds of being reincarcerated than those who did not participate in the education programs (Davis, et. al. 2013). The RAND study also found that education and vocational programs helped with employment for inmates after their release. Employment after release for those who participated in said programs was thirteen percent higher than those who did not. Inmates who participated in vocational training programs were twenty eight percent more likely to gain employment after release than those who did not have the vocational training (Davis, et. al. 2013).

 Not only has the research shown that education and vocational programs within prisons help to lower recidivism rates, but they’re also cost effective. Results from the largest meta-analysis of education programs in prisons showed that with “a one-dollar investment in prison education reduces incarceration costs by four to five dollars the first three years post-release” (Davis, et. al. 2013). Findings from this same study have also shown that the cost per inmate for education programs is about one thousand and six hundred dollars. Re-incarceration costs are about nine thousand dollars per inmate, showing another reason as to why education programs in prisons are cost effective. 

Education is something that everyone should have access to. Without proper education, the options for someone to make a successful living become smaller and narrower. Now add the burden of having a prison record on top of that and your options are depressingly limited. Without the opportunity for education, you have no opportunity for growth. As it has been said many times before, knowledge is power, and knowledge has the power to change someone’s life. I ask my readers to take the information given about how beneficial education and vocational programs in prisons can be and reflect on how this could improve both individual lives and society as a whole. Education and vocational training programs within prisons can help save money, reduce U.S recidivism rates and tackle mass incarceration, and open the doors to a new life for many people. The next time you are given the opportunity to vote on policies and laws relating to the criminal justice system, keep these things in mind. 

Reference 

Davis, L. (2013, August 22). Education and vocational training in prisons reduces recidivism, improves job outlook | Rand. https://www.rand.org/news/press/2013/08/22.html 

Prisons are not Adequate Providers of Mental Health Services

  I will always remember when I first learned about mental illness and the affects it has on the individual suffering with it. I was in the 7^th grade and was utterly fascinated to learn about the types of illnesses, but yet so saddened to hear about the treatment they receive. After learning I had friends and family members who suffered from mental health issues, I had a strong urge to become an advocate about emotional health. I try to keep myself educated on pressing issues which deal with mental health and treatment. Therefore, I was extremely upset to learn about the mentally ill being placed in prisons.

Prison is not a mental health facility, so the individuals who suffer with these problems do not belong there. According to Carolyn Zezima’s (2020) article titled “Incarcerated with Mental Illness”,  at least more than two million people with mental health issues are arrested yearly, and that many of the ill may stay in jail longer than someone who does not have a mental illness. “Roughly 9% of the population (more than 210,000 individuals) experiences serious mental illnesses including schizophrenia, bipolar disorder or major depression and fewer than 13% of these individuals receive care in the public mental health system” (Zezima, para. 4). This is extremely disheartening to learn about, especially since prisons seem to contain more people with poor emotional states than psychiatric facilities do. “Experts say jails and prisons have become the nation’s largest psychiatric facilities” (Zezima, para. 1). Furthermore, the problem with the mentally ill being incarcerated deals with treatments. These individuals either receive poor treatment, or no treatment at all. 

I remember reading an article in a social problems class I took at the college I transferred from, and this article described about penitentiaries using solitary confinement as a punishment. This is when they isolate the prisoners from others, and it is honestly horrible, especially for persons suffering from serious mentally illness. The way solitary confinement affects persons with mentally illness are very severe. According to Teddy Basham-Witherington’s article “Class Action Hero: Denied Mental Health Care, Patrice Makes a Stand for Human Rights”, Patrice Daniels was a mentally ill inmate, and he was placed in solitary confinement many times. Daniels discusses how he “feared his own mind” as his symptoms worsened, and even got charged for illegal contraband when he harmed himself (Basham-Washington, 2018). This honestly makes me really mad when I read about this because Daniels was crying for help, but the guards completely ignored him. Daniels’ illness continued to go untreated as he was constantly denied treatment by the Illinois Department of Corrections (Basham-Washington, 2018). Being denied treatment is wrong on numerous levels, and is honestly a violation of human rights. Therefore, the mentally ill do not belong in prisons.

Moreover, I feel that in order to address this problem is to advocate for the mentally ill. I feel that more people need to actually educate themselves on mental illness. There are people in this world that associate mental illness with being violent, and the shootings that have occurred in the past have not helped resolve this issue. This is why people need to get rid of that stigma and realize that not everyone who suffers from an emotional problem is “violent” or “crazy”. In addition, a huge number of the homeless population deal with poor mental states and go untreated. So, I believe that there needs to be better funding for mental health facilities and maybe better funding could grant easier access to treatment for these individuals.

References

Basham-Witherington, T. (2018, October 05). Class Action Hero: Denied Mental Health Care, 

     Patrice Makes A Stand for Human Rights. Retrieved September 29, 2020, from 

     https://www.impactfund.org/social-justice-blog/ patrice? 

     gclid=Cj0KCQjwk8b7BRCaARIsAARRTL4wmQTSWHcMrYU8shnpH7m

     Q3Gf_NUfNT1NyjxdmU77TR8nRFenljJcaAs5PEALw_wcB

Zezima Carolyn Zezima, C. (2020, August 12). Incarcerated with Mental Illness: How to Reduce 

     the Number of People with Mental Health Issues in Prison. Retrieved September 29, 2020, 

     from https://www.psycom.net/how-to-reduce-mental-illness-in-prisons

I find it a nightmarish wonder that we are still using solitary confinement with prisoners. The “skilled tormenters” of Illinois are still applying tortures that we have known do no good since the 1820s!

From my cousin George Ives’ book about penal methods written by him over 110 years ago:

...Thus the new torture was begun; but the “reformers” reached a deeper level of horror when in 1818 the legislature of Pennsylvania resolved to construct a penitentiary for enforcing solitary confinement without even work ! At another prison a trial of solitary confinement was made upon eighty convicts. In 1822 they were shut up for ten months each in a little cell 7 feet long by 3-1/2 feet broad, and were not allowed to leave it at any time or for any purpose. ...

...But the new torture, solitary confinement, was never meant to be applied that way, and never was by the skilled tormentors. In the experiments just glanced at, the zeal of the too ardent disciples of “discipline” defeated their object. Death and insanity were so wholesale and universal that no amount of figures and “philanthropy” could explain staring facts out of the way.... 

Student is disturbed by police brutality

 Police Brutality has been on my mind for quite a long time. Minority groups are being targeted the most when it comes to these issues, and yet America finds it as an issue within’ the group and not the police. After watching Frontline: Policing the Police 2020, 

I can’t stop thinking about how this really has been going on for a lifetime and not just as a 2020 thing. I knew discrimination existed towards the minority groups because it’s been going on everyday and even if it’s not being seen, it’s happening somewhere, whether it’s in America or another country, it’s happening. It got a lot more serious this year because of George Floyd, but no matter what, there is still no justice. 

Can we go back in time for a minute? I know this doesn’t have anything to do with police, but if we look at the Emmitt Till case, the two men who beat him, they didn’t get sentenced to life; they didn’t get charged; and yet later, we find out that the woman died? That’s injustice right there. [Carolyn Bryant Donham, who made a false accusation against Emmitt Till, did not die (she could still be alive, for all I know)]

If we look at Rodney King, he got beat by police officers and why? If we look at Oscar Grant, where is his justice? We have so many people in this world who deal with police brutality, and I honestly could name them, but it’ll take up my whole paper. I have a friend who died because of Police Brutality. His story didn’t make it worldwide, but my city was truly hurt when this occurred, living in Peoria, we would never think such a thing would happen and it did. 

I honestly didn’t know Newark, New Jersey was dealing with such a tremendous Police Brutality, and when something was finally going to be done to stop it, Donald Trump said “no.” He really said that Police Officers should not be careful when putting “criminals” in the car and then the people dressed in military clothes in the background clapping proudly. That is definitely not okay and if they think it’s okay, it’s because they’ll never know how it feels to be a minority in those types of situations. I know this is supposed to be Police Brutality, but I’m just expressing how I feel overall about these types of situations. 

I don’t think this will ever end just because our country is being led by a President who doesn’t really care about anyone, except for those that are on his level. The election is giving me hope that Joe Biden hopefully does find a way to stop these Police Brutalities, but if Trump wins again, there most likely won’t be any changes and it will end up getting worse. 

I have had conversations with friends and students in law enforcement, and family members who have been in law enforcement, and with criminologists who are friends.  I think that we are devoting a lot of resources to a system of justice and police and corrections that should be protecting us and making us safe, but it is not really doing this effectively or efficiently.  I am not sure that reforms will be able to solve the problem. I think my cousin George Ives addressed this well over a hundred years ago when he pointed to the fact that too few people really want to understand why crime occurs and then create systems to prevent crime.  Most people are happier to create and sustain a system devoted to finding persons who commit crime and then punishing them. This is a devastating decision, because we could save far more money and lives by putting more resources into preventing crime, rather than putting so much into the system we have now.  And yet, I do not know how we will make the transition. 

I agree with your perception that there is a widespread and deep problem of police and prosecutors being unfair. It is worth acknowledging that there are many good people in law enforcement who are well-intentioned and doing the best they can, but making that observation does not really help move us toward a solution to the problem at hand; that our overall policing and prosecution and corrections system is failing us. 

It is probably also just hair-splitting to point out that many abuses by police that are attributed to racism are probably more centrally caused by brutality and a general disregard for the rights of citizens in the police officers.  That is, many police may be just as likely, or perhaps even more likely, to kill white Americans than African-Americans. This is argued by some who say that there are far more police interactions with African-Americans, largely because police mainly interact with poor persons, and African-Americans have a higher poverty rate (18.8% compared to 9.1% for white Americans). I think this argument as been rebutted by Ulrich Schimmack and Rickard Carlsson’s analysis of fatal use of force against non-suicidal young men who are not mentally ill (lots of fatal use of force by police against white Americans involves police killing older guys who are suicidal or suffering from serious mental illness). They have confirmed that police officers are more likely to shoot younger Black men who are non-suicidal and not suffering from a mental illness. And yet, there are some serious debates about how much we can attribute police use of force to racism and how much we can attribute to the sort of bad policing and police brutality that we could all be subject to, regardless of our race. I know there are many studies where criminal attributes and crime attributes have been controlled, and these show that judges and juries and prosecutors all give out harsher sentences to Black Americans compared to white Americans. It is difficult to argue against those facts.  But, if we are facing two serious problems: widespread bad policing and widespread prejudices in law enforcement workers and prosecutors, then do we really need to argue much about which is worse or which problem needs to be addressed first?  Both problems are serious, and both need to be addressed immediately.

For psychological reasons, I do not think Donald Trump would have been interested in transforming our law-enforcement system.  His father instilled so much anger in him, that the retribution and punishment model of approaching the world seems highly central to his core values. Biden may be different, but I wonder at this ability, or the ability of his Vice President, to bring together an alliance of criminologists, law enforcement professionals, mayors, and leadership in the Department of Justice to give us the revolution in our approach to crime that could significantly improve the situation.  I fear we are stuck with incremental reforms that are unlikely to make substantial changes.