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Student Poster Presentations Mental Health Systems in Criminal Justice Spring 2014 – Dr. Gene Bonham, Jr., Professor • Each spring, this class participates in a three-pronged project in which they research a topic related to the criminalization of the mentally ill and the response of the criminal justice system. They write a paper on their topic, present a PowerPoint presentation sharing what they learn with the class, and present a poster presentation. In past years, the posters have been presented in person at symposiums and conferences. This year, the class is doing an electronic presentation. Please take a look at the variety and scope of topics presented. Also note the names of the students participating this year. They all deserve a pat on the back for a job well done! Background of Poster Presentations Asylums and Prisons: One in the Same Alexis Barbosa The University of Central Missouri Introduction Since the beginning of time, there have been criminals and there have been people with mental illness. They have been dealt with the same way throughout most of history: death, outcast, incarcerated and rehabilitated. The only difference that these two share is the name of the facility in which they are housed. The terms asylum, mental institution, and mental hospital can be used interchangeably. All of these terms are important and hold the same amount of value in their varying definitions. In a summary, all definitions mean that it is a building structure where people go for treatment of their mental illness. The history and structure of the mental institutions, as well as the different programs that are offered and the different types of people who live in these places will be examined. Prisons will also be explored in this context and then there will be a comparison of the two places. Finally, this will cover how the two establishments need to work together to better the offenders’ needs. Working Together Those who have mental illnesses and were in facilities designated for their illness were forced out onto the streets when they closed down due to funding shifting. Since the patients were homeless and had no one to care for them, they would forget or deliberately not take their medication. When they did not take their medication, their symptoms became worse and the only solution in their mind was to do whatever was possible to survive. If this meant fighting the “dragon” in the middle of the street with a sword, they would. Or if they needed other non-prescription medication, they would find it and take it. Due to these actions, the patient would then be arrested by the cops and sent to prison for their crime. They would then be released from the prison and would start the cycle all over again (Slate, Buffington-Vollum & Johnson, 2013). This cycle still holds true today even though there are mental health institutions that can help them. The patient now turned inmate does not belong in a prison setting where there is not enough staff to help them but also allow the inmate to serve the time for the crime that they committed. The two institutions need to work together to insure that the patient/inmate realizes the crime they committed and that it was wrong, but also be able to provide a safe place for the patient/inmate to get the help they need. This is a very fine line and can be crossed very easily if not properly prepared for a situation like this. It is important that both facilities take part in trainings and be prepared for a situation like this to occur. Perhaps, there can even be a facility that is created that will only take those who are mentally ill and commit a crime. Then only the staff members who are equipped with the knowledge and skill to handle these types of inmates are allowed around the patients/inmates. Mental Health Facilities Prisons • The oldest prison in America was in New Jersey and was opened in 1798. • In the 1960’s and 1970’s, the rehabilitation model was dominant and prisons were converted in to correctional institutions. • In the 1960’s, the civil right movement affected prisoners and especially inmates who were minorities. Prisoners began to demand their constitutional rights and have a more sensitive staff towards their needs. • In the past 30 years, there has been more African Americans and Hispanic inmates and more inmates have come from rural areas where there are drug-related and violent offenses. • Today, a typical cell is 8 by 6 feet and has just enough room to take a few steps until they are in front of their door. • A cell will have at least one bed in it, with a maximum of 3 beds in one cell, depending on population and funding. The beds are either free standing or they are bolted to the floor or wall. • The cell will also have a toilet and a sink for restroom usage. A window will also be provided so that the inmate(s) will have a view of outside the prison. Finally, the cells will typically, but not always, have a desk or a table of some sort in it. • The cells will be grouped off into blocks and there is a central hub for the guards to stand watch at. • There is three types of models that are predominate with incarceration: custodial, rehabilitation, and reintegration. • In the custodial model, it is assumed that prisoners have been incarcerated simply for the purpose of incapacitation, deterrence, or retribution. • The rehabilitation model focuses on rehabilitation and treatment of the prisoners. • The reintegration model recognizes that prisoners will eventually be released and that they need to reintegrate them into society before that release date. • In the Pre-Civilization ages, people thought that their behavior was due to evil spirits that inhabited their head. • The Ancient Civilization, Hippocrates was the first to identify conditions that are now known as mental illnesses, like phobias, anxiety, depression and mania. • The Middle Ages, the thought of those with mental illnesses reverted back to the thought that they were possessed with demonic sprits and must be cleansed to be healed. • Bethlem Royal Hospital (or Bedlam) in England was the first institution in the Western world that confined the “lunatics”. • Many of the patients were said to be tortured and in misery their whole stay at the hospital. • Eastern Lunatic Asylum in Williamsburg, Virginia was said to be the first psychiatric institution in America. • Their first patient was admitted on October 12 in 1773. • In the beginning, the hospital had 24 cells that had a door with a barred window that looked on a dim central passage, a mattress, a chamber pot, and an iron ring in the wall to which the patient's wrist or leg was attached. • The types of treatments that were available to the patients were strong drugs, plunge baths and other "shock" water treatment, bleeding, and blistering salves. • In 1885, an electrical fire broke out and destroyed the original building and 5 other buildings. • After this time, more asylums started to open in the United States. However, they begin to lose their narrow focus of housing only mentally ill patients who were said to be a danger and opened their doors to anyone who had a mental illness and even some who did not. • What funding is left for mental health facilities goes toward the psychiatric hospitals and acute inpatient facilities. • Mental facilities are designed with these certain aspects in mind: • The amount of space for the caretakers is minimal. • Visual supervision must be achieved at all times. • All spaces must be big enough to accommodate, but not be redundant. Similarities • Both prisons and inmates are allowed recreational and therapeutic time. • Both are housed in rooms (cells) that are only big enough to be livable in. • “Not In My Backyard” phenomenon is common with both facilities • The type of staff that works at both facilities can have a power struggle with the inmates/ patients. Conclusions In conclusion, asylums, mental health facilities, mental intuitions, etc. and prisons are similar in their setup and operation. They also tend to house the same type of people in their facilities. With the proper education and training, both facilities could be able to handle those special cases where the patient is also an inmate and where the inmate is also a patient. States should work harder to accommodate those who need the special help that they deserve. If every American is allowed life, liberty and pursuit of happiness, then those with mental illnesses deserve the same, even if they commit a crime that is not right. Those who are in prisons today are working for a better tomorrow and those who are mentally ill deserve the same respect. References •Campling, P., Davies, S., & Farquharson, G. (2004). From toxic institutions to therapeutic environments. The Royal College of Psychiatrists. •Carr, R. F. (2011, April 21). Psychiatric facility. Retrieved from http://www.wbdg.org/design/psychiatric.php •The Colonial Williamsburg Foundation. (2014). Public hospital: The colonial williamsburg official history & citizen site. Retrieved from http://www.history.org/almanack/places/hb/hbhos. cfm •Clear, T. R., Cole, G. F., & Resig, M. D. (2006). American corrections. (7th ed., pp. 242-262). Belmont, California: Thomas Wadsworth. •Grabianowski, Ed. "How Prisons Work" 24 January 2007. HowStuffWorks.com. <http://people.howstuffworks.com/prison.htm> 11 April 2014. •Slate, R., Buffington-Vollum, J., & Johnson, W. W. (2013). The criminalization of mental illness. (2 ed.). Durham, North Carolina: Carolina Academic Press. •Wilkinson, R. (1995). Revolutionizing Mental Health Care in Ohio Prisons. The Correctional Psychologist. The Mentally Ill and School Shootings Sarah Clark The University of Central Missouri Introduction How do the mentally ill and the criminal justice system correlate? Hypothesis: • When gaining insight into the correlation between these two topics people have to understand how prevalent mental illness is throughout society, instances of school shooting and the mentally ill, and possible solutions to the issue. Statistics 2013 had eighteen school shootings in high schools, colleges and middle schools across the nation. 26.2 percent of Americans ages 18 and older, about one in four adults, suffer from a diagnosable mental disorder in a given year School Shootings Why do school shootings occur? • Lack of societal care for mentally ill • Lack of the necessary medical care facilities • There is no where to place these individuals, other than correctional facilities. Characteristics and signs of these individuals • Emotional/ withdrawn • Falling behind in school • Show current extreme evidence of mental disorder • Previous history Instances • Seung- Hui Cho- 2007 Virginia Tech Shooting (left) • Adam Lanza- 2013 Sandy Hook Elementary shooting (right) There are 705,600 inmates in State prisons, 78,800 in Federal prisons, and 479,900 in local jails that have mental disorders. (percentages below) The Correctional System How the mentally ill are handled • Officers do not know how to deal with the mentally ill. • Do not fair well due to lack of help • Mentally ill end up in solitary confinement Conclusions Possible solutions to the issue • Learn to identify potential threats • Schools and mental health facilities work together o Offer help to those who need it Summary The mentally ill play a role within school shootings Correction facilities do not know how to handle these individuals. There are many possible solutions to prevent school shootings. References 1. A&E Televison Networks (2007, April 16). Massacre at virginia tech leaves 32 dead. Retrieved March 24, 2014, from History: http://www.history.com/this-dayin-history/massacreat-virginia-tech-leaves-32-dead 2. Berkoqicz, J., & Myers, A. (2013, October 22). School shootings: Mental health matters. Education Week. 3. Dikel, W. (2012). School shootings and student mental health: What lies beneath the tip of the iceberg. Retrieved from National School Boards Association: http://www.nsba.org/Search?SearchPhrase=dikel 4. Friedman, E. (2009, August 9). Va. tech shooter seung-hui cho's mental health records released. ABC News. 5. Glaze, L. E., & James, D. J. (2006, September 6). Mental health problems of prison and jail inmates. Bureau of Justice Statistics. 6. Langman, P. (2010). Rampage school schooters: A typology. The Lee Salk Center. 7. National Institute of Mental Health. (2005). The Numbers Count: Mental Disorders in America. Retrieved from National Institute of Mental Health: http://www.nimh.nih.gov/health/publications/the-numbers-count-mentaldisorders-in-america/index.shtml#Intro 8. O'Toole, M. E. (2000). The school shooter: A threat assessment perspective. National Center for the Analysis of Violent Crime , 52. 9. Robertz, F. (2007, July 30). Deadly dreams: What motivates school shootings? Scientific American , p. 4. 10.Roussey, T. (2013, November 25). Adam lanza undoubtedly afflicted with mental health problems. ABC 7. 11. University Wire. (2013, November 5). Mental health's hand in school shootings. University Wire. Psychotic Disorders: Schizophrenia, PTSD, Bipolar Disorder Robert Cunningham University of Central Missouri Facts Definitions What is a Psychotic Disorder (psychosis)? Psychosis -Number of people with psychotic disorders vary they also vary widely in their behavior Summary While more than 2/3 of people who have a psychotic disorder, may suffer a return of symptoms sometime in there life. The combination of medication, treatment , and education will help improve how greatly a person is able to function. The shorter the amount of time from when the person begins having psychiatric symptoms to when treatment begins, the better the prognosis and better help they may be able to receive. “In changing scenarios of welfare and healthcare, mental health- and specifically the unsatisfactory availability of effective tools to decrease the clinical, social, and economic burden of psychoses- has become a central issue”. (Terzian, Tognoni, Bracco, De Ruggleri, Ficociello, Mezzina, Pillo 2013) -The first time a person has their first sign or first psychotic symptoms is usually between the ages of 18 and 24 years of age. Is a loss of contact with reality that usually includes: False beliefs about what is taking place or who one is (delusions) ; Seeing or hearing things that aren't there (hallucinations). (google.com) Three Psychotic Disorders: Schizophrenia-is a mental disorder that makes it hard to: Tell the difference between what is real and not real, think clearly, have normal emotional responses, and act normally in social situations. (google.com) Post Traumatic Stress Disorder (PTSD)-is a type of anxiety disorder. It can occur after you have gone through an extreme emotional trauma that involved the threat of injury or death. (google.com) Bipolar Disorder-is a condition in which a person has periods of depression and periods of being extremely happy or being cross or irritable. (google.com) -There are genetic , biological, environmental, and psychological risk factors for developing psychotic disorders -Treatments for psychotic disorders include medications, mental health education, psychotherapy, community supportive services -Psychotic disorders known to run in families -Men at higher risk than woman of developing a psychotic disorder PTSD -“PTSD has been given many names throughout history, including soldier’s heart, cardiac weakness, traumatic shock, traumatic neurosis, nervous shock, shell shock, neurocirculatory asthenia, war psychoneurosis, battle fatigue, combat exhaustion”. (Callura, Lende 2012) - Individuals who develop PTSD face multiple life burdens such as violence, homelessness, unemployment, criminal justice involvement, domestic violence, and suicidality. -“The development of PTSD can be because of these factors. Shame in relation to the traumatic event, a sense of continued threat, a threat of life goals, the fear of losing control, and the threat of being unaccepted by others”. (Brunet, Birchwood, Upthegrove, Michail, Ross 2012) -Following a traumatic event, most people will experience such feelings as fear, sadness, guilt, and anger, with some come anxiety, depression, and substance misuse problems. -“Exposure to at least one traumatic event across the lifetime is experienced by approximately 83% of men and 75% of women”. (Bailey, Webster, Baker, Kavanagh 2012) - Men are more likely to report a greater number of traumatic event exposure, while women are likely to meet criteria for PTSD. -“People in combat zones as well as people who engage in hazardous and life-threatening service such as first-line responders in emergency zones, experience higher rates of PTSD”. (Collura, Lende 2012) Schizophrenia -Schizophrenia is a complex psychiatric disorder that is often, continuous, severe, and disabling. -“It affects approximately 1% of the population and it is characterized by hallucinations, delusions, disordered thought cognitive impairment, blunted emotions, and subtle motor abnormalities”. (Scherr, Hamann, Scwerthoffer, Frobose, Vukovich, Pitschellwalz, Bauml 2012) -Criminal behavior, more straight to the point violent behavior is a major problem among patients with schizophrenia. Major efforts in the last decade have been devoted to improving the quality of psychiatric care, in particular to ensure the use of basic processes of care including access, detection, treatment appropriateness, safety, and continuity of care. “Ultimately, better quality of care, as REFERENCES reflected by implementation of clinical guideline recommendations is Michail, expected toK.translate into study improved Brunet, K., Birchwood, M., Upthegrove, R., M., & Ross, (2012) A prospective of PTSD following recovery from first-episode psychosis: The threat from persecutors, voices and patient patient outcomes”. (Pedersen, Wallenstein, Jensen, hood. Nordentoft, Mainz 2013) British Journal of Clinical Psychology, Vol. 51 (issue 4) Pg. 418-433 DOI: 10:1111/j.2044-8260.2012.02037.x Tarrier, N., & Picken, A. (2011) Co-morbid PTSD and Suicidality in individuals with schizophrenia and substance and alcohol abuse. Social Psychiatry & Psychiatric Epidemiology, Vol. 46 (issue 11) Pg. 1079-1086 DOI: 10.1007/500127-010-0277-0 Bailey, K., Webster, R., Baker, A.L., Kavanagh, D.J. (2012) Exposure to dysfunctional parenting and trauma events and posttraumatic stress profiles among a treatment sample with coexisting depression and alcohol use problems. Drugs & Alcohol Review, Vol. 31(issue 4) Pg. 529-537 -“The risk of violent offences is 2 to 7 times higher, compared with the general population”. (Pedersen, Wallenstein Jensen, Nordentoft, Mainz 2013) -Cannabis use is highly in use among patients with schizophrenia, particularly with young people, and it is associated with an unfavorable course of the disorder and overall poor long-term outcomes. DOI: 10.1111/j. 1465-3362.2011.00401.x Collura, G.L. & Lende, D.H. (2012) Post- traumatic stress disorder and neuroanthropology: Stopping PTSD before it begins. Annals of Anthropological Practice, Vol. 36 (issue 1) Pg. 131-148 DOI: 10.1111/j.2153-9588.2012.01096x -Suicide ideation and suicide attempts are common with as many as half of all patients who have schizophrenia. - “Most recent estimates indicate 4.9% of schizophrenic patients will commit suicide during their lifetime”. (Tarrier, Picken 2011) Bipolar disorder -“Bipolar disorder is a severe, recurrent mental illness affecting 1-4% of the population”. (Kaplan, Talbot, Gruber, Harvey 2012) -This disorder impairs behavior, social, occupational, physical functioning, and general health. -This illness also frequently includes sleep disturbance. Because people with this illness have sleep problems there is a link between this disorder and its association with elevated rates of unemployment, absenteeism, and poor work performance. -“Tobacco smoking is two to three times more common among people with bipolar disorder (BD) than among individuals without the disorder and has dire health consequences”. (Heffner, Delbello, Anthenelli, Fleck, Alder, Strakowski 2012) Schnell, T., Becker, T., Thiel, M., & Gouzoulis-manfrank, E. (2013) Craving in patients with schizophrenia and cannabis use disorders. Canadian Journal of Psychiatry, Vol. 58 (issue 11) Pg. 646-694 ebscohost.com Terzian, E., Tognoni, G., Bracco, R., De Ruggleri, E., Ficociello, R., Mezzina, R., & Pillo, G. (2013) Social network intervention in patients with schizophrenia and marked social withdrawal: A randomized controlled study. Canadian Journal of Psychiatry, Vol. 58 (issue 11) Pg. 622-631 Ebscohost.com Scherr, M., Hamann, M., Scwerthoffer, D., Frobose, T., Vukovich, R., Pitschell-walz, G., & Bauml, J. (2012) Environmental risk factors and their impact of the age of onset of schizophrenia: comparing familial to non-familial schizophrenia. Nordic Journal of Psychiatry, Vol. 66 (issue 2) Pg. 107-114 -“The disorder cost significantly more than most other mental illnesses to treat and places a stark burden on patients, including increased risk of suicide and profound disruptions in work and social functioning”. (Zimmerman, Martinez, Young, Chelminsky, Dalrympie 2012) “Indeed, the average cost incurred per year for a single patient with BD is US $10,402 in medication, hospitalization, and treatment”. (Hawke, Provencher, Parikh, Zagorski 2013) DOI: 10.3109/08039488.2011.605171 Pedersen, C., Wallenstein Jensen, S., Nordentoft,M., & Mainz, J., (2013) Processes of inhospital psychiatric care and subsequent criminal behavior among patients with schizophrenia: A national population-bared; follow up study. Canadian Journal of psychiatry, Vol. 56 (issue 9) Pg. 515-521 ebscohost.com (4 references left out because the could not fit) Policing the Mentally ill Timothy Fink University of Central Missouri ABSTRACT Police officer interaction with mentally ill and the policies enacted to reduce the negative interactions with those who suffer from a mental illness. What do we look at? The major issue here is the view of mentally ill. To find out how we better help those with a mental illness, we must convey it is a serious problem. What do we look at? The amount of police interactions reported in major newspaper articles Patrol officer views on the mentally ill Patrol officer views on Crisis Intervention Teams Administrative views on the Mentally Ill Administrative views on Crisis Intervention Teams REFERENCES Barker, J. (2013). Police encounters with the mentally ill after deinstitutionalization. Psychiatric Times, 30(1), 9. Slate, R., Jacqueline, B., & Wesley, J. (2013). The criminalization of mental illness. (2nd ed.). Durham, NC: Carolina Academic Press. Sanow, E. (2006). CRISIS INTERVENTION TEAM. Law & Order, 54(12), 26-28,31-32,3435. Retrieved from http://search.proquest.com/docview/197241614?accountid=6143 RESULTS Administrative officials in law enforcement see Crisis Intervention Teams as a success. They state the amount of negative interactions between officers and the mentally ill have decreased significantly Negative interactions with physical/deadly force consequences. Alabama 7 Montata Alaska 1 Nebraska Arizona 5 Nevada Arkansas 4 New Hampshire California 42 New Jersey Patrol level officers see Crisis Intervention Colorado 3 New Mexico Teams as an excessive amount of training Connecticut 3 New york for an issue that officers already know how Delaware 0 North Carolina to handle District of Columbia 2 North Dakota Florida 27 Ohio 285 from a rough database on major Georgia 2 Oklahoma physical altercations between police and Hawaii 0 Oregon people with a mental disease. Idaho 0 Pennsulvania Illinois 6 Rhode Island CONCLUSIONS Indiana 4 South Carolina Over 2800 departments have Crisis Iowa 2 South Dakota Intervention Team training, such as Kansas 2 Tennessee Kansas City, St. Louis, New York, Los Kentucky 4 Texas Angeles, Chicago, and other major Lousiana 5 Utah departments. Maine 3 Vermont Crisis Intervention Teams DO work, even Maryland 7 Virginia despite what a patrol officer thinks of the Massachusetts 1 Washington training. Michigan 1 West Virginia The biggest issue with mental illness is Minnesota 3 Wisconsin public opinion, if the public starts to notice Mississippi 3 Wyoming that mentally ill people are just people, the Missouri 1 police will follow suit and more drastic changes will be taken to fix the problem The above is the amount of negative that is the labeling system of the mentally interactions with a minimum of physical ill altercation with police and schizophrenics publicized by major newspaper outlets. 1 1 1 3 9 3 15 6 0 10 5 5 10 2 4 0 3 23 4 1 6 8 1 3 0 Crisis Intervention Training Jennifer Forester University of Central Missouri What are crisis intervention teams? According to the National Alliance on mental health {NAMI], “C.I.T programs are local initiatives designed to improve the way law enforcement and the community responds to people experiencing mental health crises. They are built on strong partnerships between law enforcement, mental health provider agencies and individuals and families affected by mental illness.” Police officers are likely to encounter a PWMI at least once a month. This program was created to ensure the safety of our law enforcement officers and to eliminate ineffective fatal encounters between PWMI’s and first responders. Training Procedures For Officers. 40 Hours of class room style training. Mental Health Signs Symptoms Medications & Side Effects A tour of local Mental Health Facilities Verbal De- escalation techniques Active Listening Skills Restraint techniques promoting reduced force. Suicide Prevention Results of Training in the US According to a recent news release from the American Psychiatric Association, they examined officer behavior in more than 1,000 emergency encounters. CIT-trained officers had sizable and persisting improvements in knowledge, diverse attitudes about mental illnesses and their treatments, self-efficacy for interacting with someone with psychosis or suicidality, social distance stigma, deescalation skills, and referral decisions. The effectiveness of CIT training was also supported by data from the trained officers’ emergency encounters, which were more likely to result in referral or transport of the person to mental health services and less likely to result in arrest—a form of prebooking jail diversion.” Figure 1. Specialized Response Data. The Mental Health Based Mental Health Response has shown to be the most effective out of the three specialized responses. Effectiveness of CIT Training • • • • • • • Helps prevent future crisis Enhances officer safety De-Stigmatizes PWMI’s Diversion Programs Medication Knowledge Understanding Symptoms Decreased arrests rates You Community needs your Support! A great way to help support crisis Intervention Training in your community is to become a member of CIT International. This organization create awareness, expand programming, and creates the programs to educate our officers. http://www.citinternational.org/ REFERENCES 1. Fogelson, D. (2013, January 26). NAMI: National Alliance on Mental Illness - Mental Health .... Crisis Intervention Team (CIT) Advocacy Toolkit. Retrieved April 14, 2014, from http://www.nami.org/ 2. Woody, M. (2011, August 22). CIT Brochure . CIT International. Retrieved March 5, 2014, from http://www.citinternational.org/ 3. Herold, E. (2014, April 1). Crisis Intervention Training for Police Officers Effective in Helping Respond to Individuals with Behavioral Disorders. www.psychiatry.org.. Retrieved April 10, 2014, from http://www.psychiatry.org. Abstract The History of Mental Illness & the Publics Perception Krishonya Greer CJ 4330 Mental illness affects the condition of ones mind. A mental illness is never the fault of one person. Mental illnesses also carry different effects for different people. The learning and understanding of mental illnesses has been continuous throughout the years with the discovery of new medicine and other treatment options. Introduction RESULTS Discussion Mental illness has had a long history not only here in the United Ancient Civilizations •Dates back to the stone age •Strange behaviors were related to evil spirits, possessions, or displeasure from the gods. •Trephining used to treat mental illness •Family or clan left in charge on managing individuals with mental illness •Exorcisms, incantations, prayer, and other methods used to drive out spirits •Ancient Greece first to document perspectives on the mind and mental illness •Hippocrates first to identify conditions of mental illness •Spots on the skin to identify a mental illness Middle Ages •Religion, religion, religion! •Exorcism rituals •Rich vs. poor in terms of treatment •Fear of labels such as a witch •Johann Weyer •Freedom to those who arent a danger •Isolation of those with mental illness •Awful treatment for the insane Age of Enlightenment •Significant changes made •Capital punishment •“Undesirables” state of mind •Advances in treatment options and treatment of individuals Pre-Civil War •Mental illness viewed as immorality •Harsh punishment •Few community resources •First organized societal initiative to manage mentally ill was through the construction of the Eastern Lunatic Asylum in Virginia •Benjamin Rush father of American Psychiatry •Dorothea Dix ‘s impact on mental illness Clearly, you can see the broad history of mental illness. It has spanned many States, but all over the world. According to the National Alliance on Mental Illness, approximately 61.5 million people experience mental illness in a given year and one in 17 Americans live with a serious mental illness. The publics perception of this illness has always been a negative one due to media perception and rumors. Many people don’t fully understand mental illness so it is crucial in this day and age to educate people on these horrible illnesses. Mental illness is described as a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others, and daily functioning. Treating individuals with mental illnesses has been a long process of trial and error guided by false knowledge and poor attitudes. These attitudes have been shaped by ideas from politics, society, the economy, and advances in the fields of science, medicine, and psychology. Mental illness costs America $193.2 billion in lost earnings per year. METHODS • Emil Kraepelln’s findings on schizophrenia • State hospitals overwhelmed and overcrowded The World Wars • Negative attitudes towards foreigners • Xenophobia- fear/hatred of people from other countries • New disorder- PTSD • Electo-convulsive therapy • Insulin-induced comas • Lobotomies • Electro-shock therapy • National Mental Health Act • New medicines Mental Illness Today • Treatment resources • Medicine Medias role in mental illness • Television • Newspapers • Misrepresentations of violence Stigmas of Mental Illness • Not in my backyard mentality • Assumed violence of persons with mental illness • Avoidance of employing and working with PWMI years and continues to change daily. The importance of this paper and the importance of mental illness is to teach those who do not know about these diseases so we can avoid negative stigmas REFERENCES • National Institutes of Health, National Institute of Mental Health. (n.d.). Statistics: Any Disorder Among Adults. Retrieved March 2, 2014, from http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT.shtml • Prevalence numbers were calculated using NIMH percentages (cited) and 2010 Census data. Census data is available at: United States Census Bureau. (revised 2011). “USA [State & County QuickFacts].” Retrieved March 2, 2014, from http://quickfacts.census.gov/qfd/states/00000.html • Slate, R., Buffington-Vollum, J., & Johnson, W. (2013). The criminalization of mental illness. (2nd ed.). Durham, North Carolina: • Mental Illness of Ancient Civilizations State hospitals • The Middle Ages Picture/Chart • The Age of Enlightenment impact on the Picture/Chart • Pre Civil War have had a large history of mental • The World Wars illness. • Mental Illness today • Medias role in mental illness There are a variety • Stigmas of mental illness of mental illness Lobotomies were a standard procedure to “cure” mental Thorazine was discovered in Picture/Chart that can affect a Paris and used to treat person. illnesses. symptoms of mentall illness. Carolina Academic Press. • Giliberti, Mary. "NAMI - The National Alliance on Mental Illness." NAMI. NAMI, n.d. Web. 04 Apr. 2014. Mentally Ill Inmates Lindsay Grindel University of Central Missouri ABSTRACT Deinstitutionalization has caused our society and our special needs individuals a great deal. Deinstitutionalization has moved mentally handicapped people back out into society where they are not getting the proper treatment and medication that they need. These individuals then start to self-medicate and end up facing law officials and time in jails. ISSUES MENTAL DISORDERS Patients went back into society without proper care Appropriate health care is not as readily available Schizophrenia Deinstitutionalization took away multiple jobs Bipolar Disorder Stress is put back on the families Correctional and police officers are trained to deal with mental illness Post-Traumatic Stress Disorder (PTSD) Disorders worsen in correctional facilities DEINSTITUTIONALIZATION Began in the 1960s Our most recent heath reform The true driving force to deinstitutionalization was cutting costs and budget cuts Deinstitutionalization effected the patients as well as the families Our society now relies on our correctional system to be the primary health provider for individuals with a mental disorder REFERENCES Aufderheide, D. (2011) Coffey, P. (2012) Geiman, D. (2012) Payne, E., Watt, A., Rogers, P., & McMurran, M. (2008) Samuel, L. B., Vincent, B. V. H., Abigail, S. T., & Gregory, M. V. (2011) Swann, A. C. (2006) Tahir, L. (2003) Tewksbury, R., & Dabney, D. (2009) Tucker, A. S., Van, V. B., & Russell, S. A. (2008) Wright, E. R., Avirappattu, G., & Lafuze, J. E. (1999) Wynne, D., & Jacques, K. S. (2011) OPTIONS Better training for law officials and correctional officers Police and correctional officers need to have the same goals when it comes to helping individuals with mental illness Mental health clinicians need to figure out what works best for their facilities Solitary Confinement With the Mentally Ill Alec Hart University of Central Missouri Solitary Confinement “The adverse effects of solitary confinement are especially significant for persons with serious mental illness, commonly defined as a major mental disorder (e.g., schizophrenia, bipolar disorder, major depressive disorder) that is usually characterized by psychotic symptoms and/or significant functional impairments. The stress, lack of meaningful social contact, and unstructured days can exacerbate symptoms of illness or provoke recurrence,” (Berry). Solitary Confinement shows little positives when dealing with Mentally Ill people in the prison systems. Not only that, but there are statistics that show Solitary Confinement. “Isolation can be psychologically harmful to any prisoner, with the nature and severity of the impact depending on the individual, the duration, and particular conditions (e.g., access to natural light, books, or radio). Psychological effects can include anxiety, depression, anger, cognitive disturbances, perceptual distortions, obsessive thoughts, paranoia, and psychosis,” (Blackmon). The most important teaching within this semester has been how to be pro-active instead of reactive when dealing with people who come in contact with Mentally Ill people while on the job of Criminal Justice Activities. Methods/Theories Pros of Solitary Confinement Cons of Solitary Confinement In theory, solitary confinement is for the worst of the worst prisoners, those who cause serious, usually violent, disruptions in the general prison population. In practice, these kinds of prisoners make up only a small minority of the segregated population in U.S. prisons. The biggest reason for the use of solitary confinement is when prisoners are dangerous to others. Supporters of solitary confinement argue that some prisoners need to be separated from society at large for their own safety and the safety of others. Positivist Theory: As defined, the positivist rejects the idea that each individual makes a conscious, rational choice to commit a crime; rather, some individuals are abnormal in intelligence, social acceptance, or some other way and that causes them to commit the crime. Solitary confinement can also make it more difficult for inmates to integrate themselves back into society, as solitary confinement can cause inmates to lose the ability to regulate their lives and have normal interactions with people. Studies also show that inmates who have undergone solitary confinement are more prone to bouts of severe anger and depression, both conditions that are likely to cause recidivism. In the short version, usually all the positive or something positive comes out of a criminally insane person and that makes them commit a crime. Solitary Confinement Chart In the early years of solitary confinement, researchers noted increased suicide and mental illness among prisoners. A big Con in today’s Society that is viewed as least important is the type of cost each inmate needs to live off of for Solitary Confinement. As of 2013 the total cost of each inmate is 78,000 dollars. That is Tax paying money and grants from the government that needs to be reached per each inmate for Solitary Confinement A lot of study’s suggest that safety is an important key, but another study suggest that being away from human society for so long, mental people start becoming mentally insane on their own. Studies suggest that it is impotent whenever dealing with recidivism rates along the general prison population. 69% who dealt with solitary confinement landed themselves back in prison three years after being released. That is opposed to the other 31%. Source: Colorado Institution. Conclusion Some 80,000 people are held in solitary confinement in U.S. prisons, according to the latest available census. The practice has grown with seemingly little thought to how isolation affects a person's psyche. But new research suggests that solitary confinement creates more violence both inside and outside prison walls. Do I personally think Solitary Confinement is okay for anyone, insane or sane, it should not be an option involved within our prison system or criminal justice system. Solitary Confinement is a money burner for out tax payers, the statistics do not add up, and there are more cons then there are pros. I do not see the analytical research that makes any thing relating to Solitary Confinement as a positive. Prison is suppose to make people change for the better, not make individuals come out worse whenever they went in. I see this as a huge issue and hopefully be published some day talking about what is for the greater good, especially mentally insane that are put in a worse situation like Solitary Confinement. “The use of segregation to confine the mentally ill has grown as the number and proportion of prisoners with mental illness have grown. Although designed and operated as places of punishment, prisons have nonetheless become de facto psychiatric facilities despite often lacking the needed mental health services,” (Berry). The statistics do not lie, the use of segregation among the mentally ill will cause a disruption in their attitude and ways of life it is just not normal or healthy. Solitary Confinement 1981 References Berry, T. (2012). Solitary confinement . Retrieved from http://www.ehow.com/info_8661607_pros-vs-cons-solitary-confinement.html Vasquez, E. (2007). Solitary confinement is cruel and ineffective. Retrieved from http://www.scientificamerican.com/article/solitary-confinement-cruel-ineffective-unusual/ Both Pictures Google.Images/SolitaryConfinement Under standing criminal justice theories . (2013 ). Retrieved from http://www.criminology.com/resources/understanding-criminology-theories/ The Aftermath of Deinstitutionalization Jesslyn F. Clark Mental Health Systems Introduction • Deinstitutionalization is the process of moving persons with a mental illness out of the state hospitals and back into the communities. This occurred in three phases. 1.Establishing Community Treatment Services 2.Moving Patients into the Communities 3.Providing alternative community facilities and treatment centers • Ultimately this caused a great deal of controversy and was generally unsuccessful due to a lack of funding. Moving Patients into the Communities • Although proper funding was not in place persons with mental illnesses continued to be released from the mental hospitals into the communities. • Many individuals were released from the state hospitals with no entry programs or community treatment centers to fall back on. • . In 1955, 559,000 persons with mental illness were being treated in the state hospitals, and by 2010, the number was reduced to around 40,000. That means that between those 55 years close to 520,000 persons with a mental illness were now on their own. Alternative Community Facilities and Treatment Centers • At this time there were very few options for persons with mental illness within the communities. • The major court case O'Connor v. Donaldson mandated that in order for these persons to be eligible to receive treatment they must be shown as a danger to themselves or society. • With the rules and regulations regarding persons with a mental illness becoming tighter and tighter, the option of placing these individuals into one of the few community treatment centers available became near impossible. • The individuals with mental illnesses and no resources to turn to such as family, treatment centers, or money, resorted to the only option they had: the streets. Establishing Community Treatment Services • Instead of funding being delivered for the states, it was sent to the communities for the creation of their very own treatment centers and hospitals. • Crises throughout the nation at this time such as: The Vietnam War interrupted the process of deinstitutionalization tremendously by funneling resources else where. ChangeGraph of PWMI in State Hospitals Over 58 Years 600,000 500,000 400,000 300,000 200,000 100,000 0 PWMI in… • The passage of the Community Mental Health Care Centers Act on October 31, 1963 provide d treatment for people with all mental health conditions and worked to promote mental health more broadly by establishing mental health treatment centers in communities all over the country. Picture Police Encounters • Since the 1970s, our country has focused more on the crime control model, which encompasses harsh sentences due to truth in sentencing, mandatory sentencing laws, and determinant sentencing. • Each day Law Enforcement officials come into contact with persons with a mental illness and are faced with the tough decisions of arrest. • Although the amount of training Law Enforcement officials are receiving is getting better with the implication of Crisis Intervention Teams there is still room for improvement. Trans-institutionalization • This theory stemmed from deinstitutionalization as the process of simply shifting individuals between the criminal justice system and the mental health system • Federal and state prisons are quickly becoming one of the most used resources for persons with a mental illness to receive treatment. • It was reported that one in ten men and almost one in three women in federal prisons have some form of mental health problem References Year • Kreig, R.G. (2001). An interdisciplinary look at the deinstitutionalization of the mentally ill. Social Science Journal, 38, 367-380. • Slate, R.N., Buffington-Vollum, J.K., & Johnson, W.W. (2013). The criminalization of mental llness (2nd ed). Durham, NC: Carolina Academic Press. • Stall, N. (2013). Imprisoning the mentally ill. Insanity Trial Brandi Kelly Abstract What the trial must prove Insanity cases are mostly uncommon because they are hard to win. With a case such as this one the person must first admit that they have committed the crime then the lawyer has to convince that the defendant should be held responsible for the crime. They must prove that the person lacked the responsibility related to mental illness as a criminal defense. To prove that a person was not in their right state of mind at that time there are several test that can be given. In American law, a criminal defendant must be competent to understand the criminal process and the nature of the charges that they are facing. They must also be able to participate in their own defense. Insanity Trial Cases Types of Insanity Test Perceptions With Insanity Defense Cases. M’Naughten Rule - Defendant either did not understand what he or she did, or failed to distinguish right from wrong, because of a "disease of mind. Irresistible Impulse Test - As a result of a mental disease, defendant was unable to control his impulses, which led to a criminal act. Durham Rule - Regardless of clinical diagnosis, defendant's "mental defect" resulted in a criminal act. Model Penal Code Test for Legal Insanity - Because of a diagnosed mental defect, defendant either failed to understand the criminality of his acts, or was unable to act within the confines of the law John Hinckley was successful in his insanity plea. He had taken a liking to the movie Taxi and an obsession to the actress Jodie Foster. He began to stalk her in attempts to gain her attention as well as attempting suicide. His ultimate plea of obsession came when he attempted to take his own life in front of them. That had not gotten him the attention he seeked so he attention by attempted assassination on president Ronald Reagan. Although unsuccessful, he pleaded insanity to all charges against him and was put in a mental asylum instead of taken to jail. Pictured to the left References What exactly does insane look like? http://criminal.findlaw.com/criminalprocedure/insanity-defense.html Buffington-Vollum, J.K., Johnson, W.W., Slate, R.S. (2013). The Criminalization of Mental Illness. Carolina: Academic Press Use of Insanity as a Criminal Defense Andrew Kenney University of Central Missouri ABSTRACT Whenever many of these arrests go trial, more than half of the defendants try to claim “insanity” as a defense. They try to claim that it happened in the heat of the moment, or that they were under duress, or that it was out of necessity. This sounds like a cop out. This sounds like a cheap way to get away with their crime with a lesser, or in some cases, no sentence. RESULTS How are they considered “Criminally Insane” What is the process to determine them as “Criminally Insane” Are they actually “Criminally Insane” What are the standards to be considered “Criminally Insane” CONCLUSIONS A criminal defendant who is found to have been legally insane when he or she committed a crime may be found not guilty by reason of insanity. In states that allow the insanity defense, defendants must prove to the court that they did not understand that what they were doing was wrong. SUMMARY Graphs and Charts METHODS Figure 1. •Insanity Defense Court Cases •Lawyers used •Caselaws and Precedent Figure 2. The persons failed to know right from wrong; acted on an uncontrollable impulse or some variety of these factors Figure 3. Insanity Defense is not Always the Easy Way Out Clayton T. Kertz University of Central Missouri Richard Lawrence- 1835 • First person to attempt to assassinate an American President • Andrew Jackson- seventh president • Two pistols misfired • Found not guilty by reasons of insanity • Spent the rest of his life in mental hospital Source: Foulkes, Debbie . "RICHARD LAWRENCE (1800?-1861) First Person to Attempt to assassinate an American President" Forgotten Newsmakers. N.p., n.d. Web. 7 Apr. 2014. <http://forgottennewsmakers.com/2010/03/02/richard-lawrence-18001861-first-person-to-attempt-to-assassinate-an-american-president/>. Ed Gein- 1957 • Inspiration for The Silence of the Lambs and The Texas Chainsaw Massacre • Grave robber • Suspected of killing up to six people • Convicted of killing one, Bernice Worden • Found guilty, but not responsible • Spent rest of life in mental hospital Source: Bell, R., & Bardsley, M. (n.d.). Eddie Gein. The Beginning — — Crime Library. Retrieved April 8, 2014, from http://www.crimelibrary.com/serial_killers/notorious John Hinckley, Jr.- 1981 • Attempted to assassinate Ronald Reagan • To impress Jodie Foster after her role in Taxi Driver • Found not guilty by reasons of insanity • Remains in mental hospital • Since 2006, allowed unsupervised home visits; Ten days per month, but recently extended to seventeen days per month Source: Reuters. (2014). John Hinckley to Spend More Time Outside Mental Hospital. (2014, February 27). NBC News. Retrieved April 9, 2014, from http://www.nbcnews.com/news/us-news/john-hinckleyspend-more-time-outside-mentalhospital-n40656 John W. Hinckley, Jr. Biography. (n.d.). John W. Hinckley, Jr. Biography. Retrieved April 8, 2014, from http://law2.umkc.edu/faculty/projects/ftrials Andrew Goldstein- 1999 David Trebilcock- 2011 • Killed girlfriend’s daughter • Low prevalence • Thought he was sent by god and she was antichrist • Low success rate • Plead insanity • Sent to mental hospital; bi-yearly checkups to see if he is fit to leave • Judge suspects he will spend the rest of his life there Source: News. (2012, February 14). Trebilcock found "not responsible" for murder of young Sherrill girl. NBC-WKTV News Channel 2. Retrieved April 9, 2014, from http://www.wktv.com/news/local/Verdict-expected-in-Trebilcock -case--139274383.html Traynor, C. (2012, February 14). News. Trebilcock not guilty of murder (updated 4:22 pm with photo). Retrieved April 9 , 2014, from http://www.oneidadispatch.com/generalnews/20120214/trebilcock-not-guilty-of-murder- updated-422-pm-with-photo • 7 successful insanity defenses out of 6000 murder trials in New York • Spend longer in mental hospital than would in jail if found guilty • Very hard to prove James Holmes- 2012 • Shoved Kendra Webdale in front of a train • Aurora Colorado movie theatre shooting • Was self-committed 13 times in two years prior to offense • 12 killed, 60 injured • Set free too early every time, despite 12 assaults on staff members Overview • Dressed up like The Joker from Batman • Attempted to plead guilty to avoid the death sentence • Insanity defense failed • Sentenced to 23 years in prison + 5 years probation • Brought about Kendra’s Law Source: Gregg, J. (2000, March 3). Will the Real Andrew Goldstein Take the Stand. Time. Retrieved April 9, 2014, from http://content.time.com/time/arts/article/0 Hartocollis, A. (2006, October 10). Nearly 8 Years Later, Guilty Plea in Subway Killing. The New York Times. Retrieved April 9, 2014, from http://www.nytimes.com/2006/10/11/nyregion/11kendra.html?ref=andrewgoldstein&_r=0 • Guilty plea rejected; Plead insanity • Trial scheduled for October 2014 Source: Healy, J. (2013, May 13). Mental Evaluations Endorse Insanity Plea in Colorado Shootings, Defense Says. The New York Times. Retrieved April 9, 2014, from http://www.nytimes.com/2013/05/14/us/jamesholmes-aurora-shooting-suspect-enters-insanity-plea.html Hickey, C. (2014, April 7). James Holmes’ attorneys file motion to move trial out of Arapahoe County. KDVRcom. Retrieved April 10, 2014, from http://kdvr.com/2014/04/07/james-holmes-attorneys-filemotion-to-move-trial-out-of-centennial/ http://german.fansshare.com/community/uploads24/8 210/insanity_defense_map_jpeg/ Substance Abuse & Mental Health Brianne Kokotiuk University Of Central Missouri Introduction • Characterized as the repeated use of a substance(s) in situations where it can lead to negative outcomes. • Abuse refers to the use of these substances when they are not medically indicated and their use exceeds the social norm. • Continuum of substance-related disorders begins with substance use, intoxication, then withdrawal. Followed by abuse and finally dependence. •This progression marks an escalation in the use of substances that can lead to numerous social, medical, and psychological problems. Mental Health Issues •There is an increasing number of people who have a combination of mental health and substance abuse issues. •Experts estimate that at least 60% of people battling one of these conditions are battling both. •Mental health problems and substance abuse are often seen together because one makes you more vulnerable to the other. •Mental health issues are very common in the U.S. An estimated 1 in 5 adults suffers from a diagnosable mental disorder. (National Institute of Mental Health) •There may be a biological/ genetic vulnerability to a mental health problem- substance abuse can trigger the onset of it. •Substance abuse does not cause mental illness, but causes the condition to manifest. •Mental health issue may be present, but person may not be aware of it. The problem is driving the addiction. Their condition just hasn’t been diagnosed yet. Materials Prevention Conclusions Substance Abuse and Mental Health Charts Best Treatment Efforts In Conclusion, helping to understand and prevent substance abuse is not only that individual’s job, it can also be everyone’s job. Educating others on treatment and the prevention of substance abuse can better and enrich the lives of the community. Mental health and substance abuse often go hand and hand, but must be treated differently. By enhancing and promoting acceptance of each, people with mental illness can live full productive lives in our communities. • Suppression. Suppression efforts include raising the minimum drinking age, outlawing the production, distribution and sale of alcohol or other drugs. •Demand reduction.. Research has shown that if there is no market for such products, then their use will effectively be prevented. Demand reduction can be classified into three categories: primary, secondary, and tertiary. •Primary: Primary prevention activities are intended to reach a broad audience in an effort to avert the onset of use. An example of a primary prevention program is that of Drug Abuse Resistance Education. •Secondary : Secondary prevention includes efforts to reduce the underlying causes of substance abuse among populations that are at risk for use. Studies have shown that substance abuse is predicted by both individual and environmental factors. By successfully targeting the appropriate risk or protective factors with a prevention/intervention program, a reduction in negative outcome behaviors may occur. •Tertiary: Tertiary prevention includes activities that are designed to minimize the impact of substance use. The harm reduction approach can be considered a tertiary prevention strategy, in as much as it attempts to minimize the harmful consequences of drug use and the high-risk behaviors associated with drug use. References •National Institute Of Mental Health •Substance Abuse And Mental Health Services Administration •National Institute On Drug Abuse •NAMI •National Institute On Alcohol Abuse And Alcoholism •Mental Health America.net •American Psychiatric Association. Diagnostic and Statistical Manual on Mental Disorders, fourth edition (DSM-IV). Washington, DC: American Psychiatric Press, 1994. The Insanity Defense Samantha Moeller University of Central Missouri HISTORY •The origins of the insanity defense have been cited as beginning as early as the 12th century, however, modern use of the insanity defense actually began much later in the early 19th century. (Weiner, 1985) • The M’Naghten Case in 1843 was the first major court hearing involving the insanity defense. It is important because its’ decision represents the first standard for insanity in the legal system. (Weiner, 1985) EVALUATION & PROCEDURAL ASPECTS • Mental State at the Time of the Offense Evaluation (MSO) • Did defendant have mental illness at time of offense? • Did casual relationship exist between criminal behavior and mental illness? • Does casual relationship meet the insanity standard criteria in that jurisdiction? (Slate et al., 2013) • Insanity defense is affirmative in nature WHAT IS INSANITY? • Those who are deemed legally insane are, “unable to form intent due to mental disease or defect” ( Slate, Buffington-Vollum, & Johnson, 2013). • Burden of proof in most states falls to the defense (Weiner, 1985) • Whether or not jury instructions about the consequences of an acquittal in these cases is heavily debated (Ellias, 1995). • M’Naghten Rule – individual’s cognitive state when crime occurred is the focus; understanding good from bad and right from wrong • Product Test/ Durham Rule – not responsible if criminal act found to be result of mental defect or disease; too broad • Irresistible Impulse Test – focus is on individual’s volitional state; not criminally responsible if they can not control their own actions • Model Penal Code Test – essentially a combination of the M’Naghten rule and the irresistible impulse test AFTERMATH FOR ACQUITTEES Many people are under the belief that becoming acquitted under the insanity defense is a cope out and that acquittees are not getting the punishment they deserve but the these beliefs are far from the truth. (Steadman, 1985) • Not guilty by reason of insanity (NGRI) acquittees have been shown to spend longer stays in mental institutions than others spend in prison • NGRI acquittees carry harsh stigma •Slight possibility of conditional release /graduated release (Chappell, 2010) PUBLIC OPINION An overwhelming majority of the population dislike the use of the insanity defense. Many say it is an easy way out for defendants and that their lack of punishment is not right. An interesting thing to note is that jurors are more harsh on defendants who use the insanity defense. (Steadman, 1985) REFERENCES Chappell, D. (2010). Victimisation and the insanity defence: Coping with confusion, conflict and conciliation. Psychiatry, Psychology and Law, 17(1), 3951. doi: 10.1080/13218710903443070 Ellias, R. (1995). Should courts instruct juries as to the consequences to a defendant of a “not guilty by reason of insanity” verdict? The Journal of Criminal Law & Criminology, 85(4), 1062-1083. Slate, R. N., Buffington-Vollum, J. K., &Johnson, W. W. (2013). Traditional court processing of defendants with mental illness, part II: The insanity defense. In A. Editor, B. Editor, &C. Editor (Eds.), The criminalization of mental illness (pp. 339-369). Durham, North Carolina: Carolina Academic Press. Steadman, H. J. (1985). Insanity defense research and treatment of insanity acquittees. Behavioral Sciences and the Law, 3(1), 37-48. Weiner, B. A. (1985). The insanity defense: Historical development and present status. Behavioral Sciences and the Law, 3(1), 3-35. Mental Illness: an Evolution of Treatment Taran Parker Dr. Bonham ORIGINS OF TREATMENT Treatment for mental illness has been around as early as the 1600’s, beginning with Reverend Samuel Willard, who attempted to treat the mentally ill by dunking them in freezing water (obviously with limited success). In the following century, Benjamin Rush “Father of Psychiatry”, began intense research into mental illness. Treatment through psychotherapy actually began much later with Sigmund Freud and his conception of psychoanalysis, this too has evolved vastly over the years. MODERN TREATMENTS Psychiatric Drugs are utilized by psychiatrists to balance the chemicals in our brains and solve illnesses at a biological level Psychotherapy is conducted by psychologists and used to evaluate the causes for your condition Psychosurgery: Deep brain stimulation, process of sending shocks into deep portions of the mind SUMMARY As previously stated, mental health treatment went through many changes. From humble beginnings we embarked into uncharted territory and caused many more problems than we solved. However from this we learned and grew. Today we combine several schools of treatment to create a custom cure for each individual, and with each new success our knowledge grows and we become capable of helping more. PAST MISTAKES Any medical treatment goes through stages of trial and error, mental health is no exception. In 1927 patients with Schizophrenia and Epilepsy were treated with Insulin Shock Therapy (repeatedly given insulin and then shocked during a drug induced coma), it has since been outlawed. Shortly after in 1935, the practice of Lobotomy began. This procedure left the patient with severely decreased mental abilities and has likewise been ceased. REFERENCES Tartakovsky, M. (2011). The Surprising History of the Lobotomy. Psych Central. Retrieved on April 14, 2014, from http://psychcentral.com/blog/archives/2011/03/21/the-surprising-history-of-the-lobotomy/ NIH. (2013, September 17). Benjamin rush, m.d. (1749-1813): “the father of american psychiatry”. Retrieved from http://www.nlm.nih.gov/hmd/diseases/benjamin.html Stone, A. (2008, June 08). Psychosurgery—old and new. Retrieved from http://www.psychiatrictimes.com/articles/psychosurgery—old-and-new Grohol, J. (2014). Psychotherapy. Retrieved from http://psychcentral.com/psychotherapy/ Mental Ill in Prison Cam Price University of Central Missouri ABSTRACT This paper will look at the types of Mentally Illnesses within the prisons and how the prison system treat these people. METHODS RESULTS CONCLUSIONS My results showed that the prisons have all types of mental illness within the prison system. Not all prisons have the on hands knowledge to deal with all the types of mental illness, but they are doing there best. My conclusion is that the prison system is not a fit place for over half the mentally ill it holds within. The prison system should team up with a mental hospital to better help these inmates with the problems they are having. My research showed me that surveys were giving to the prison staff and inmates asking certain questions. They then took those answers and compared it to other prisons. REFERENCES SUMMARY In summary, I looked at what types of mental illness was in the prison system and how the prison system handled it. The prison does a poor job of helping these people. 1. Aufderheide, D. H., & Brown, P. H. (2005). Crisis in corrections: The mentally ill in america's prisons. Corrections Today,67(1), 30-33. Retrieved from http://search.proquest.com/docview/2156942 59?accountid=6143 2. Smart, C., & Tribune, S. W. (1991, Feb 01). Corrections official says mentally ill inmates go untreated. The Salt Lake Tribune. Retrieved from http://search.proquest.com/docview/2884161 51?accountid=6143 3. Mentally ill in prison system. (1999, Sep 18). The Southland Times. Retrieved from http://search.proquest.com/docview/3307211 17?accountid=6143 Reintegration for Mentally Ill Criminals Taylor Rehmeier ABSTRACT Criminalized mentally Ill person’s find it incredibly difficult reintegrating back into the community after encountering the criminal justice system. Since they have such a hard time, they usually end up returning to the system several times in their life. Since their rate of recidivism is high, the chances of them being successful in society is slim to none. METHODS With the criminalization of mentally Ill being so high there is a need to help those that exit the system and don’t wish to reenter. Programs have been put into effect that attempt to assist these persons with their reintegration back into the community. Getting these individuals back into society with the ability to live normal lives is a difficult task but definitely not an impossible one. Statistics show that offenders with mental illnesses that are released from prison are just as likely to reoffend as a criminal without mental illness. These individuals have a chance at a life free of crime they just need the guidance on how to accomplish that feat. Mentally Ill rehabilitation and reintegration programs are the best chance at giving mentally ill a better chance of success RESULTS CONCLUSIONS With the programs in place it is still very difficult to reintegrate mentally ill criminals back into the community after being in the criminal justice system. With the rate of recidivism being comparable to that of criminals without mental illness, reintegration programs are the only way to lessen the amount of mentally ill that enter the criminal justice system. A study done to show the rate of recidivism reveals that in part, recidivism of mentally ill persons can be forecasted in some instances and in others can be done decently accurate. New programs need to be made and put into effect that are able to rapidly adapt the mentally ill. These programs have to be ever- changing when needed so they can effectively reintegrate mentally ill criminals. Since there are ways to foresee several signs of recidivism there are ways to assist with those criminals whom are the most likely candidates to reoffend. SUMMARY REFERENCES Sigurdson, C. (2000). The mad the bad and the abandoned: The mentally ill in prisons and Corrections Today, 62(7), 70-78. Retrieved from http://search.proquest.com/docview/215707094?acco untid=6143 Annual Report to the Legislature. (n.d.). Retrieved from http://www.dshs.wa.gov/pdf/main/legrep/Leg1202/MIO CTP.pdf Gagliardi, G. J., Lovell, D., Peterson, P. D., & Jemelka, R. (2004). Forecasting Recidivism in Mentally Ill Offenders Released from Prison. Law and Human Behavior , 133-155. There are currently programs in place that attempt to reintegrate the mentally ill criminals coming out of the criminal justice system but they alone are not effective enough. New programs are needed to better help reintegration become more simplistic. New programs combined with new medications and different availability of therapies. More mentally ill enter the criminal justice system every day; the best hope for the future is to help rehabilitate these individuals and make their criminal justice experience a one time occurrance. Substance Abuse and Corrections Rebecca E. Ruggles University of Central Missouri Substance Abuse Treatments Nearly 24 million Americans admitted to drug usage in 2012 in the month before the survey. Marijuana was the most common drug used with over 18 million people using it. Most of those who use drugs began doing so in their youth.1 The prevalence of substance abuse disorders was 14.6 percent in 2005.2 There are three empirical treatments that should be discussed for substance abuse treatment: Acceptance and Commitment Therapy The goal of this evidence based treatment is to help the client not just feel good but to have a good life 5 43.8 percent abstinent after six months of treatment 6 Project BRITE 7 Uses positive reinforcement Had support from staff and participants CT System 8 4 tier program (1st is class to 4th is residential treatment). Corrections Community Very cost effective One meta-analysis of 13 studies about the overall prevalence of alcohol abuse in prisons reveals that between 18 and 30 percent of male prisoners have substance abuse issues .3 Another study was conducted to evaluate the prevalence of substance abuse issues with female inmates. This study found that 70 percent of females that were surveyed in the Minnesota Department of Corrections were dependent on at least one substance when entering the system.4 Community corrections is becoming a favorable alternative to incarceration, probably due to overcrowding concerns and cost. Overall, community corrections programs tend to reduce recidivism. This includes decreases in violations of probation or parole (Though this was the most common recidivism type), and new violations .9 Community corrections offers a unique benefit in that offenders can stay with their support systems and keep their jobs.10 References 1. National Institute on Drug Abuse (2014). Drugfacts: Nationwide trends. Retrived from http://www.drugabuse.gov/publications/drugfacts/nation wide-trends 2. Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005).Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychology, 64, 593-602. 3. Fazel, S., Bains, P., & Doll, H. (2006). Substance abuse and dependence in prisoners: A systematic review. Addiction, 101, 181191. doi: 10.1111/j.1360-0443.2006.01316.x 4. Proctor, S.L. (2012). Substance use disorder prevalence among female state prison inmates. American Journal of Drug & Alcohol Abuse, 38(4), 278-285. doi: 10.3109/00952990.2012.668596 5. Blackledge, J.T., & Hayes, S.C. (2001). Emotion regulation in acceptance and commitment therapy. Psychotherapy in Practice, 57, 243-255. 6. Villagra-Lanza, P., & Gonzalez-Menendez, A. (2013). Acceptance and commitment therapy for drug abuse in incarcerated women. Psicothema, 25(3), 307312. doi:10.7334/psicothema2012.292 7. Burdon, W.M., St. De Lore, J., & Prendergast, M.L. (2011). Developing and implementing a positive behavioral reinforcement intervention in prisonbased drug treatment: Project BRITE. Jouranl of Psychoactive Drugs 43(1), 40-50. doi: 10.1080/02791072.2011.60.1990 8. Daley, M., Love, C.T., Shepard, D.S., Peterson, C.B., White, C.L., & Hall, F.B. (2004). Cost-effectiveness of Connecticut’s in-prison substance abuse treatment. Journal of Offender Rehabilitation, 39 (3), 69-92.doi: 10.1300/J076v39n03_04 9. Pérez, D.M. (2009). Applying evidence-based practices to community corrections supervision: An evaluation of residential substance abuse treatment for high risk-probationers. Journal of Contemporary Criminal Justice, 25, 442458. doi: 10.1177/1043986209344557 10. Mckiernan, P., Shamblen, S.R., Collins, D.A., Strader, T.N., & Kokoski, C. (2013). Creating lasting family connections: Reducing recidivism with communitybased family strengthening model. Criminal Justice Policy Review, 24, 94 122. doi:10.1177/0887403412447505 Mental Illness in Corrections Ali Swaggart University of Central Missouri Prisoners With Serious Mental Illness • 3 Major Serious Mental Illnesses: Schizophrenia, Bipolar Disorder, Major Depressive Disorder • The number of inmates with serious mental illnesses has consistently been found to be at a higher level than that of the civilian population Up to 45% of federal inmates and as many as 56% of state inmates (Slate et al., 2013). Challenges in Correctional Facilities Disciplinary Infractions • Associated with a violation of institutional policy. Disciplinary infractions negatively affect inmates’ eligibility for privileges and early release Victimization • Inmates with serious mental illness experience rates of physical victimization twice as high and sexual victimization three times as high as compared to inmates without serious mental illness (Slate et al., 2013) Housing Offenders with Serious Mental Illness • Solitary Confinement • Can intensify pre-existing or initiate anxiety, depression, anger, cognitive disturbances, perceptual distortions, obsessive thoughts, paranoia, and psychosis (Metzner & Fellner, 2010) More suitable housing assignments are those that don’t limit human interaction and provide programming and recreation opportunities Figure 1. Percent of Inmates that Receive Disciplinary Infractions Treatment and Release • Minimal programming opportunities available in correctional facilities (Ashford et al., 2008) • Needs Upon Release: • Transportation, housing, employment, access to community resources • Access to Medical Care • Many persons don’t have medical insurance; the rates are disproportionately high among those with serious mental illness (Wenzlow et al., 2011) Policy Suggestions • Increase specified training for correctional staff • Limit use of administrative segregation or isolation • Increase programming opportunities • Mandate individualized programming release plans References Self-Injury • Includes cutting, burning, and head banging Suicide • Inmates with serious mental illness are the most likely to successfully commit suicide (Slate et al., 2013) Ashford, J. B., Wong, K. W., & Sternbach, K. O. (2008). Generic correctional programming for mentally ill offenders: pilot study. Criminal Justice and Behavior, 35, 457-73. Slate, R. N., Buffington-Vollom, J. K., & Johnson, W. W. (2013). The criminalization of mental illness. North Carolina: Carolina Academic Press. Metzner, J. L., & Fellner, J. (2010). Solitary confinement and mental illness: A challenge for medical ethics. Journal of the American Academy of Psychiatry and the Law Online, 38, 10408. Wenzlow, A. T., Ireys, H. T., Mann, B., Irvin, C., & Teich, J. L. (2011). Effects of a discharge planning program on medicaid coverage of state prisoners with serious mental illness. Psychiatric Services, 62(1), 73-8. Mental Health Issues Directly Contribute to Increasing Prison Recidivism Rates Tara R. Jones University of Central Missouri RECYCLING PRISON LIFE V. FREE SOCIETY The majority of incarcerated individuals with mental illness find themselves returning to an incarceration facility at an alarming rate. This is due to the ineffectiveness of the criminal justice system to implement appropriate mental health care options prior to an inmate’s release. Due to the fact that there are limited mental health programs on the outside, individuals released become more unstable and irrational. Thus, allowing the individual to unfortunately relapse into familiar criminal behavioral patterns. Consequentially, the same behaviors that directly contributed to their initial introduction into the criminal justice system. The prison environment, because of its structure, tends to be more disciplined and regimented as opposed to the unstructured and carefree environment on the outside. While incarcerated, individuals suffering from mental illness will find that their daily activities are controlled by prison officials, and can find themselves in confinement if their behavior becomes unmanageable. In sharp contrast, there is no direct supervision over an individual’s daily activities upon release, and their dysfunctional behavior may go unnoticed by outside authorities. These individuals are now solely responsible for managing their own conditions, and all too often become frustrated and overwhelmed when dealing with everyday life. Figure 1. CONCLUSIONS The current public mental health system is in desperate need of restructuring. Establishing a mental health care program that would adequately provide extended mental health services upon an inmate’s release may dramatically reduce recidivism rates. This could be established between prison health officials working in conjunction with community outreach programs that specifically specialize in a variety of mental health services. SUMMARY If there is to be any positive reform in the mental health service industry, it is vital that mental health programs be readily available to individuals after the incarceration phase has ended. REFERENCES Mencimer, S. (2014, April 8). There are 10 times more mentally ill people behind bars than in state hospitals. Mother Jones. Retrieved from http://www.motherjones.com/mojo/2014/04/r ecord-numbers-mentally-ill-prisons-and-jails Law Enforcement Response and Interaction with the Mentally Ill Liz Weiss University of Central Missouri Introduction Law enforcement officers are the first responders to any call. A great amount of those calls deal with people who have mental illness. The public looks to law enforcement to do something, and to have a solution, but usually nothing can be done and the situation cycles. Many of those calls have ended with a death because officers were not educated or certified to handle situations involving persons with mental illness. Much of the time, law enforcement is not equipped with the correct training to help those with mental illness. Response teams in law enforcement, like CIT or other wise known as Crisis Intervention Team, are trained and educated to work with those who are ill. CIT's are being implemented in more department throughout the U.S. Those certified, trained, and educated individuals could be the major difference between a suicide, homicide, and a ride to receive help. Interaction with the Mentally Ill - Law enforcement is limited to what they can do in a situation involving PWMI. - LE options for situations involving PWMI include:(NAMI, 2008, p. 8-9). Solutions Give Warning Take person into custody and take for examination with mental health authorities, possibly be civilly committed, if so help at hospital 24-72 hours, then released back into the community with no further action. Citations Make an arrest, this is the last option - CIT officers are trained in handling situation involving PWMI. CIT procedures include: (Slate, Buffington-Vollum, and Johnson, 2013, p. 186) Interact with persons who are mentally ill. De-escalate crisis and move person away from violent opportunities Use resources and services available (mental health facilities, psych examination, etc.) When fatal shootings involving PWMI occur, it is much easier for the public to scrutinize. PWMI are more likely to be injured by police than for police to be injured by PWMI (Slate, Buffington-Vollum, and Johnson, 2013, p. 184). More understanding communities, less scrutiny Detach stigma from mental illness More health care options for PWMI Insurance or no insurance PWMI should not have a stigma attached to them. Fatal incidents involving PWMI can be avoided more with CIT, training, and education for officers and the community. Officers are accustomed to giving orders and expecting compliance with their commands (Slate, Buffington-Vollum, and Johnson, 2013, p. 181). PWMI may not respond with the same amount of reasonableness. Mental Illness carries a stigma that is shown by the lack of mental heath treatment, care, and responses from communities. Mobile Crisis Team (MCT) or specialized response team LE need to be trained and educated to work and handle PWMI in crisis situations. Crisis Intervention Teams are becoming more common in departments. Improve understanding of signs/symptoms of mental illness Law Enforcement handles situations involving persons with mental illness more than hospitals (Waldman, 2004, p. 83). Most response calls that end violently begin to go wrong within the first 30 to 40 seconds after police arrive (Waldman, 2004, p. 85). Reduce unnecessary arrests of PWMI Key Points the United States in 2012 (National Institute of Mental Health, 2012). Response to Calls of the Mentally Ill Many PWMI who are killed is because officers respond out of fear and lack of training. Ensure officer safety Figure 1. Persons with any Mental Illness v. Persons w/out Mental Illness in CIT Training/Training for all LE (Slate, BuffingtonVollum, and Johnson, 2013, p. 197) LE are the first responders, but there are now more resources available to help with PWMI. Figure 2. Arrests made of PWMI involving CIT v. PWMI arrested without CIT. (Slate, Buffington-Vollum, and Johnson, 2013, p. 215). More options of treatment and mental health care are needed. REFERENCES NAMI. (2008, April 17). A guide to mental illness and the criminal justice system. Retrieved from http://www.nami.org/Content/NavigationMenu/NAMILand/ CJguidetomentalillnessandcjsystem.pdf National Institute of Mental Health. (2014). Any mental illness (AMI) among adults. Retrieved from http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT.shtml Slate, R.N., Buffington-Vollum, J.K., & Johnson, W.W. (2013). The criminilization of mental illness (2nd ed.). Burhan, NC: Carolina Academic Press. Waldman, A. (2004). Police brutality. S. Fitzgerald (ed.). Farmington Hills, MI: Greenhaven Press.