The Register-Herald, Beckley, West Virginia

January 5, 2013

Inmate's death should refocus us on mental health


— The Nov. 30 death of Michael English in the District of Columbia jail is a sad, obscure footnote but for the Dec. 14 school shootings in Newtown, Conn.

English was 22, a successful high school student who had dropped out of college after a series of criminal charges and diagnoses of mental illness. That he was found hanging in his jail cell with a bed sheet around his neck is no surprise to the people who knew about his case, The Washington Post reports.

His probation officer told the court a year ago that he feared for English’s well-being along with the community’s safety.

Margaret English said her son’s death should not be in vain. “Jail is not an appropriate place to be for people with mental illness.”

She’s not the first to say that, but maybe after Newtown, she will become one of the last.

This country has a problem admitting that mental illness is real and that it can afflict anyone at any time. What separates one person who commits suicide or serial killings from another who is down on his luck could be one supportive friend. When options start falling like dominos, it’s easy to believe that ending it is a viable alternative.

And the dominos have been falling since the 1980s when the Reagan administration’s deregulation of everything, including health care, took away many of the options available to those with mental illness.

In the early 1990s, health care providers regularly told this reporter the closure of mental institutions was increasing the burden on hospitals and already overloaded mental health clinics.

They were right then and prophetic. The number of people flooding into correctional facilities has overwhelmed state budgets and state corrections officials.

The deregulation of health care combined with a reduction in reimbursement through Medicaid has forced hospitals to throw the mentally ill back into the streets with a hope and a prayer.

Here’s how the lives of English and thousands of others like him play out. Some event triggers mental illness. If no crime directly occurs and the person is legally an adult, family members intervene with an involuntary hospital commitment. After a stay of a few hours or a few days, the person is released with medication in hope that he or she will be successful in taking the medications.

The person often isn’t. Just as American society denies the existence of mental illness, so do those who suffer from it. Once they feel better from taking the medications, they decide to stop them because they don’t think they need them any more, they don’t like the side effects or both. However, the lack of medication brings back the pain, so the person starts self-medicating with alcohol and/or illegal drugs. Next comes homelessness. The next step is usually a criminal act that thrusts the person into the criminal court system.

Once the person enters the court system, it’s nearly impossible to get proper mental health treatment. If the person gets treatment in lieu of jail time, the cycle begins again with the responsibility for self-care falling on the patient.

Former Washington Post reporter Pete Earley described this cycle in his book “Crazy,” which chronicles his family’s descent into hell when son Mike is diagnosed with mental illness and criminally charged after illegally entering a neighbor’s home.

Earley made several visits to the crowded Miami-Dade County jail. He saw inmates who went unfed and unclothed because guards weren’t trained on how to handle mental illness and because adequate care was not available.

Earley recounts the daily rounds of Dr. Joseph Poitier, the psychiatrist who attempted to treat the mentally ill inmates. On one day, Poitier saw 92 inmates at the jail’s mental health cell block in 19-1/2 minutes. Earley noted that was an average of 12.7 seconds per inmate.

The horror movies of those trapped in cruel insane asylums are not scenes that people want repeated in real life, but they are happening every day in correctional facilities.

Requiring people to live in homes where their medication can be regulated and their movements restricted does infringe on individual civil liberties. But as the number of serial killings continues to grow, this nation must balance restricting the civil rights of one against ending the lives of dozens.

People who suffer from chronic, debilitating mental illness need help to manage their lives safely. Asking families and the criminal court system to bear that burden is unfair and unsafe.

It’s time for mental health reform. It’s time for humane asylums.

— Young is a Register-Herald columnist. E-mail: ynerissa@frontier.com