Author: Mary Beth Pfeiffer
APA Style Citation
Pfeiffer, M. (2007). Crazy in America: The Hidden Tragedy of OurCriminalized Mentally Ill. Carroll and Graf Publishers, N.Y., New York.
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Shayne Eggan was a beautiful girl with a charismatic personality who took after her dynamic and free-spirited Greek mother. She had a normal and happy life until her mid-teens when she began to respond to the overtures of boys and older men and started to express the belief that others could “read her mind.” Shayne was hospitalizedfor these delusions and her strange Indian themed hallucinations. She became a ward of the state of Iowa because her parents` minimal means could not pay for her continued hospitalization and she was determined to have paranoid schizophrenic tendencies which could cause her to become violent. Shayne believed she was an Indian princess. She became obsessed with an older Indian man and continued to write to him and believe they would be together long after he was married and had children. Shayne often became violent, first with her family, and then with others. She expressed that, “I get so scared that people are going to hurt me, that I have to hurt them first.” During one such psychotic episode, the police were called,andshe lunged at a police officer with a knife because she thought he was going to hurt her. She was arrested and thus began Shayne`s life in the criminal justice system. Shayne had a baby in prison who was immediately removed from her care because it was claimedthat Shayne expressed a desire to kill him, which she denied. Shayne would be releasedafter serving a term but within a few days would often wind up back in prison because her delusions caused her to break into someone`s home, or act out violently when she felt she was being threatened. Because of her record, instead of a warning or probation, she would wind up back in prison. Once in prison, she could not abide by the strict rules of the institution which would result in an extended sentence or time in solitary confinement, which often made her delusions worse. The local mental health care facility was not an option because the facility which had housed 1,800 people in the 1940s, housed only 95 patients in the 1990s. From 1995 to 2000, Iowa went from having 204 beds for every 100,000 people to having six.
Shayne needed immediateintervention and could not wait years for treatment. She attempted to treat her delusions and hallucinations with drugs, which often exacerbated the problems. In solitary confinement, Shayne`s delusions became so intense that she dug her owneye out, she explained that this made her feel good. While prison officials panicked, Shayne played with her hanging eye, and was eventually handcuffed to restrict this behavior. Later, during another stint in solitary, Shayne attempted to chew off her pinky and lost four teeth in the process.
Shayne is not alone in suffering from her mental illness while incarcerated. Of the 2.2 million people in American jails in 1999, roughly 330,000 were mentally ill. In 2005 estimates were that 34% of those in prisons were mentally ill. By 2006, Shayne was one of the lucky ones as she was able to procure a bed at the mental health institute in Independence, Iowa. By that time, Shayne had lost her second eye in much the same way as her first and was completely blind. While she is not curedtoday, her symptoms seem more under control, although she still has not accepted her diagnosis.
Shayne’s story is typical of hundreds of thousands of Americans dealing with a criminal justice system that does not allow for the different and often “belligerent” behavior of some individuals withmental illness. These individuals often have no place to go and as a result of their illness wind up in prison where treatment is lacking if there is any treatment at all. While Shayne eventually received the treatment she so desperately needed, many others are not so lucky.
In another case study described in the book, Luke Ashely who suffered from debilitating anxiety and schizophrenia self-medicated with drugs. He was initially arrestedfor possession of two pills of ecstasy. Eventually, after begging his mother to come and get him out of prison somehow, he hanged himself in his cell as the stress and anxiety of prison was simply too much for him to take.
In another tragic case depicted in the book, Alan Houseman wandered the streets of his Tampa neighborhood where he was recognizedas odd but not dangerous. He lived with his mother, andafter her death,his paranoia became increasingly more intense. He would eventually lose his life after being shot by a police officer who confronted him as he urinated in a public parking lot. His paranoia of law enforcement caused him to ignore orders from the officer, andwhile he attempted to flee (because he believed she was there to take him to a mental health care facility),he was shotmultiple times. In yet another case, Peter Nadir who was extremely autistic got into a physical altercation with his disabledmother. Concerned neighbors called the police,andin the pursuit of Peter who would not abide by officers` request,Peter died of asphyxiation. A police officer who was trying to get Peter under control, was kneeling on his back but also cutting off his ability to breathe.
Between 2000 and 2006, 24 people were killed by police officers in the Tampa Bay area alone. Most investigations into the deaths of these individuals resulted in the exoneration of police officers, most of whom have not been trainedin dealing with the mentally ill. In 2002, in Florida jails, 23 percent of inmates had a mentalillness, which is three times the figure from 1992. Florida, like many other states, hasessentially replaced state psychiatric hospitals with state and local correctional institutions. America`s prison system had the world’s highest per capitaincarceration rate in 2005; 714 per 100,000 people. In the U.S., 60 billion dollars was spent on prisons while a fraction of that was spenton the proactive treatment of the mentally ill. In 1980, 57% of people incarcerated in New York had gone to prison for violent offenses. By 2002, that number was down to 29%. Many mentally ill individuals attempt to self-medicate by using illicit drugs and because of “get tough”laws on drug crimes many of these individuals find themselves in prison and unable to manage day-to-day prison life because their illness makes it difficult to abide by the strict rules of the system. Thisoften results in increased sentences because of misbehavior or time in solitary, which often makes the psychotic symptoms worse. While the history of treatment for the mentally ill in America has certainly been far from perfect, we appear to have moved away from a structured and helpful treatment.
Proactive efforts to treat the mentally ill would allow many to lead healthy and productive lives before the symptoms get out of control. Law enforcement agents need to be trainedon how to deal with mentally ill individuals who may feel threatened or act violently because of their illness. Community programs are necessary to reintegrate or keep those suffering from mental illness in the community that may mean helping with simple tasks such as paying bills and supporting the individualswith empathy and understanding. Despite some progress, mental illness still carries a stigma, andmany of those suffering are forced to live on the fringes of society. America has done little to assist this population, andthe impact has been profound.
Other Related Resources
Stigma in a Global Context: Mental Health Study Indiana University
The Atlantic: Should the United States Bring Back Psychiatric Asylums?
John Oliver Last Week Tonight on Mental Health
National Bureau of Economic Research: Mental Health Treatment and Criminal Justice Outcomes by Richard Frank and Thomas G. McGuire April 2010
PEW Charitable Trusts: Prison Health Care: Costs and Quality: How and Why States strive for high-performing systems October 2017
National Public Radio: How the Loss of U.S. Psychiatric Hospitals led to a Mental Health Crisis
Technology and the Future of Mental Health Treatment: National Institute of Mental Health
Five-point Plan to Improve the Nations Mental Health
Psychological Figures and Concepts