HOW THE JUSTICE SYSTEM CRIMINALIZES MENTAL ILLNESS

Jesse McCann was a baby-faced teenager of 17 the day he hanged himself in a
New York State prison. The letters he had written to family and friends in
the final weeks of his young life were not at all what one would expect of
a person about to take his own life. In a letter dated March 16, 2001 - the
final day of his life - he wrote passionately about wanting to pursue a
degree in paralegal studies while in prison so that he could make a
difference for young people in trouble. He asked his Uncle Dennis for a
shipment of coffee - and talked about Twizzlers, one of his favorite
candies. He signed the letter, "Love you, Jesse," and added a smiley face
to the salutation.

This optimistic tone probably came from the medication he was taking. It
seemed to ease his panic attacks and the depression and rages for which he
had been treated often. The mood on display in this last letter, however,
was not destined to last. According to official accounts, Jesse was being
escorted to the mental health unit for his medication when he lost control
- - as inmates with mental problems often do - and began shouting
obscenities. Predictably, a corrections officer tried to quiet him. Just as
predictably, Jesse exploded. He struck the officer and was placed in the
disciplinary housing unit, where unruly prisoners can be shut up for 23
hours each day.

Isolation, a hardship for even healthy inmates, is often catastrophic for
those with mental problems. Their symptoms get worse and they often end up
trying to harm themselves. Studies show, for example, that mentally ill
inmates who are placed in isolation are far more likely to attempt suicide.
The prospect of being isolated as a result of the latest outburst was
apparently too much for Jesse. Shortly after being placed in the cell, he
tied one end of a sheet to the window, the other to his neck and hanged
himself.

This story has become familiar in New York, which has been widely
criticized for using isolation too freely, especially with the mentally
ill. Studies of suicide in the state prison system, underscored with
stories like Jesse McCann's, have led the New York State Legislature to
consider passing a law that would give psychiatric workers more latitude in
the handling of inmates with serious mental illnesses. The proposed statute
aims to expand access to psychiatric treatment and prevent disturbed
inmates from trying to hurt themselves.

The prison mental health crisis, which has gotten so much attention lately
in New York, is actually national in scope. Simply put, most of the mental
institutions that would have once housed and cared for mentally ill people
have been closed down - in most cases deservedly so, because they did their
jobs poorly. But the community-based mental health system that was supposed
to replace the mental hospitals never materialized. As a result, prisons
have been become de facto mental hospitals, but without the treatment that
would allow mentally ill patients to control their symptoms and organize
their lives.

The debate surrounding this problem goes well beyond the admittedly serious
matter of suicide. Also at issue is the fact that mentally ill people often
serve substantially longer sentences than other prisoners convicted of
similar crimes. No one has yet accounted for the difference. But it seems
clear that mentally ill people often enter the criminal justice system for
offenses and aberrant behaviors related to their illnesses. They end up
doing longer sentences - and harder, more punitive time - for acting out in
prison. To put it another way, people who hear voices - or who can't
control themselves or follow even the most basic instructions - become
automatic candidates for punitive sanctions like solitary confinement.

Jesse was not innocent when it came to breaking the law, but his case fits
this category, too. He was arrested and confined to a county jail for a
nonviolent offense. While there, he succumbed to hysteria and was charged
with assaulting a corrections officer, which is a felony. The offense seems
to have drawn him special attention from corrections officers, who make it
their business to keep close tabs on inmates charged with assaulting one of
their own. Isolated and under more pressure than ever, Jesse McCann ended
his life.

The federal government began to focus on the mental health problem when it
became clear that mentally ill inmates were driving up the prison
population and contributing to recidivism. Congress made a promising start
when it passed a law that encouraged states to integrate community mental
health services more closely into the corrections system. What the country
needs to do, however, is decriminalize mental illness. That means taking
mental problems into account in the first instance - at least with
nonviolent crimes - so that as many offenders as possible can go into
treatment instead of into prison.