This post is part of the Mental Health Monday series, in which iustitia examines one aspect of the intersections between mental health and the law. You can find previous posts here.
One in five Americans suffers from a mental health condition. Approximately 24 percent of state prisoners have a recent history of a mental health condition. Individuals suffering from mental illness are four and a half times more likely to be arrested than any member of the general population. Instead of equipping prisons to competently handle the issues associated with caring for prisoners with mental health conditions, states are increasingly turning to privatization, both of mental health services and of prisons generally. However, the problems that arise with privatization far outweigh the benefits and put states at risk of violating the Eighth Amendment of the United States Constitution.
The U.S. Constitution’s Eighth Amendment prohibits the infliction of cruel and unusual punishment. This provision of the Eighth Amendment embodies the “broad and idealistic concepts of dignity, civilized standards, humanity, and decency.” Jackson v. Bishop, 404 F.2d 571, 579 (CA 1968). In Estelle v. Gamble, 429 U.S. 97 (1976), the U.S. Supreme Court ruled that the government has an obligation to provide medical care for incarcerated individuals. The Supreme Court noted that the denial of such care could result in pain, suffering, torture, or death.
The privatization of mental health care for mentally ill inmates brings with it a host of problems. Despite the constitutional requirement to provide adequate mental health care for inmates, only about one-third of state prisoners in need of mental health care report receiving any during their incarceration. For private mental health care providers, there is a strong disincentive to report abuse of inmates by public prison officials because doing so could jeopardize their contract.
Moreover, for-profit corporations running private prisons are incentivized primarily by profit—the total U.S. corrections market exceeds $70 billion. Privatized prisons are widely accused of dangerously understaffing in an effort to save money and increase profits. Disproportionate guard-to-inmate ratios have a direct correlation to increased violence, abuse, and sub-substandard care. Disturbingly, many private prison contracts require corporations to maintain a high capacity. This leads to large corporations, like Corrections Corporation of America and GEO Group, pouring millions into lobbying for their interests, including stricter sentencing laws to keep America’s prisons occupied, their contracts fulfilled, and pockets lined.
Mental health services for inmates should remain a state responsibility with checks and balances. Iustitia Legal Center believes that corporations should not be profiting from the United States justice system in a way that compromises the health care and wellbeing of vulnerable individuals deprived of their liberty. Prison administrators have a constitutional obligation to protect individuals in their custody, and leasing that obligation out to companies motivated by personal profit rather than the public good is primarily harming individuals with mental illness and disabilities who do not receive the services they need.
Finally, although the U.S. Supreme Court has established the constitutional obligation to provide health care for incarcerated individuals, including treatment for serious illness, the law should be explicitly clarified to ensure the inclusion of mental health care and treatment for mental illnesses. Iustitia Legal Center recommends this development in the law as an important step toward reforming the current U.S. prison system, protecting those that suffer from mental health conditions, and destigmatizing mental health care.