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In recent years, there has been an increasing need for the
services of forensic psychologists largely due to the
deinstitutionalization movement. Deinstitutionalization is the
process by which large numbers of patients with chronic and severe mental
illness were discharged from psychiatric hospitals into the community to
receive outpatient treatment. This movement began in America in the 1950’s
when state psychiatric hospitals began closing at rapid rates, and is still
continuing today. The theory behind deinstitutionalization was sound – to
manage the mentally ill in the least restrictive treatment environment
possible in order to increase their civil liberties and freedom. The
development of new antipsychotic medications in the 1950’s and 1960’s which
were more effective in managing psychotic patients’ symptoms led people to
believe that many of these individuals could be treated in the community.
The central idea behind the deinstitutionalization movement was that the
funding previously provided to state hospitals was supposed to
be poured into the community to develop outpatient mental health centers and
residential treatment facilities. Unfortunately, the deinstitutionalization
movement did not succeed for two primary reasons. First, the government never
adequately funded these necessary community resources. In fact, funding for
mental health services continues to decline in America today. Second, the
movement failed to consider that there is a subset of mentally ill
individuals whose illnesses are so severe that they require long-term
hospitalization and simply cannot function in the community no matter what
services are provided to them. |
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The unfortunate consequence of deinstitutionalization is that
mentally ill individuals have been left to fend for themselves with few
resources, and thus have become homeless. Research studies have shown that
up to 70% of all homeless individuals in America have been diagnosed with a
mental illness. This phenomenon has led to the criminalization of the
mentally ill, as many homeless mentally ill people find themselves
arrested for minor crimes such as trespassing, disturbing the peace for
talking to themselves, or walking into moving traffic. Thus, this subset of
mentally ill individuals who are unable to function in the community no
matter what resources are provided to them are now primarily on the streets,
in jails, and in prisons. Since the 1950’s, the nationwide state hospital
population has decreased by 90%, whereas the prison population has increased
by 400%. In Florida, there are five times more people with mental illness in
jails than in hospitals. In fact, the largest public psychiatric facility in
Florida is the Miami-Dade Pre-Trial Detention Center. Ironically, the costs
of housing inmates with severe mental illnesses in jail are much higher than
it was for them to receive treatment in state hospitals. It costs twice
as much money to detain a mentally ill inmate in Broward County, Florida
(Fort Lauderdale) than it does to detain an inmate without a mental
illness. Further, such individuals typically do not get the treatment they
need in jails. It is not surprising that treatment is much more effective
when it is provided by professionals who have been trained to treat the
mentally ill such as psychologists than correctional officers. In addition,
the newest and most effective medications are often not available in the
jails. Individuals with severe mental illnesses also languish in jail much
longer than mentally healthy inmates as they struggle to navigate their way
through the complexities of the legal system. In fact, estimates suggest
that mentally ill defendants remain in jail eight times longer than their
non-mentally ill counterparts. |
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The staggering numbers of mentally ill offenders in jails
have created a tremendous need for these individuals to be evaluated by
forensic psychologists. For example: |
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Prosecutors may wish to know whether mentally ill
defendants are more likely to commit violent crimes than defendants
without mental illness. |
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The courts have a duty to ensure that chronically mentally
ill defendants are competent to stand trial, and if deemed incompetent to
proceed these defendants must receive the treatment necessary to restore
their
competence. |
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Public Defenders and private criminal
defense attorneys may wish to know what the role of a defendant’s mental
illness was in the commission of a crime. |
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