Mental Illness and the Prison System: A Student’s Journey

Sarah Smolyansky
Department of Biology
Lake Forest College
Lake Forest, Illinois 60045
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As he sits in the observation room, Thomas looks across the table at a man whose hands lie motionless in his lap, constrained by the handcuffs he is being forced to wear. These lifeless hands once held a gun—a gun that is responsible for another man’s death. “I am an agent of God,” he claims. This undeniable belief is how he justifies following a random man off a bus and shooting him twice in the head. Though the state has labeled him a criminal, doctors have assigned him a different name: victim.

                  Experiences like this one were not unusual for Lake Forest College senior Thomas Estruth, who spent his summer interning at the Office of Behavioral Health in Pima County of Tucson, Arizona. Throughout the course of his internship, Thomas fulfilled the role of “special staff assistant.” Some days were spent in the office making sure that the proper paperwork was in place to bring detainees from other counties to the local Pima County jail. It was also common for Thomas to travel to Mental Health Court, where he watched the behavioral health judge go through the due process of a trial for thirty to forty cases. If the judge found that a detainee was not mentally fit to stand a trial, he or she was placed in the Restoration to Competency Program—a program in which individuals accused of committing a crime undergo psychiatric treatment. On days that he did not attend court, Thomas’ internship took place at the jail. This time was spent shadowing a forensic psychologist whose duty is to educate detainees on the court system and trial process. 

                  The majority of the patients Thomas worked with had schizophrenia—primarily paranoid schizophrenia—and bipolar disorder. “I pitied them,” he noted several times. “These people are basically abandoned by society,” he expressed, “and their families, too.” During his three months at the office, Thomas interacted with roughly thirty inmates and witnessed three cases from beginning to end. His sympathy toward the detainees stemmed from these three cases in which the inmates were able to return to “normal” behavior. For example, the man who shot a random man he followed off a bus achieved remission through the treatment program. His behavior transformed to such a high degree that he moved from a psychotic state to a very depressed state. The man no longer perceived himself as an agent of God, but rather a murderer. “I felt bad, because when the power of the drugs brought the detainees to a state of reality, they were very sad about their former behaviors,” Thomas explained. For some inmates, the difficulties of remission lead them to discontinue taking their treatment drugs once released from jail, for they would rather be in a psychotic state where the world makes more sense to them.

                  Thomas is glad that mental health is increasingly becoming more recognized in Arizona and that the state is taking more time to understand how to deal with prisoners who suffer from such disorders. On the administrative side, Pima County has recently established the Crisis Response Center (CRC), which treats victims of mental illness for 24 hours and then releases them back into society. This center helps the mental health field and saves money for the people of Pima County, for police officers are able to admit individuals they find having a mental health episode directly to the CRC without needing to monitor them for several hours in the hospital. In terms of future prospects, Pima County is in the process of trying to get the jail on a mandatory court-ordered insurance program to provide released inmates with unlimited access to their prescribed medications.

                  After interning at the Office of Behavioral Health, Thomas is confident that he would like to work in this field in the future. “The entire internship changed my perception of mental health and the use of drugs to assist with mental disorders,” he explained. Thomas feels much more consciously aware of individuals with serious mental disorders and hopes that Pima County’s changes will improve how society addresses this form of illness.



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