Tuesday, August 23, 2016

Facing the problem of mass incarceration part 5

America's jails and prisons are overcrowded and are growing in alarming numbers. Let's look at some alternatives to incarceration.

Frequently, punishments other than prison or jail time place serious demands on offenders and provide them with intensive court and community supervision. Just because a certain punishment does not involve time in prison or jail does not mean it is “soft on crime” or a “slap on the wrist.” Alternatives to incarceration can repair harms suffered by victims, provide benefits to the community, treat the drug-addicted or mentally ill, and rehabilitate offenders. Alternatives can also reduce prison and jail costs and prevent additional crimes in the future. Before we can maximize the benefits of alternatives to incarceration, however, we must repeal mandatory minimums and give courts the power to use cost-effective, recidivism-reducing sentencing options instead.

FAMM supports the creation and use of alternatives to incarceration because:
· They give courts more sentencing options. Each offender and crime is unique, and prison or jail time may not always be the most effective response. If courts have options other than incarceration, they can better tailor a cost-effective sentence that fits the offender and the crime, protects the public, and provides rehabilitation.

· They save taxpayers money. It costs over $28,000 to keep one person in federal prison for one year (some states’ prison costs are much higher). Alternatives to incarceration are cheaper, help prevent prison and jail overcrowding, and save taxpayers millions.

· They strengthen families and communities. Prison or jail time separates the offender from his or her spouse and children, sometimes for decades at a time. Alternatives to incarceration keep people with their families, in their neighborhoods and jobs, and allow them to earn money, pay taxes, and contribute to their communities.

· They protect the public by reducing crime. Over 40% of all people leaving prison will reoffend and be back in prison within three years of their release.
 Alternatives to prison such as drug and mental health courts are proven to confront the underlying causes of crime (i.e., drug addiction and mental illness) and help prevent offenders from committing new crimes.

· The public supports alternatives to incarceration. Eight in ten (77%) adults believe that alternatives to incarceration (probation, restitution, community service, and/or rehabilitative services) are the most appropriate sentence for nonviolent, non-serious offenders and that prison or jail are appropriate only if these alternatives fail.

Some of the most frequently used alternatives to incarceration are described here. More alternatives exist, but are too numerous to be included.

Drug Courts – Drug courts are a special branch of courts created within already-existing court systems. Drug courts provide court-supervised drug treatment and community supervision to offenders with substance abuse problems. All 50 states and the District of Columbia have at least a few drug court programs. There are no drug courts in the federal system. Some states
have drug courts for adults and for juveniles, as well as family treatment or family dependency treatment courts that treat parents so that they might remain or reunite with their children. Drug court eligibility requirements and program components vary from one locality to another, but
they typically require offenders to complete random urine tests, attend drug treatment counseling or Narcotics Anonymous/Alcoholics Anonymous meetings, meet with a probation officer, and report to the court regularly on their progress; Give the court authority to praise and reward the offender for successes and discipline the offender for failures (including sending the offender to jail or prison); Are available to non-violent, substance-abusing offenders who meet specific eligibility requirements (e.g., no history of violence, few or no prior convictions); Are not available on demand – usually, either the prosecutor or the judge handling the case must refer the offender to drug court; sometimes, this referral can only be made after
the offender pleads guilty to the offense; and allow offenders who successfully complete the program to avoid pleading guilty, having
a conviction placed on their record, or serving some or all of their prison or jail time; some programs also allow successful participants who have already pled guilty to havetheir drug conviction removed from their record.
Average cost: Between $1,500 and $11,000 per participant per year

Probation/Community Corrections – Usually referred to as “community corrections” in the states (however, the federal Bureau of Prisons uses the term “community corrections” to refer to halfway houses (see below), a different alternative to incarceration), probation keeps the offender in the community but puts limits and obligations on his freedom. Probation can come with many conditions attached, including meeting regularly with a probation officer, staying under house arrest during certain parts of the day, taking random urine tests, remaining drug-free, working, doing community service, and participating in substance abuse or mental health treatment. If an offender does not comply with the probation conditions, more stringent supervision can be required, or, if the violation is serious, probation can be revoked and the person can be required to serve time in jail or prison. There are different varieties of probation: On Intensive Supervisory Probation and Parole (ISP), probation officers have fewer cases, monitor offenders more closely, and meet with offenders more often. Day reporting requires offenders to report to a location similar to a probation office on a
daily basis. Here, they undergo daily drug and alcohol tests and inform their supervisors of their plans for the day, including where they will work or search for employment.
Average cost: Probation: $9.92 per day per participant (state average)6
 $10.79 per day per participant (federal)7
 ISP: $6,000 per participant per year8
 Day Reporting: $20 per day per participant9

Halfway Houses – Halfway houses (also called “community correction centers” or “residential reentry centers” by the federal Bureau of Prisons) are used mostly as an intermediate housing option to help a person return from prison to the community after he has served a prison sentence. Sometimes, though, halfway houses can be used instead of prison or jail, usually when a person’s sentence is very short. For example, halfway houses may be a good choice when a person has served time in prison, been released on parole, and then violated a parole condition and been ordered to serve a few months additional time for that violation. While in halfway
houses, offenders are monitored and must fulfill conditions placed on them by the court. Usually, offenders must remain inside the halfway house except when they are going to court or to a job.
 Average cost: $58-$112 per day per participant (federal system)10

Home Confinement/Electronic Home Monitoring – Home confinement (also called “housearrest”) requires offenders to stay in their homes except when they are in certain pre-approved areas (i.e., at court or work). Often, home confinement requires that the offender be placed on electronic home monitoring (EHM). EHM requires offenders to wear an electronic device, such as an ankle bracelet, that sends a signal to a transmitter and lets the authorities know where the offender is at all times. Like probation, home confinement usually comes with conditions. If the offender violates those conditions, he can be put in jail or prison. Offenders on EHM usually
contact a probation officer daily and take frequent and random drug tests. In many jurisdictions, an offender cannot be placed on EHM unless the court or a jail official recommends it.
Average cost: $5-15 per day per participant11

Fines and Restitution – Requiring the offender to pay supervision fees, fines, and court costs can be used as an independent punishment or in addition to other punishments. “Tariff fines” are a set amount applied to every offender when a particular crime is committed (e.g., $500 for
driving while intoxicated), regardless of the offender’s income level or ability to pay. For the wealthy, tariff fines can be too small to be a meaningful punishment. For the poor, tariff fines can be too large, resulting in jail time when the offender cannot pay. “Day fines” are one solution. They are not a flat amount, but are based on the seriousness of the crime and the offender’s daily income. Wealthier offenders pay more and pay an amount that is a meaningful loss of income, while those with lower incomes pay an amount they can afford and avoid jail. Restitution requires offenders to pay for some or all of a community or victim’s medical costs or property loss that resulted from the crime.

Community Service – Community service can be its own punishment or can act as a condition of probation or an alternative to paying restitution or a fine (each hour of service reduces the fine or restitution by a particular amount, until it is paid in full). Community service is unpaid work
by an offender for a civic or nonprofit organization. In federal courts, community service is not a sentence, but a special condition of probation or supervised release.

Sex Offender Treatment and Civil Commitment – Many sex offenders are placed on probation, with requirements that they attend a sex offender treatment program, report regularly to a probation officer, do not contact their victims, do not use the internet, and do not live or work in certain areas. Sex offender treatment programs can be inpatient (residential) or
outpatient (non-residential) and generally use cognitive-behavioral therapy, counseling, and other approaches to reduce the likelihood that the person will commit another sex offense. About 20 states also have “civil commitment” programs, which place sex offenders in secure
hospitals or residential treatment facilities for treatment. These offenders typically receive civil commitment only after they have finished serving a prison term for their sex offense. Offenders can be required to stay on civil commitment indefinitely, which means the programs can cost up
to four times what it costs to keep an offender in prison.

Mental Health Courts – Mental health courts, like drug courts, are specialized courts that place offenders suffering from mental illness, mental disabilities, drug dependency, or serious personality disorders in a court-supervised, community-based mental health treatment program.
Court and community supervision is combined with inpatient or outpatient professional mental health treatment. Offenders receive rewards for compliance with supervision conditions and are disciplined for noncompliance. They are also linked to housing, health care, and life skills
training resources that help prevent relapse and promote their recovery. Often, offenders must first plead guilty to charges before being diverted to mental health court.

Restorative Justice – Restorative justice is a holistic sentencing process focused on repairing harm and bringing healing to all those who are impacted by a crime, including the offender. Representatives of the justice system, victims, offenders, and community members are involved
and achieve these goals through sentencing circles, victim restitution, victim-offender mediation, and formalized community service programs. Sentencing circles occur when the victim, offender, community members, and criminal justice officials meet and jointly agree on a sentence that repairs the harm the offender caused. Victim-offender mediation allows the
offender and victim to meet and exchange apologies and forgiveness for the crime committed. Restorative justice practices can be used alone or as a condition of a sentence of probation.


Facing the problem of mass incarceration part 4

Incarceration can impact a individuals life forever, especially those with mental illness. The research and facts are all over but we refuse to look at them out of fear. Here are the impacts on education and employment.

Juvenile detention interrupts young people’s education, and once incarcerated, some youth have a hard time returning to school. A Department of Education study showed that 43 percent of incarcerated youth receiving remedial education services in detention did not return to school after release, and another 16 percent enrolled in school but dropped out after only five months. Another researcher found that most incarcerated 9th graders return to school after incarceration but within a year of re-enrolling two-thirds to three-fourths withdraw or drop out of school: After four years, less than 15 percent of these incarcerated 9th graders had completed their secondary education.

Young people who leave detention and who do not reattach to schools face collateral risks: High school dropouts face higher unemployment, poorer health (and a shorter life), and earn substantially less than youth who do successfully return and complete school. The failure of detained youth to return to school also affects public safety. The U.S. Department of Education reports that dropouts are 3.5 times more likely than high school graduates to be arrested. The National Longitudinal Transition Study reveals that approximately 20 percent of all adolescents with disabilities had been arrested after being out of school for two years.

If detention disrupts educational attainment, it logically follows that detention will also impact the employment opportunities for youth as they spiral down a different direction from their non-detained peers. A growing number of studies show that incarcerating young people has significant immediate and long-term negative employment and economic outcomes.
A study done by academics with the National Bureau of Economic Research found that jailing youth (age 16-25) reduced work time over the next decade by 25-30 percent. Looking at youth age 14 to 24, Princeton University researchers found that youth who spent some time incarcerated in a youth facility experienced three weeks less work a year (for African-American youth, five weeks less work a year) as compared to youth who had no history of incarceration.

Due to the disruptions in their education, and the natural life processes that allow young people to “age-out” of crime, one researcher posits, “the process of incarceration could actually change an individual into a less stable employee.” A monograph published by the National Bureau of Economic Research has shown that incarcerating large numbers of young people seems to have a negative effect on the economic well-being of their communities. Places that rely most heavily on incarceration reduce the employment opportunities in their communities compared to places that deal with crime by means other than incarceration. “Areas with the most rapidly rising rates of incarceration are areas in which youths, particularly African-American youths, have had the worst earnings and employment experience.” The loss of potentially stable employees and workers—and of course, county, state, and federal taxpayers—is one of numerous invisible costs that the overuse of detention imposes on the country and on individual communities.

The fiscal costs of incarcerating youth are a cause for concern in these budget-strained times. According to Earl Dunlap, head of the National Juvenile Detention Association, the annual average cost per year of a detention bed—depending on geography and cost of living—could range from $32,000 ($87 per day) to as high as $65,000 a year ($178 per day), with some big cities paying far more. Dunlap says that the cost of building, financing, and operating a single detention bed costs the public between $1.25 and $1.5 million over a twenty-year period of time.

By contrast, a number of communities that have invested in alternatives to detention have documented the fiscal savings they achieve on a daily basis, in contrast to what they would spend per day on detaining a youth. In New York City (2001), one day in detention ($385) costs 15 times what it does to send a youth to a detention alternative ($25). In Tarrant County, Texas (2004), it costs a community 3.5 times as much to detain a youth per day ($121) versus a detention alternative ($35), and even less for electronic monitoring ($3.75).

Whether compared to alternatives in the here and now, or put to rigorous economic efficiency models that account for the long-term costs of crime and incarceration overtime, juvenile detention is not a cost-effective way of promoting public safety, or meeting detained young people’s needs.
The Washington State Institute for Public Policy (WSIPP), a non-partisan research institution that—at legislative direction—studies issues of importance to Washington State, was directed to study the cost effectiveness of the state’s juvenile justice system. WSIPP found that there had been a 43 percent increase in juvenile justice spending during the 1990s, and that the main factor driving those expenditures was the confinement of juvenile offenders. While this increase in spending and juvenile incarceration was associated with a decrease in juvenile crime, WSIPP found, “the effect of detention on lower crime rates has decreased in recent years as the system expanded. The lesson: confinement works, but it is an expensive way to lower crime rates.” The legislature directed them to take the next step, and answer the question, “Are there less expensive ways to reduce juvenile crime?”

WSIPP found that, for every dollar spent on county juvenile detention systems, $1.98 of “benefits” in terms of reduced crime and costs of crime to taxpayers was achieved. By sharp contrast, diversion and mentoring programs produced $3.36 of benefits for every dollar spent, aggression replacement training produced $10 of benefits for every dollar spent, and multi-systemic therapy produced $13 of benefits for every dollar spent. Any inefficiencies in a juvenile justice system that concentrates juvenile justice spending on detention or confinement drains available funds away from interventions that may be more effective at reducing recidivism and promoting public safety.

Justice institute policy

Tuesday, August 16, 2016

Facing the problem of mass incarceration part 3

The impact of incarceration on mentally ill youth and any youth is huge, it can cause a number of problems. Let's take a look at the aftermath of incarceration of our youth.

The adaptation to imprisonment is almost always difficult and, at times, creates habits of thinking and acting that can be dysfunctional in periods of post-prison adjustment. Yet, the psychological effects of incarceration vary from individual to individual and are often reversible. To be sure, then, not everyone who is incarcerated is disabled or psychologically harmed by it. But few people are completely unchanged or unscathed by the experience. At the very least, prison is painful, and incarcerated persons often suffer long-term consequences from having been subjected to pain, deprivation, and extremely atypical patterns and norms of living and interacting with others.

The empirical consensus on the most negative effects of incarceration is that most people who have done time in the best-run prisons return to the free-world with little or no permanent, clinically-diagnosable psychological disorders as a result. Prisons do not, in general, make people "crazy." However, even researchers who are openly skeptical about whether the pains of imprisonment generally translate into psychological harm concede that, for at least some people, prison can produce negative, long-lasting change. And most people agree that the more extreme, harsh, dangerous, or otherwise psychologically-taxing the nature of the confinement, the greater the number of people who will suffer and the deeper the damage that they will incur.

Instead of reducing crime, the act of incarcerating high numbers of youth may in fact facilitate increased crime by aggravating the recidivism of youth who are detained.
A recent evaluation of secure detention in Wisconsin, conducted by the state’s Joint Legislative Audit Committee reported that, in the four counties studied, 70 percent of youth held in secure detention were arrested or returned to secure detention within one year of release.The researchers found that “placement in secure detention may deter a small proportion of juveniles from future criminal activity, although they do not deter most juveniles.”

Behavioral scientists are finding that bringing youth together for treatment or services may make it more likely that they will become engaged in delinquent behavior. Nowhere are deviant youth brought together in greater numbers and density than in detention centers, training schools, and other confined congregate “care” institutions.
Researchers at the Oregon Social Learning Center found that congregating youth together for treatment in a group setting causes them to have a higher recidivism rate and poorer outcomes than youth who are not grouped together for treatment. The researchers call this process “peer deviancy training,” and reported statistically significant higher levels of substance abuse, school difficulties, delinquency, violence, and adjustment difficulties in adulthood for those youth treated in a peer group setting. The researchers found that “unintended consequences of grouping children at-risk for externalizing disorders may include negative changes in attitudes toward antisocial behavior, affiliation with antisocial peers, and identification with deviancy.”

Many young people in fact engage in “delinquent” behavior, but despite high incarceration rates, not all youth are detained for delinquency. Dr. Delbert Elliott, former President of the American Society of Criminology and head of the Center for the Study of the Prevention of Violence has shown that as many as a third of young people will engage in delinquent behavior before they grow up but will naturally “age out” of the delinquent behavior of their younger years. While this rate of delinquency among young males may seem high, the rate at which they end their criminal behavior, (called the “desistance rate”) is equally high. Most youth will desist from delinquency on their own. For those who have more trouble, Elliott has shown that establishing a relationship with a significant other (a partner or mentor) as well as employment correlates with youthful offenders of all races “aging out” of delinquent behavior as they reach young adulthood.

Of all the various health needs that detention administrators identify among the youth they see, unmet mental and behavioral health needs rise to the top. While researchers estimate that upwards of two-thirds of young people in detention centers could meet the criteria for having a mental disorder, a little more than a third need ongoing clinical care—a figure twice the rate of the general adolescent population.
Why is the prevalence of mental illness among detained youth so high? First, detention has become a new “dumping ground” for young people with mental health issues. One Harvard academic theorizes that the trauma associated with the rising violence in the late 1980s and early 1990s in some urban centers had a deep and sustained impact on young people. At the same time, new laws were enacted that reduced judicial discretion to decide if youth would be detained, decreasing the system’s ability to screen out and divert youth with disorders. All the while, public community youth mental health systems deteriorated during this decade, leaving detention as the “dumping ground” for mentally ill youth.

Another reason for the rise in the prevalence of mental illness in detention is that the kind of environment generated in the nation’s detention centers, and the conditions of that confinement, conspire to create an unhealthy environment. Researchers have found that at least a third of detention centers are overcrowded, breeding an environment of violence and chaos for young people. Far from receiving effective treatment, young people with behavioral health problems simply get worse in detention, not better. Research published in Psychiatry Resources showed that for one-third of incarcerated youth diagnosed with depression, the onset of the depression occurred after they began their incarceration.“The transition into incarceration itself,” wrote one researcher in the medical journal, Pediatrics, “may be responsible for some of the observed [increased mental illness in detention] effect.”

An analysis published in the Journal of Juvenile Justice and Detention Services suggests that poor mental health and the conditions of detention conspire together to generate higher rates of depression and suicide idealization: 24 percent of detained Oregon youth were found to have had suicidal ideations over a seven-day period, with 34 percent of the youth suffering from “a current significant clinical level of depression.”
An indicator of the shift was spelled out by a 2004 Special Investigations Division Report of the U.S. House of Representatives, which found that two-thirds of juvenile detention facilities were holding youth who were waiting for community mental health treatment, and that on any given night, 7 percent of all the youth held in detention were waiting for community mental health services.


Justice Policy Institute

Monday, August 15, 2016

Facing the problem of mass incarceration part 2

When do children's brains fully develop that is the question many people like to debate. Currently our juvenile justice system thinks it's justifiable to try children ranging in age from 10-16 in adult court. While research shows that children's brains don't develop well into their 20's. So why are we still trying children as adults? Why are we silent on such a serious matter in America? What is the impact on these children, their families, and our communities? Those are all answers I have been searching for and I am going to also share some of the answers and research with you in order to bring awareness to what we are ignoring.

In the past, many experts believed that the brain may have been done developing in the mid to late teens.  These days, a consensus of neuroscientists agree that brain development likely persists until at least the mid-20s – possibly until the 30s. All behaviors and experiences you endure until the age of 25 have potential to impact your developing brain. It may seem logical that those aged 18 to 25 are completely mature, the brain still is maturing – specifically the area known as the “prefrontal cortex.” Changes occurring between ages 18 and 25 are essentially a continued process of brain development that started during puberty. When you’re 18, you’re roughly halfway through the entire stage of development. The prefrontal cortex doesn’t have nearly the functional capacity at age 18 as it does at 25.

This means that some people may have major struggles with impulsive decisions and planning behavior to reach a goal. The brain’s reward system tends to reach a high level of activation during puberty, then gradually drifts back to normal activation when a person reaches roughly the age of 25. Adults over the age of 25 tend to feel less sensitive to the influence of peer pressure and have a much easier time handling it.There are a variety of functions for which the prefrontal cortex is responsible. Although significant development of the prefrontal region occurs during adolescence, experts argue that it continues until (at least) our mid 20s.
  • AttentionThe ability to focus on one thing, while ignoring distractions is a function of our prefrontal cortex. Those with attentional deficits (e.g. ADHD) may have abnormalities within the prefrontal region. Similarly, those who abuse drugs and/or alcohol may end up with attention problems as the brain forms.
  • Complex planningThe prefrontal region is responsible for complex planning. Anytime you set a goal that requires some degree of planning, your prefrontal region is at work. Planning out tasks in your day, developinga business plan, etc. – this region is responsible. An underdeveloped prefrontal region means that your planning capabilities haven’t been solidified.
  • Decision makingWe often struggle to make good decisions when we are teenagers, but as we enter our 20s, our decision making improves. This is due to the fact that our prefrontal cortex helps us think logically and make more calculated assessments of situations. Our brain weighs the risks and tells us whether a certain behavior or choice is a good idea vs. a bad one.
  • Impulse control: Struggling with impulsivity is often related to deficits in the prefrontal cortex. The ability to maintain self-discipline and avoid impulsive behaviors hasn’t reached its peak until the 20s. This means that if you struggle with impulsivity when you’re 18, it may get better as you continue to age.
  • Logical thinkingJustifying behaviors based off of emotions rather than logic is common among teens. When the prefrontal cortex fully develops, logical thinking simultaneously improves. This means you will be better at rationalizing and making smarter choices. It also means that your ability to write and solve math problems will improve.
  • Organized thinking: Organizing your thinking can be difficult when you’re a teen. A barrage of thoughts are typically influenced by hormones and you may have concentration difficulties. As you continue to age and your thoughts become more organized. The organization of your thoughts is a result of your prefrontal cortex.
  • Personality developmentYour personality is directly expressed based off of your prefrontal cortex. Without proper stimulation, you may struggle with identity issues and developing a favorable personality. Since personality development continues throughout the 20s, you may want to consider how environmental inputs may affect who you are.
  • Risk managementThe ability to assess risky situations and determine whether they will result in long-term benefit is a byproduct of your prefrontal cortex. Those who are poor at assessing risk may have underdeveloped prefrontal regions. The ability to turn down immediate gratification for long-term rewards is a result of this region.

  • Short-term memoryYour short-term memory function is influenced by the prefrontal cortex. When still in development, your short-term memory isn’t as good as it will be by the time you’re 25. As the brain continues to mature, your cognitive function and memorization capacity will improve.

It can be difficult to offer quality mental health treatment in corrections facilities, because prisoners are reluctant to open up in environments where they do not feel physically or psychologically safe. Also, the transition to care outside of prisons often is spotty. "Prisoners essentially fall out of the system because there's not an effective pass-off to the service providers in the community,". Treatment for mental health — as well as medical conditions — also is less effective in privately run prisons (about 10
percent of prisons), which may see medical treatment as a place to cut costs, the report says.

Mental health professionals are often unable to mitigate fully the harm associated with isolation. Mental health services in segregation units are typically limited to psychotropic medication, a health care clinician stopping at the cell front to ask how the prisoner is doing (i.e., mental health rounds), and occasional meetings in private with a clinician. Individual therapy; group therapy; structured educational, recreational, or life-skill-enhancing activities; and other therapeutic interventions are usually not available because of insufficient resources and rules requiring prisoners to remain in their cells.

The use of segregation to confine the mentally ill has grown as the number and proportion of prisoners with mental illness have grown. Although designed and operated as places of punishment, prisons have nonetheless become de facto psychiatric facilities despite often lacking the needed mental health services. Studies and clinical experience consistently indicate that 8 to 19 percent of prisoners have psychiatric disorders that result in significant functional disabilities, and another 15 to 20 percent require some form of psychiatric intervention during their incarceration. Sixty percent of state correctional systems responding to a survey on inmate mental health reported that 15 percent or more of their inmate population had a diagnosed mental illness.

People with untreated serious brain disorders comprise approximately 16 percent of the total jail and prison inmate population, or nearly 319,000 individuals. These individuals are often incarcerated with misdemeanor charges but sometimes with felony charges as a result of behaviors caused by their psychotic thinking. People with untreated psychiatric illnesses spend twice as much time in jail as non-ill individuals and are more likely to commit suicide.he longer individuals with serious brain disorders go untreated, the more uncertain their prospects for long-term recovery become. Recent studies have suggested that early treatment may lead to better clinical outcomes, while delaying treatment leads to worse outcomes. For example:

A 1997 study from California (Wyatt et. al.) compared people with schizophrenia who received psychotherapy alone (89 patients) versus those who received antipsychotic medications (92 patients); those who received medications had much better outcomes three and seven years later.
A 1998 study from England (Hopkins et. al.) revealed that delusions and hallucinations among patients suffering from psychosis increased in severity the longer treatment was withheld from the time of the initial psychotic break (51 patients were included in the study).
A 1994 study from New York (Liebeman et. al.) showed that the longer a patient waited to receive treatment for a psychotic episode, the longer it took to get the illness into remission (70 patients were included in the study).
A 1998 study from Italy (Tondo et. al.) demonstrated that the sooner patients were started on lithium for their manic-depressive illness, the greater their improvement became (317 patients participated in the study).

Isolation can be psychologically harmful to any prisoner, with the nature and severity of the impact depending on the individual, the duration, and particular conditions (e.g., access to natural light, books, or radio). Psychological effects can include anxiety, depression, anger, cognitive disturbances, perceptual distortions, obsessive thoughts, paranoia, and psychosis.The adverse effects of solitary confinement are especially significant for persons with serious mental illness, commonly defined as a major mental disorder (e.g., schizophrenia, bipolar disorder, major depressive disorder) that is usually characterized by psychotic symptoms and/or significant functional impairments. The stress, lack of meaningful social contact, and unstructured days can exacerbate symptoms of illness or provoke recurrence.Suicides occur disproportionately more often in segregation units than elsewhere in prison. All too frequently, mentally ill prisoners decompensate in isolation, requiring crisis care or psychiatric hospitalization. Many simply will not get better as long as they are isolated.



Friday, August 12, 2016

Facing the problem of mass incarceration part 1

We have a crisis in America, we are incarcerating at such a high rate our prisons and jails are becoming overcrowded and our mentally ill youth are struggling even more after incarceration. So let's dig deep into the research and then let's take a look at some alternatives. This is Part 1 of a 5 part series on the problem of incarcerating our youth.

Approximately 100,000 youths are currently incarcerated in the US[1], Just over two million youth under the age of 18 were arrested in 2008.

About two-thirds of the nation’s juvenile inmates or 92,854 in 2006, have at least one mental illness.[2]Of these two million, about 95 percent had not been accused of violent crimes, such as murder, rape, or aggravated assault. In 2010, of the nearly 100,000 youth under the age of 18 who were serving time in a juvenile residential placement facility, 26 percent had been convicted of property crimes only, such as burglary, arson, or theft.[1]

Every state in America has different laws on transferring  juveniles to adult court here are the states and their age restrictions;

No minimum age requirements;[3]
Alaska, Arizona, Delaware, Dist. of Columbia, Florida, Hawaii, Indiana, Maine, Maryland,
Nebraska, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, West Virginia

Age10; Kansas, Vermont, Wisconsin

Age 12; Colorado, Missouri, Montana

Age 13; Illinois, Mississippi, New Hampshire, New York, North Carolina, Wyoming

Age 14; Alabama, Arkansas, California, Connecticut, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Dakota, Ohio, Texas, Utah, Virgina

Age 15; New Mexico

California was at the forefront of the spiral towards imprisonment rather than treatment, when it turned its back on community based mental health programs. As usual, what started in California spread throughout the country. In 1971 there were 20,000 people in California prisons; by 2010 the population had increased to 162,000 people, of which 45 percent are estimated to be mentally ill. [4]

One psychologist found that for one-third of incarcerated youth diagnosed with depression, the onset of the depression occurred after they began their incarceration, and another suggests that poor mental health, and the conditions of confinement together conspire to make it more likely that incarcerated teens will engage in suicide and self-harm. [5]

Juveniles are 5 times as likely to be sexually assaulted in adult rather than juvenile facilities. Often within 48 hours of incarceration. [6]

Increasingly, research points to the negative effects of incarcerating youth offenders, particularly in adult facilities. Literature published since 2000 suggests that incarceration fails to meet the developmental and criminogenic needs of youth offenders and is limited in its ability to provide appropriate rehabilitation. Incarceration often results in negative behavioral and mental health consequences, including ongoing engagement in offending behaviors and contact with the justice system. Although incarceration of youth offenders is often viewed as a necessary means of public protection, research indicates that it is not an effective option in terms of either cost or outcome. The severe behavioral problems of juvenile offenders are a result of complex and interactive individual and environmental factors, which elicit and maintain offending behavior. [7]

David Gottesman and Susan Wile Schwarz[1]
Solomon Moore[2]
WGBH educational foundation[3]
Standford Law School, California State Senate pro Tem, Darrell Steinberg Stanford Law School Professor, David Mills Stanford Law School Three Strikes Project Director, Michael Romano[4]
Justice Policy Institute[5] 
The prison rape elimination act of 2003, Justice policy institute[6]
 Anna Aizer Brown University and NBER Joseph J. Doyle, Jr. MIT and NBER, 
 Psychology Department, University of Auckland, New Zealand[7] 

Thursday, August 11, 2016

Morgan's story

Morgan Geyser ( affectionately nicknamed Mogo while in utero) was just 12 years old when her life changed forever due to the consequences of mental illness and the justice system. Before her mental illness took it's toll on her, her mother Angie is quoted as saying "Morgan loved animals and was always gentle and kind. She enjoyed reading, writing, drawing, anime, and playing with her American Girl dolls. She was an excellent student and her teachers always loved having her in class. She used to stay after school to help her English teacher clean up the classroom. She was always a quirky kid who marched to the beat of her own drum. She was intensely creative and had a silly sense of humor. She was a loving and affectionate member of our family." 

Morgan is diagnosed with early onset schizophrenia or psychosis, she did not tell her parents she was experiencing symptoms . She was diagnosed in December 2014.Schizophrenia and other psychotic disorders are medical illnesses that result in strange or bizarre thinking, perceptions (sight, sound), behaviors, and emotions. Psychosis is a brain-based condition that is made better or worse by environmental factors - like drug use and stress. Children and youth who experience psychosis often say "something is not quite right" or can't tell if something is real or not real. It is an uncommon psychiatric illness in young children and is hard to recognize in its early phases.

The appearance of symptoms of psychosis before age 12 is rare (less than one-sixtieth as common as the adult-onset type), but studying these cases is important for understanding this disorder. For those who might develop psychotic disorders or schizophrenia as adults (adult-onset), it is not uncommon for them to start experiencing early warning signs during puberty or adolescence. The period of time when an adolescent experiences the early warning signs of psychosis is called prodrome. During this time, youth recognize that their experiences (hearing or seeing things that are not there) are strange or concerning. They may not easily admit these problems unless asked. Being aware of the early warning signs and offering support is crucial.
Childhood-onset - Most children with schizophrenia show delays in language and other functions long before their psychotic symptoms (hallucinations, delusions, and disordered thinking) appear. In the first years of life, about 30% of these children have transient symptoms of pervasive developmental disorder, such as rocking, posturing, and arm flapping. Childhood-onset of psychosis may present with poor motor development, such as unusual crawling, and children may be more anxious and disruptive compared to those with later onset. 
  • Feeling like their brain is not working
  • Feeling like their mind or eyes are playing tricks on them
  • Seeing things and hearing voices that are not real
  • Hearing knocking, tapping, clicking or their named being called
  • Confused thoughts
  • Vivid and bizarre thoughts and ideas
  • Sudden and bizarre changes in emotions
  • Peculiar behavior that seem unusual
  • Increased sensitivity to light, sounds, smells or touch
  • Concept that people are “out to get them”
  • Fearfulness or suspicion that isn't warranted
  • Withdrawal from others
  • Severe problems in making and keeping friends
  • Difficulty speaking, writing, focusing or managing simple tasks 

  • Treatments- Early diagnosis and medical treatment are important. It is especially important that children and youth with the problems and symptoms listed above receive a complete evaluation. These children may need individual treatment plans involving other professionals. A combination of medication and individual therapy, family therapy, and specialized programs (wraparound services, early psychosis treatment) is often necessary. Changes in life style (keeping stress low, taking fish oils), additional supports (therapy and school support) and psychiatric medication can be helpful for many of the symptoms and problems identified.
  • Making the choice about whether or not to use medications can be difficult. Second-generation (atypical) antipsychotic drugs are usually tried first because they may cause fewer side effects than standard drugs. Serious side effects of second-generation antispychotic drugs can include weight gain, diabetes and high cholesterol. Currently, the Food and Drug Administration approves the use of two second-generation drugs in children ages 13-17, Risperidone (Risperdal) and Aripiprazole (Abilify). Source; mental health America

An expert witness revealed that Geyser's father had suffered from a similar mental illness as an adolescent and was hospitalized at least four times when he was 14. Matthew Geyser later went on disability because of his schizophrenia, said Deborah Collins, a forensic psychologist, who said she interviewed him and reviewed his medical records as part of her work for the defense."There is a genetic component in psychiatric disorders," Collins said. "If a parent has a history, there can be a higher rate of incidence among offspring." (Source; JSOnline)

Both Morgan and Anissa were twelve years old at the time of the stabbing, as was the victim. All three were classmates, enrolled in the same middle school and had been at a sleepover at Morgan's home the night before. Morgan and Anissa had discovered Slender Man on the Creepypasta Wiki, a website that hosts creepypasta, or Internet horror stories. Morgan and Anissa at the time believed that Slender Man was real, and that they wanted to become his "proxies", or followers, to prove their loyalty to him, prove his existence and to prevent him from harming their families. Morgan and Anissa believed that the only way they could become Slender Man's proxies was to sacrifice someone.After they carried out the assault, Morgan and Anissa believed they would become servants of Slender Man and be allowed to live in his mansion, which they believed was in Nicolet National Forest. (source;wikipedia)

Morgan and Anissa planned to carry out the attack Saturday morning in a bathroom at a local park. However, they actually carried out the attack in a nearby forest while playing a game of hide-and-seek. The victim was stabbed nineteen times. The girls then fled. Law enforcement conducted a mass search for Morgan and Anissa. Morgan and Anissa were found walking by a Waukesha County Sheriff's Deputy.(source;wikipedia)

 Morgan and Anissa have been charged with attempted first-degree intentional homicide in adult court. Children's brains don't develop fully until their 20's. Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well into the 20s. Current studies demonstrate that brain structures and processes change throughout adolescence and, indeed, across the life course. These findings have been facilitated by imaging technologies such as structural and functional magnetic resonance imaging (sMRI and fMRI, respectively). Much of the popular discussion about adolescent brain development has focused on the comparatively late maturation of the frontal lobes, although recent work has broadened to the increasing “connectivity” of the brain.
Throughout childhood and into adolescence, the cortical areas of the brain continue to thicken as neural connections proliferate. In the frontal cortex, gray matter volumes peak at approximately 11 years of age in girls and 12 years of age in boys, reflecting dendritic overproduction . Subsequently, rarely used connections are selectively pruned  making the brain more efficient by allowing it to change structurally in response to the demands of the environment. Pruning also results in increased specialization of brain regions; however, the loss of gray matter that accompanies pruning may not be apparent in some parts of the brain until young adulthood. In general, loss of gray matter progresses from the back to the front of the brain with the frontal lobes among the last to show these structural changes.
Neural connections that survive the pruning process become more adept at transmitting information through myelination. Myelin, a sheath of fatty cell material wrapped around neuronal axons, acts as “insulation” for neural connections. This allows nerve impulses to travel throughout the brain more quickly and efficiently and facilitates increased integration of brain activity. Although myelin cannot be measured directly, it is inferred from volumes of cerebral white matter . Evidence suggests that, in the prefrontal cortex, this does not occur until the early 20s or later.
The prefrontal cortex coordinates higher-order cognitive processes and executive functioning. Executive functions are a set of supervisory cognitive skills needed for goal-directed behavior, including planning, response inhibition, working memory, and attention. These skills allow an individual to pause long enough to take stock of a situation, assess his or her options, plan a course of action, and execute it. Poor executive functioning leads to difficulty with planning, attention, using feedback, and mental inflexibility, all of which could undermine judgment and decision making.
Synaptic overproduction, pruning and myelination—the basic steps of neuromaturation—improve the brain’s ability to transfer information between different regions efficiently. This information integration undergirds the development of skills such as impulse control . Although young children can demonstrate impulse control skills, with age and neuro-maturation (e.g., pruning and myelination), comes the ability to consistently use these skills. (source; http://www.ncbi.nlm.nih.gov)

In August 2014, Morgan was ruled incompetent to stand trial.Morgan had been diagnosed by state psychiatrists with Childhood Onset schizophrenia, and was remanded to the Winnebego Mental Helath Institute. In December 2014, both girls were ruled competent to stand trial.They have been set to be tried as adults because Wisconsin law states, "all murder and attempted-murder charges for children older than 10 start in adult court." A conviction on first-degree charges in adult court could result in a sentence of up to 45 years in state prison, whereas a conviction in juvenile court could lead to three years incarceration, better mental health treatment and then supervision until the age of 18. Bail was set at $500,000 each. Morgan's parents have appealed the decision to remain in adult court several times and lost the appeal. 

Morgan is held in the state hospital currently and is allowed contact visits daily. She had no windows in her room and no access to the outdoors at the juvenile detention center, she was only allowed contact visits twice a month and non-contact visits twice a month. Morgan's parents are allowed to visit daily at the hospital. Morgan was sexually assaulted while in custody by her roommate and her roommate was simply moved to another room.  Morgan did not receive treatment for her schizophrenia for 19 months. Morgan's family and medical team have seen a steady decline in her mental state since returning to Juvenile Detention. 

The impact of being detained instead of rehabilitated will forever make its mark on Morgan and her family.
Families that lose a loved one to the justice system and mental illness can also be traumatized. The loss of a loved one has been said to feel like death in the family. It can cause major depression, PTSD, financial problems, personal attacks by society and much more. Angie Geyser states "It feels like a death. The sense of loss is impossible to describe. I had the highest of hopes for Morgan, and now I just hope to bring her home."

After thoughts: I chose to write this article because I could be Morgan's mother, anyone could be Morgan's mother. The mass incarceration of mentally ill youth in America has ballooned. We are no longer focusing on rehabilitation, our society would rather lock them up and throw away the key. We are charging children as adults now and it has a major impact on our society. With the right treatment and therapy those with serious mental illness CAN be rehabilitated and I will touch on this later in my series on the mass incarceration of our mentally ill youth. I am deeply touched by Morgan's story due to my own struggles with mental illness and my children's struggles with mental illness. It can happen to anyone and until we wake up and begin to treat it as a illness our prisons will continue to have overcrowding and mental illness will progressively get worse. I am blown away by Angie Geysers strength to continue to fight for Morgan and to provide her with the support and unconditional love she needs despite everything and everyone that is against her, Angie is attacked daily as is her family. But then when I put myself in her shoes I know I would do the same for my child. We don't have to support crime but we can choose to change the cycle and give those in need of help the help they deserve. We are our children's biggest advocates, no matter the crime a child deserves the love and guidance of their parents, after all that is our responsibility as a parent so why are we giving up on the most vulnerable people in America? 

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Tuesday, August 2, 2016

My experience with incarceration and mental illness

My experience

This will be my first post on this blog because this issue is something we as a society need to talk about, yet we avoid so often because it makes us uncomfortable.

At 15 I was arrested for the first time, I had gotten into a argument with my mother and we both got physical with each other. When the police arrested me I didn't understand why I was being taken to jail. All I knew was I was upset and angry. I was not the same person, in fact for part of the argument I blacked out and I don't remember it which is referred to as disassociation. Let me tell you how uncomfortable it is to be locked in a 5x5 foot cell with no windows, no human contact besides the guards, and locked into your own head.

I spent 2 weeks in Juvenile hall, 2 weeks of pure hell. I spent time with kids that were incarcerated for theft, battery, sexual assault, drug possession, etc. I suspect many of them also had mental illnesses.

We were allowed 1 hour of free time a day, we had open shower that had knobs you needed to press every few seconds to continue the water flow or it would turn off. Most of us had hair falling out due to the de-lice shampoo we were required to use. We were shackled like felons when going to court hearings and we were often treated like felons by the court.

The impact it left on my life was and still is devastating. I had flashbacks for years after and I lost a lot of trust in not only the justice system but my family. The mental devastation it left will forever haunt me.

I have done my best to push the memories aside and lock them away, however I get flashbacks frequently. Some things I saw I keep buried deep and refuse to talk about with those close to me, including the fact that I was held in the very same facility as my rapist mentioned in my other blog.

The reason I chose to write on this topic is because my children are affected by mental illness and I could very well see the same thing happen to any one of them, so I choose to bring awareness to the situation so I can help my children, other children and their families.

When parents lock their own children in windowless, empty rooms, it is considered child abuse and we surround the family with social services. Yet states routinely engage in this abusive practise, confining youth in small cells, alone, for 22 to 24 hours a day for weeks or even months at a time. Where is the outrage?