Mental Health Matters: Women, drugs and the criminal justice system
Mental Health Matters
Good fortune. The Incline Village chapter of the American Association of University Women asked me to talk. I did, last week. My topic, “Women, Drugs, and the Criminal Justice System.”
A thoroughly depressing topic, I know, but I wasn’t there for stand-up comedy. Here’s the talk, edited to fit this column and the next, two weeks from now.
There is a hidden rot eating away at the American soul. We see ourselves as a good people, a kind and caring tribe, given to sharing our bounty with those less fortunate, providing a helping hand, a second chance, or a third, for those who fall from grace.
Until you get caught with “illegal drugs.” Then, unless you’re well off and/or talented, you will likely suffer a lifetime of hurt. Probably a permanent felony record, disenfranchisement, a ban on food stamps, public housing, other state benefits, markedly diminished employment opportunities, and criminal stigma.
Most who get arrested for felony drug possession will spend time in jail or prison — days, weeks, months or years. Drug treatment and/or other rehabilitation services are meager at best, and are usually distinctly dogmatic, impersonal and ineffective.
Some data: The United States has less than 5 percent of the world’s population, but 25 percent of the world’s prisoners, more than either Russia or China, countries with far larger populations. We have some 10 times as many drug prisoners now than in 1980, when the War on Drugs really got fired up.
In the past 30 years, drug offenses account for 2/3 of the increase in federal prisoners, and over 50 percent in state prisoners. In New York City, there were 50,000 marijuana possession arrests in 2010 alone.
There are more African Americans under correctional control today, namely in prison, jail, probation or on parole, than there were slaves in 1850, a decade before the civil war. In 2004, more African Americans were disenfranchised than in 1870.
Put simply, the crime of drug possession has produced a vast expansion of the criminal justice system in the past 40 years, much of it on the backs of African-Americans, Hispanics and the poor.
But perhaps the carceral state, as some call it, produces positive results. Well, here are some outcomes.
Two-thirds of released prisoners reoffend within three years and return to prison. In the first two years following release, the risk of death is 13x higher than the general public. Suicide rates skyrocket shortly after prison release. And a recently released prisoner is 129x more likely to die of a drug overdose than a comparable non-prison population!
What about women prisoners? The number of incarcerated women has grown by 800 percent in the past 3-0 years: Two-thirds are non-violent. Thirty percent are imprisoned for drug related crime. Eighty to ninety percent have a history of abuse. Most tend to be poor, undereducated, and unskilled.
And their children? In 2007, 53 percent of prisoners had a child under 18. More than two and 1/2 million children have an incarcerated parent, while 8 percent of black children have a parent incarcerated.
These are not encouraging results. And it’s not a rap on conscientious, thoughtful, judges or decent, caring police, deputies or correctional officers — all trying to help substance abusers when they have limited clinical expertise.
There is a fundamental problem here — drug abuse and addiction is a result of emotional pain and suffering, not of loose ethics or immoral behavior.
How then do you ask a drug abuser to come out of the shadows when they are labeled criminals, demeaned and denigrated? This real life impact lends further terror to the already disordered mind of the substance abuser. And sometimes to an unnecessary death.
When a drug abuser believes the emergency room will call the sheriff or refuse detoxification assistance, that a drug counselor will call your probation officer, or that a drug rehabilitation program might call the police, he or she will be much less likely to seek help.
Now picture the mental health provider who works in or with the criminal justice system — who is your client? The drug abuser or the system? The drug abuser wants your help, but will not fully trust you, knowing your duel and dueling loyalties.
Do you report each and every mistake, lapse, error, or slip of your addict client, knowing that you are instructed to do just that, but that doing so may land your client in jail?
The ethical band is only so wide, and this duel loyalty stretches it to the breaking point.
Enough for now. In my next column, I will address some of the historical precedents leading up to the Drug Wars, and some of the new and innovative programs that law enforcement is finally starting to introduce.
Incline Village resident Andrew Whyman, MD, is a clinical and forensic psychiatrist. He can be reached for comment at firstname.lastname@example.org.