How Many of the Mentally Ill are Really in Prisons, Exactly?

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1 Boring Old Man has written a series of posts examining some of the older and newer scientific literature about the number of people with mental disorders in prison populations, and finds himself questioning a lot of their methods.

transinstitutionalization? I… (1 Boring Old Man, December 17, 2014)

transinstitutionalization? II… (1 Boring Old Man, December 18, 2014)

transinstitutionalization? III… (1 Boring Old Man, December 19, 2014)

transinstitutionalization? IV… (1 Boring Old Man, December 20, 2014)

9 COMMENTS

      • Hi Darby and Uprising,

        This is a challenge I thnk we all face all day every day in all of our dialogues, blog posts and reporting. I won’t try to speak for anyone else, but here’s my challenge: If I was strict about this, I would be putting virtually every second word in “quotes”. The terms “mental health” and “normal” and “average” and “not mentally ill” are laden with assumptions, too (And let’s not forget, there are some people who argue quite eloquently that perhaps in some ways “everyone” is indeed “mentally ill” because our society is fundamentally “sick”.). Many people find “consumer” or “survivor” offensive, while others embrace one of those labels but rarely both. Some would call themselves “patients” or “ex-patients”, while others find even the implied suggestion of a person with an illness being treated to be offensive. The words “schizophrenia” and “psychotic” carry very powerful, often negative connotations. Do antidepressant drugs actually have proven “anti-depressant” qualities, or should that word also be in quotes? How about “antipsychotics”? The word “criminal” also has both a literal, factual dimension (‘person who has been found guilty of a crime under a jurisdiction’s laws’) and a very derogatory one, so one could reasonably argue that word should always be in quotes, too.

        In practical terms, all of that becomes difficult to manage in the context of putting out multiple stories every day. So the ‘rule’ I tend to go with is, when I’m trying to reasonably neutrally summarize or report on someone else’s writing, I tend to use the terms that writer used. If they put something in quotes, then I usually do. If they did not, then I do not. Sometimes, it may not be immediately obvious, so I might try to understand if the writer seems to be raising particular terms or ideas into question or not, and then make my own decision from there about how to summarize it. Or if the particular context for the word or label seems particularly unusually inflammatory, then that may prompt me to put it in quotes regardless. If you read a lot of my articles, you may notice that I frequently write “people diagnosed with…” as opposed to “people with…”, but the reality is, that too becomes difficult to manage in pithy headlines or grammatical sentence structures and I start to wonder if it really makes any fundamental difference to most readers. Besides, “diagnose” also implies illness, and so others would suggest going with “labeled with…”; however, writing “people labeled as having mental illnesses” is a phrase that would make many “ordinary” readers immediately doubt the “neutrality” of the author…

        In the case of this particular headline, I think Uprising’s alternative is good. However, 1 Boring Old Man does use the term mental illness without quotes. And I also felt that putting the headline in the frame of a question, and noting that 1 Boring Old Man’s articles were fundamentally questioning all the methodologies at work, sufficiently flagged that ‘all may not be as it seems in the world of mental disorders and criminals.’

        None of this is excusing myself of anything, by the way. Just an explanation, for your interest. It’s a delicate balancing act for all of us, trying to communicate effectively with a broad readership about these complex, highly sensitive issues.

        Thanks for reading!

        Rob

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        • Hey Rob,

          Thanks for the explanation. I have often thought about how glad I am that I don’t have to navigate the minefield of coming up with these headlines. I really admire the work you’ve been doing. It’s neat to understand your process, and I think it works 99% of the time. I think this is a rare case in which it doesn’t work.

          I feel that the phrase, “the mentally ill,” if it must be used, should be in quotation marks, regardless of it being the author’s choice of words. This is because, as Darby wrote, it does have the quality of an epithet. Reading those words, as a person with psychiatric diagnoses, I feel like I am being written about as something less than human.

          I’ve never actually thought much about why that is. Maybe it’s the objectifying “the.” Could you imagine the following headline: How Many of the Blacks are Really in Prison, Exactly? or How many of the Gays are Really in Prison, Exactly? I can’t help but think that either of these hypothetical phrases would be in quotes if they appeared on MIA.

          I understand why you chose to use the phrase, “the mentally ill,” in this instance, but that understanding does not take away the phrase’s emotional impact. I know that you have a lot to factor into your editorial decisions, but I feel that it is important to share this.

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          • Hey Uprising,

            Thanks for your thoughts. I see the problem with the “the” in that context! Although, like you, I can’t readily figure out why that doesn’t sound good, other than that it’s grammatically superfluous to use the “the” in that context… I would never use such titles for that reason, but if I did…

            Headline: How many of “the blacks” are really in prison?
            — That’s very odd, and I don’t think that’s what you’re after, is it?

            And of course without the “the”, it’s common to say or write “Gays Speak Out” or “Blacks Concerned about Racist Policing.”

            But does that mean you’d be okay with “How Many Mentally Ill are in Prison?” and “How Many Blacks are in Prison?”

            And of course the phrase is actually in the title of the book after which this website is named… “Mad In America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill.” Does it sound equally bad to you there?

            I’ll probably never use the phrase again merely because I’ll be even more aware of it now after our exchange! 🙂 But still, I’m not sure I really know why you would think it so much worse than so many other of the examples… All of which also concern me, of course, don’t get me wrong.

            Alternatively, if you look, you’ll see many of the Around the Web titles are entirely in quotes, if I’m taking a quote or title from the source. Would that have been better?

            Rob

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          • Great reply 🙂

            Headline: How many of “the blacks” are really in prison?
            – That’s very odd, and I don’t think that’s what you’re after, is it?

            No, it’s not; though even here, it seems to me that it’s not quite as offensive as it might be if you weren’t setting the phrase off in quotes and thereby distancing yourself from it.

            And of course without the “the”, it’s common to say or write “Gays Speak Out” or “Blacks Concerned about Racist Policing.”

            But does that mean you’d be okay with “How Many Mentally Ill are in Prison?” and “How Many Blacks are in Prison?”

            As I said, I hadn’t given all this much thought before. This is clearly where my examples break down. That’s what I get for freestyling! It still seems like the “the” is a factor in all this, but it must not be the only one. “How Many Mentally Ill are in Prison?” is better without the “the,” but still dehumanizing, in my opinion – maybe because it’s like saying those people who have been given psychiatric diagnoses ARE “mental illness,” broken brains with arms and legs. Maybe the phrase “mentally ill,” used in this way (with or without the “the”) is actually closer to the kinds of words that no one here would ever print in the context of discussing other oppressed populations? Perhaps someone who has thought about it more than I have can help me out on this.

            And of course the phrase is actually in the title of the book after which this website is named… “Mad In America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill.” Does it sound equally bad to you there?

            Yes, it does. I’d actually remembered that subtitle when I wrote earlier, but I was afraid of getting off track. It’s a great book and I understand the decision to go with “the mentally ill” in the subtitle. It prevents the subtitle from being clunky and/or burdened with awkward quotes, and certainly it’s fairly uncontroversial to use the phrase in mainstream society, and yes, there are many people who might not read the book if that phrase were in quotes, and yet… it still doesn’t sit well with me.

            Alternatively, if you look, you’ll see many of the Around the Web titles are entirely in quotes, if I’m taking a quote or title from the source. Would that have been better?

            Yes, definitely. And it seems to me now, thanks to this conversation, that doing so would be less awkward than merely putting the offending phrase in quotes. I really appreciate this conversation, Rob. It has been enlightening.

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  2. The main problem is that it is circular thinking:
    a) many things are criminalized because they are bizarre not because they are dangerous. One should stop putting people away (to prisons but to mental institutions as well) for bs “crimes” and not complain about mentally ill being locked up in the wrong kind of hole
    b) a lot of DSM disorders are defined by criminal behaviour or “oppositional” attitudes so in many cases criminal = mentally ill by definition not because of any underlying medical problem but because we chose to redefine criminal behaviour as mentally ill

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    • “b) a lot of DSM disorders are defined by criminal behaviour or “oppositional” attitudes so in many cases criminal = mentally ill by definition not because of any underlying medical problem but because we chose to redefine criminal behaviour as mentally ill”

      B, I agree with redefining criminal behavior not as mentally ill. If psychiatry had its way all of humanity would be considered mentally ill and there fore more to drug.

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      • “If psychiatry had its way all of humanity would be considered mentally ill and there fore more to drug.”

        That is the case where I live. Every single person in my State is considered to have a mental illness by the definition in our Mental Health Act. Saves a whole bunch of problems for mental health workers when they want to lock someone up and drug them. Matter of degree, not kind that way. It then becomes a matter of separating out who poses the greatest risk to self or other. Anyone with a negligence claim against a doctor goes straight to the top of the list lol.

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