The Rich and Mentally Ill Find Hospitals, the Rest Find Themselves in Jail
When socio-economic disadvantage becomes a one-way ticket to jail
Poverty and Mental Illness
It would not strike anyone as surprising to find that poverty is closely linked with the mental health of an individual. It can be both a cause and a consequence of illness. The mental health of an individual is shaped by a wide array of contributing factors, but inequalities in the social, physical and economic environment stand out as one of the most prominent ones. Poverty and homelessness paint an extremely hostile environment for an individual and his/her family, not only due to lack of provision of basic needs, but also a weakened sense of personal safety and protection, status in the community, social exclusion and loneliness, disturbed family dynamics and functioning, as well as poor healthcare provision. All of these are magnified to an unimaginable level when symptoms of mental illness inevitably begin to surface.
According to a report by the WHO, even the most common mental disorders are more common amongst the poor as compared to the rich, by about 1.5 times to double. It is estimated that those experiencing hunger, having the burden of debt repayment looming over them, and living in overcrowded housing have a much higher prevalence of common disorders among them. The situation is more or less similar for those with lower levels of education and those struggling with unemployment. For severe disorders such as schizophrenia, the likelihood of developing them amongst the financially disadvantaged is about 8 times more than the financially stable. To top it all off, within this group of individuals most prone to mental illness, the illness goes largely unrecognised. As a result, when one of them is found committing a felony, there is no further probing as to what the reason behind it could be, and it is simply chalked off as ‘desperation’, natural behaviour of someone in a disadvantaged position. Treatment is out of the question, one goes straight behind bars (although, if treatment was to be taken into consideration, how many low-income groups can afford the expensive ordeal that quality mental healthcare services are?). So, if you find yourself at the last rung of the socio-economic ladder, remember that you still have not hit rock bottom until wrongly imprisoned.
Committing an Offence by a Person Suffering from Mental Illness
The Douglas Mental Health University Institute reported a number of reasons why an individual from a low-income group with a mental disorder has a higher probability of being imprisoned. Firstly, they s/he is more likely to commit crimes of survival due to poverty, such as stealing, or dining and dashing. Secondly, people belonging to the general population are more unaware and therefore less tolerant of those exhibiting symptoms of a disorder. Strange behaviour including talking to self, shouting, etc. is a cause of worry for those ignorant about mental illness and is enough reason for them to call the police. They view the individual as a threat to themselves and to society. Thirdly, those struggling with poverty are more vulnerable to exposure to alcohol and drugs, and therefore to substance dependence and addiction — a major risk factor influencing crime, especially of violent nature, in the overall population. Finally, those with personality disorders may commit minor crimes or acts of violence, but if they also happen to be poor, their behaviour as perceived to be a consequence of inadequate upbringing and overall deprived life.
Why should we be pissed off about this? For starters, on the rare occasion, that stigma is broken through and mental illness is acknowledged amongst the less privileged, the likelihood of them finding effective treatment and professional services is almost impossible. Private sector mental healthcare services are accessible almost exclusively to the elite, and public sector mental healthcare services are nothing short of a nightmare, at least in India. On the off chance that the individual wishes to seek help, the opportunities enabling him/her for doing so are scarce. Those fortunate enough to have such opportunities in abundance may have committed the same crimes as the less fortunate had their illness been allowed to reach a debilitating stage and had they been as socially isolated.
Another reason to be infuriated for the same is that the stigma surrounding mental illness is not only capable of letting a disorder go unnoticed, but also deliberately worsen the situation on behalf of officials in the position of authority. According to the Douglas Mental Health University Institute, a majority of people convicted of committing minor offences may have been let go had they not had a mental disorder. The stigma attached to this illness can actually get one arrested for something a mentally healthy individual would be let off the hook for. This lack of empathy stems from the fact that mental illness is a grossly misunderstood phenomenon, and what is difficult to understand is often automatically viewed as a threat. A report on Mental Health and Prisons by the WHO explains the root cause of this to be the widespread misconception that all people with mental disorders are a danger to the public, encouraging a general intolerance towards those struggling with them. The conditions in prison only further exacerbate the environmental stress imposed upon the (quite wrongly) arrested individual. This is only worsened by the fact that the poor are less likely to be able to afford bail, and are therefore unfairly contained for extended periods of time for minor infractions. It is for this reason that an Al Jazeera article calls US jails “clearing houses for poor, ill who can’t afford bail”, while a New York Times article calls jails “warehouses” for the poor and mentally ill. Hmm…problematic.
Why the Existing Landscape NEEDS to Change
Because if we break it down, criminal law exists to handle those who commit acts that are wrong.
Criminal law works on the grounds that those acquitted were aware of the law and chose to disregard it.
But things are much more complex when you add mental illness to the mix, and adequate steps have to be taken to not only acknowledge the possibility of an existing mental illness but also evaluate the degree to which a crime was committed as a direct consequence of said mental illness. If violence, misuse of substance, etc. can be a result of poverty and also a disturbing manifestation of a symptom of a disorder, one cannot disregard the role of the illness in the committing of a crime. Poverty is not always solely responsible for breaking of the law but is often the only possible explanation considered for the same as the general population expects certain types of criminal offences to be performed only by the less privileged sections of society. The lines are blurry when the illness and poverty are closely interlinked, but careful examination of each cannot be brushed under the carpet for the sake of convenience. Undeserved imprisonment has to be replaced with subsidised quality mental healthcare services, and not considered an optional alternative.
Written by Manasi Pant.
