“The New Asylum”: The State of the Mentally ill in the American Prison System

“The New Asylum”: The State of the Mentally ill in the American Prison System


On average, inmates with mental illnesses serve longer sentences that inmates with no mental health issue; have a more likelihood of being involved in violence while incarcerated; and are more susceptible to victimization by other inmates. They are also more prone to be re-incarcerated upon release into the community.  This clearly demonstrates challenges that face the mentally ill populations incarcerated in the American justice system. It demonstrates the importance of having in place policy measures that are necessary to ensure that the needs of mentally ill inmates are well addressed to ensure that their transition into the community is undertaken with minimum effort as well as ensure that convicted mentally ill inmates are placed in a prison system that aptly attends to their health needs and ensures they are not exposed to vulnerabilities that put their life and health at risk.



The purpose of this paper is to provide a brief overview of the United States prison system based on the information presented in the film “The New Asylum.” The paper will present my view on why there are many mentally ill inmates in the United States prison system, and suggest some of the reforms that need to be undertaken so as to provide mentally ill offenders with adequate mental health treatment. The paper will further suggest the interventions that I am of the opinion are needed in the United States prison system and the types of aftercare programs needed for mentally ill offenders who are released from prisons. Finally, the paper will demonstrate the significance of the film in training future counselors and psychologists, and concludes by giving a brief conclusion of the paper,


Summary and Analysis of the Film“The New Asylum

The film “The New Asylum” is a documentary by PBS Frontier, which argues that the prison system in the United States is the new mental health facility. It was shot and produced in 2005 and is based on a prison located in the state of Ohio as a model for mental health in penitentiary system. The film aimed at answering the questions of why the prison system is the new mental health providers for the reason that there are 500,000 people suffering from mental illnesses in jails and prisons, compared to 50,000 people being helped in psychiatric hospitals. The New Asylumrevealed that the American prison system provides needed mental health services more than if the prisoners were not there. It also emphasized that the prison system is a very challengingbackground in which to provide mental health services, and it results in a cycle of recidivism for individuals with mental health issues. The documentary included recordings of inmates during mental health crisis, as well as interviews with inmates, prison guards, and mental health professional. The film is backed by facts and statistics that present the picture in a much clear and understandable manner that allows the viewer to get a clearer picture of how the issue of mentally ill inmates is grave and requires immediate policy action.

Reasons Why the United States Has an Inflated Number of Mentally Ill Offenders in the Prison System

The movie “The New Asylum” indicated that 16 percent of prison inmates in the state of Ohio are mentally ill requiring specialized attention in terms of medication and, or follow up. The movie further adds that while 50,000 mentally ill offenders stay in state hospitals, 500,000 offenders are housed in prisons. These statistics demonstrate the high number of mentally ill offenders in the prison system.

Personally, I have several thoughts on why the United States has an inflated number of mentally ill offenders in the prison system. These include:First, the country’s policy regarding which sector should render mental health services to the offenders is tilted towards imprisoning mentally ill inmates as opposed toputting in place facilities that would facilitate their treatment in a different setting. While other countries such as the United Kingdom in Europe and Japan in Asia have put in place policies that divert mentally ill offenders from the criminal justice system into the health or social services systems, the United Stateshas weaker or no structures that dictate the sector that such offenders should be taken to. Secondly, there is a higher probability of mentally ill persons to commit a criminal offense. According toAllen(2008)mentally ill individuals are more probable to engage in activities that may land them in jail, and are also likely to be re-incarcerated upon release. This coupled with the unavailability structures that help mentally ill inmates to reintegrate back into the community contributes to the high number of mentally ill inmates in the prison system.Thirdly, there is thedifficulty in defining the mentally ill population and determining who should receive specialized treatment. Other reasons why there is a high number of incarcerated mentally ill inmates include: the lack of effective treatment options; the fragmented and uncoordinated system of resources from private organizations, the state, and federal andas well as the resulting gap in care; the Lack of and misapportionment of funding for the treatment of mental health within the united states criminal justice system; and unavailability of psychiatric facilities and services to the public which results to individuals who should have been in mental hospitals finding themselves instead in prison or on the streets without access to effective treatment. Finally, the criminalization of the mentally ill population. Mentally ill individuals who commit crimes or create public disturbances directly go to jail or prison, transforming America’s prisons the de facto custodian of people with mental illnesses.

Reforms needed to provide mentally ill offenders with adequate mental health treatment

While the Eighth Amendment of the American constitution compels the prison system to afford a system of ready access to ample health care, including mental health care, a lot of reforms need to be done to provide mentally ill offenders with adequate mental health treatment.The reforms should not only aim at making the life of the mentally ill offender comfortable in the prison environment, but it should also develop an effective care and management strategy that prepares the offender for community life that reduces their chances of being rearrested or convicted.

The reforms needed to provide mentally ill offenders with adequate mental health treatment include: putting in place measures to ensure that there is adherence to pre-release continuity of care planning and after release. This involves enabling mentally ill offenders to access community treatment by facilitating their access to community programs. This will curb recidivism among the mentally ill population. There is also the need to conceptualize mental illnesses as a chronic illness and therefore broaden public health services into the prison system upon individuals’ incarcerations.

Other steps that can be undertaken in order to provide mentally ill offenders with adequate mental health treatment include: provision of appropriate treatment for prison and jail inmates with severe mental illnesses; implementation and promotion of jail diversion programs; promotion of the use of assisted outpatient treatment; encouragement of cost studies and establishment of careful intake screening procedures; and finally, management of release planning.

Types of Services/Interventions Needed in the United States Penal System

The United States prison system has a constitutional commitment to make available treatment options to prison inmates with severe medical and psychiatric illnesses. The case of Ruiz v. Estelle set the minimum musts for making available mental health services in the United States correctional system.The prison system should offer standard outpatient and inpatient mental health treatment, such as individuals or group psychotherapy, psychotropic medication, and discharge planning.A variety of interventions can be undertaken to reform the United States penal system to be more responsive to the treatment needs of the offenders. These interventions can broadly be categorized into two: incarceration-based interventions and offenders transitioning from incarceration to community interventions.

Incarceration-based interventions include pharmacologic therapy, psychological therapies such as cognitive skills training in form of reasoning and rehabilitation and group cognitive therapy, and finally all-inclusive interventions for inmates with a dual diagnosis, encompassing Modified Therapeutic Community (MTC) with an aftercare element and Modified Therapeutic Communitypersonalized to the needs of female offenders.Interventions that affect offenders transitioning from incarceration to community include: better implementation of the mentally ill offender community transition program; high fidelity integrated dual disorder treatment, discharge planning interventions that encompass assistance applying for mental health benefits; interpersonal therapy(IPT); and finally, interventions coordinated and/or administered by specially trained forensic providers.

Types of Aftercare Programs Needed For Mentally Ill Offenders Who Are Released From Prison and Changes That Need To Be Made To the Parole System In Order To Prevent Individuals from Re-Offending

Offenders suffering from mental illnesses face a myriad of challenges upon being released back into the community. Such offenders become a target for extreme social isolation and are prone to co-occurring substance abuse disorder. These offenders also find it hard to secure suitable accommodation or secure employment, and they may need additional medical and therapeutic assistances and help with financial management.These factors, coupled with non-compliance of treatment orders make these individuals not only a risk to themselves, but also to others.The unique challenges faced by offenders who are mentally ill upon release necessitates the putting in place of community-based treatment models of after release care to tackle the vulnerabilities and risks, as well as needsthis offender population. Treatment modesl based on the community and on continuing care may minimize the risk to the society, and theoffender and reduce the involvement of correctional system for these individuals in future, as well as provide a diversion program from the traditional justice system. According to Hartwell & Orr(1999), continuity of care is an indispensable constituent of effectual mental health treatment of mentally ill person who are involved in the criminal justice system.

Various aftercare programs can be employed to assist mentally ill offenders who are released from prison to integrate back into the community with minimum effort. These can include:Undertaking programs that focus on ensuring the offenders illness or mental state is stabilizing; taking steps that are targeted at enhancing the offenders independent functioning; maintainingmentally ill individualsexternal  as well as internal controls in order to reduce the chances of this population actingaggressively and perpetrate new offenses;and establishing a cooperation between staff charged with treatment and the justice system; as well as providing structure in the offenders daily life.

Other aftercare programs that can be put in place to assist mentally ill offenders release from prison include working with the offender’s family to determine if they are a reliable source of social support, obtaining therapeutic living arrangements, and providing a structure for the offenders daily life as well as integrating treatment and case management.

SignificanceOf This Video In Training Future Counselors And Psychologists And Usefulness For Policy Writers

The documentary, The New Asylum,was meant to answer the question of why prisons have been transformed into the new mental health providers. This video would of much help in training future counselors and psychologists who are interested in working in or with individuals in the prison system. The documentary portrays the illnesses and the legalities that surround the prison system,Itenables future counselors and psychologists be prepared on how to handle various mental illnesses within the context of the prison system, an experience that cannot be obtained through in class training.The film challenges common fears among the public about working with the mentally ill inmatesthereby giving a more vivid picture of how things actually are. The Media portrayals of some mental illnesses have been inaccurate, and the general public has little knowledge and plenty of fear about this particular population. However, the film clarifies these perceptions and presents a clear portrayal of the way things are. It therefore, prepares counselor and psychologists on how to handle such populations by understanding how they express themselves.

To policy makers, the film presents the situations and conditions which prisoners are release into, for example, they are released with a little cash and only two weeks worth of medications and no place to go. This usually results to released convicts ending up off their medications, homeless and end up recidivating. The documentary therefore informs policy makers of how things are in the prison system and therefore places them in a better position to come up with policy steps that better address the needs of the mentally ill inmates within and upon release from the prison system.


In conclusion, the documentary opens the public’s eyes to the social problem of mentally ill inmates, a concern that is rarely addressed. Prisons and jails are often not the most appropriate places to manage and deal with individual’s suffering from mental health issues. The presence of a large number of inmates with mental illnesses represents a significant and costly problem for the American prison and jail system.Perhaps now more than ever has the care and treatment of mentally ill offenders in prisons and jails in America became a public safety and public health concern. With individuals being released into the community out of jails having disproportionately high rates of mental illnesses and substance abuse disorders, the time is favorable for policy changes to be undertaken that address this societal concern and not only protect the society from such individuals but also the individuals from themselves.



Adams, K., & Ferrandino, J. (2008). Managing Mentally Ill Inmates in Prison. Criminal Justice and Behavior, 35, 913-927.

Allen, S. (2008). Mental Health Treatment and the Criminal Justice System. Journal of Health and Biomedical Law, IV(I), 153-191.

Hartwell, S. W., & Orr, K. (1999). The Massachusetts Forensic Transition program for Mentally ill Offenders Re-entering the Community. Psychiatric Services, 1220-1222.

Navasky, M. (Director). (2005). The New Asylums [Motion Picture]. Retrieved December 18, 2014, from http://www.pbs.org/wgbh/pages/frontline/shows/asylums/view/

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