Mental health in our prisons

By George Clifford

Approximately one-third to one-half of the people in prison in the United States are addicts or mentally ill, according to the federal Bureau of Justice Statistics. At a meeting that I recently attended, several healthcare advocates remarked that socially conservative Democratic and Republican legislators object to the state providing treatment for criminal wrongdoers who are addicts or mentally ill. These advocates made that observation after presenting the legislators with well-documented evidence showing that treating convicted criminals for addiction and mental illness saves taxpayers substantial sums. Treatment, in other words, costs less than incarceration. Treatment also diminishes recidivism and prevents future crimes associated with addiction, not to mention offering health to the one who receives treatment. Nevertheless, socially conservative legislators have consistently blocked efforts in North Carolina and many other states to provide appropriate treatment to wrongdoers.

As a Christian who has spent most of his working life as a military chaplain, I found the attitude of those legislators surprising and confusing. Some military leaders do not agree with providing help to wrongdoers. However, the military system – a bastion of social conservatives – emphasizes both accountability and help.

Accountability holds people responsible for their actions, a key component of justice. Accountability is also an important element in shattering the wall of denial with which many addicts and mentally ill people seek to insulate themselves from facing the reality of their disease.

Help is providing treatment, whether while the person remains in the military or through the Veterans Administration after the service discharges the person (a possible consequence of accountability).

The military system is far from perfect. Some leaders are too quick to hold people accountable and too slow to offer help. Some personnel refuse the help offered or are treatment failures. Yet the military system retains and values both emphases.

As a chaplain, I spoke with considerable moral and systemic authority when an emphasis on accountability overwhelmed the emphasis on getting a sick person help. Uniformed healthcare providers similarly challenged the system, speaking up to emphasize an individual’s right to treatment and the benefits to the military of providing that treatment. The military’s centrally funded healthcare system ensured that financial costs never entered into a local decision about a particular individual. The military decades ago had recognized that the cost of helping people was less than the cost of recruiting and training replacement personnel.

The military system, at least with respect to this issue, is profoundly Christian. Addiction is not a moral issue. Addiction is a health issue, a reality the medical professions have recognized and taught for more than half a century. Modern medicine defines alcoholism, for example, as a chronic, progressive disease that unless treated is fatal. Continuing to treat addicts as sinners and moral reprobates reinforces the illness rather than helping the addict move towards sobriety and health. Likewise, mental illness is every bit as real as physical illness. Indeed, any dichotomy between the two is probably artificial as brain research increasingly uncovers the physiological basis of mental illness.

Liberal and conservative Christians split over their interpretation of many aspects of Jesus’ message and life. Debates rage over how Jesus healed, what illnesses Jesus healed, who Jesus healed, etc. However, one point on which near unanimity exists among these disparate voices is their agreeing that Jesus did in fact heal the sick.

The Christian tradition also highlights God’s justice. Justice without mercy is not Christian because it contradicts God’s love manifested in Jesus. Conversely, mercy without justice is not Christian. Mercy without justice would leave the Church with nothing to say to the oppressed, the exploited, and the downtrodden. Jesus rebuked Pharisees who twisted the Torah to their own advantage, warned of a day of judgment, and drove out of the temple those who profited exorbitantly from the devotion of God’s people. Addiction and mental illness do not exempt people from constructive accountability for their actions.

The Christian Scriptures make it clear that all are my neighbors. Some early Christians attempted to apply a filter, screening people to determine to whom they should (e.g., Jews) and should not (e.g., non-Jews) communicate the gospel. The New Testament insists that the gospel is for all. Paul identified himself as THE apostle to the Gentiles. Peter has a wonderful vision in which he sees, not once but three times, a cloth lowered from heaven that contains all kinds of animals, clean and unclean. God tells Peter, Do not call unclean anything that I made. When a non-Jew sends for Peter, Peter realizes that God is referring to people, not to food.

What confuses me about the opposition of socially conservative legislators to providing proper healthcare treatment for wrongdoers who are addicts or mentally ill is that this policy is not only Christian but has also proven financially prudent. In a state like North Carolina, where a large majority of the voters claim to be Christian, what surprises me is that socially conservative legislators are sufficiently numerous to block the establishment of policies and funding for treatment for wrongdoers who are addicts or mentally ill.

This is one of those rare times when doing good saves money. Addicts and the mentally ill frequently make lousy neighbors. That is irrelevant. God made them. They are God’s children. That means that addicts and the mentally ill, no matter how unlovable, deserve justice and our best healing efforts. This is not an either or proposition. They deserve both. With the right measures of justice and healing, many addicts and mentally ill will become great neighbors and productive, taxpaying citizens.

The Rev. George Clifford, Diocese of North Carolina, served as a Navy chaplain for twenty-four years, with tours at sea, with the Marine Corps, on the staff of the Chief of Chaplains, on exchange with the Royal Navy in London, as the senior Protestant chaplain at the Naval Academy, and as the senior chaplain at the Naval Postgraduate School.

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