For many, drug addiction and mental illness go hand-in-hand. This is typically either because drug addiction exacerbates the symptoms of mental disorders, or because those suffering from mental illnesses will utilize drugs and alcohol as a means of self-medication. It has been estimated that nearly three-quarters of individuals in jail who are afflicted with a serious mental illness concurrently struggle with drug addiction. When providing treatment, it is absolutely essential that these two disorders are not decoupled. It has been repeatedly proven that treating both disorders at the same time is crucial to maintained recovery.
Dual Diagnosis Treatment
If an individual who is suffering from drug addiction and severe depression attends an inpatient rehab geared exclusively towards substance dependency (and his depression is entirely overlooked), he will likely return to using eventually due to a persistence of invasive, unaddressed symptoms. The intense feelings of hopelessness, despondency, and dejection that a depressed individual may experience will, more often than not, lead him back to drinking and drugging – seeing as he knows no other way to cope. If an individual is being treated solely for depression (but is still actively abusing drugs and alcohol), his substance use will inevitably interfere with whatever mental health treatment he is receiving. Medications (antidepressants) will be rendered ineffective, not able to work properly while competing with other chemical substances. Therapeutic care will be severely compromised, and even if treatment does prove temporarily effective, chronic substance abuse will eventually trigger a relapse into detrimental psychological symptoms.
The Judicial System and Mental Health
Unfortunately, the ‘justice-system first’ reaction to related criminal offenses has lead to the exacerbation of both mental illness and substance abuse amongst men and women who desperately need dual diagnosis treatment. Because the justice system has a harshly limited ability to holistically and therapeutically treat individuals, those afflicted with mental disorders and substance abuse issues are merely separated from their families and their communities -hidden behind a thick wall of criminal records and disallowed the services they need in order to live fulfilled and functional lives. The level of care the judicial system provides is determined by punitive assessments rather than clinical requirements.
The long-standing misconception that those who suffer from mental illnesses commit crimes based exclusively on lack of treatment was recently compromised. Chelsea Davis and Ayesha Delany-Brumsey of the Substance Use and Mental Health program at the Vera Institute of Justice published their findings on the subject in the New York Times earlier this month (May, 2016). “We found that a complex mix of issues — for example, substance use, trauma, loneliness, poverty, unemployment and homelessness — connect the justice system’s response to mental health problems. When we asked what might prevent future arrests, people talked about needing stable homes, jobs and stronger relationships. Many more people mentioned the need to stay away from drugs than receive mental health treatment, despite the fact that every study participant had an identified mental health disorder.” The study concludes that adequate mental health care in conjunction with a concentration on a range of other needs – namely substance dependency – is crucial to the recovery of mentally ill criminal offenders.
Taking a Look at the Statistics
In 2010, it was found that 65% of all U.S. inmates met the medical criteria for drug addiction or alcoholism. It was also found that out of nearly 1.5 million addicted inmates, only around 11% were receiving any kind of treatment during their incarceration. In 2005, local and state governments spent a total of $74 billion on court proceedings, incarceration, probation, and parole for drug addicted juvenile and adult offenders – and less than $632 million on treatment and prevention. Since 2005, the amount of drug-related convictions has skyrocketed. Despite increased public awareness of the addiction epidemic, very little progress has been made in reducing the amount of substance-involved men and women crowding jails and prisons nationwide. In 2016, a whopping 46.3% of all criminal cases directly involve drug offenses. Other crimes range from 0.0% (national security) to 16.9% (weapons, explosives, and arson). No other offense even comes close to touching drug-related felonies.
It has been estimated that over 20% of all inmates struggle with severe mental illnesses. The most common psychological issue amongst inmates is depression, followed by bipolar disorder. Over 75% of those who are currently incarcerated and diagnosed with a mental disorder simultaneously struggle with drug addiction. A recent study conducted in a Washington county jail concluded that of 132 suicide attempts, 77% suffered from a chronic psychiatric illness. According to a report published by the Treatment Advocacy Center in 2012, American jails and prisons housed roughly 356,268 mentally ill men and women – more than 10 times the number of mentally ill patients who were receiving treatment in state psychiatric hospitals that same year (around 35,000 individuals in total).
What Can Be Done?
A widespread failure to concurrently treat substance dependency issues and mental health issues has lead to an overflow of prison inmates, and a steadily climbing rate of drug-related felonies. Without adequate treatment, it can only be assumed that a previously convicted individual will return right back to the only way of life he or she knows after being released. Local and state governments are spending billions of dollars annually on judicial proceedings, when effective and long-term treatment can be provided for an exceedingly smaller cost.
Medication-assisted treatment has proven exceptionally effective, and is significantly less expensive than court proceedings and repeated incarceration. Community programs have begun to increase the circulation of harm-reduction practices, such as the distribution of naloxone and the implementation of syringe exchange programs. Counseling has become more widely available, and programs such as Drug Court have proven beneficial and successful in pointing mentally ill addicts in the right direction.
Share Your Thoughts and Experiences
The facilitation of long-term recovery through the combined treatment of psychological disorders and substance abuse is necessary – and while steps are being taken in the right direction, there is still ample work to be done. The whole system – the multibillion-dollar judicial system – is still a big, gnarled mess. Tackling the issue on a smaller scale will prove significantly more effective – at least for now. If you or someone you love is struggling with addiction and mental health issues, look into available dual diagnosis treatment options. Next Chapter Addiction Treatment offers a program of recovery that focuses heavily on mental disorders and substance abuse, providing clients with the comprehensive treatment they need to maintain lasting and fulfilled sobriety.
What is your opinion on mental health, drug addiction, and the judicial system? Do you have any relevant personal experience? Please feel free to share!