Personally Speaking: The criminalization of mental illness
By Karla Jones*
I’ve had two severe psychotic breaks, both lasting months. They destroyed my life: I lost my house, job, car, and even friends and family. I also had several encounters with police, some of which resulted in incarceration.
My first psychotic break happened in 2014 after the sudden death of my father. During my first hospitalization, I refused medication and was given a court ordered injection of an antipsychotic. The second time, I was brought to the hospital after I had been tased. A neighbor called the police because of my erratic behavior and when I pulled my hand away from a police officer and tried to walk away, I was tased twice.
My second psychotic break happened in 2018. I was served a restraining order at a psychiatric hospital and not understanding it, I violated it when I got out. I spent two weeks in jail. After I got out of jail, I was again hospitalized and after my release, I violated the restraining order again. I was incarcerated for five months.
According to Treatment Advocacy founder Dr. E. Fuller Torrey, jails and prisons have become de facto hospitals for people with mental illness. Individuals with mental illness are ten times more likely to be incarcerated than hospitalized and 18 times more likely to find a bed in jail than at a state hospital. Forty percent of all people with mental illness will at some point come into contact with the criminal justice system. And, in the state where I live, there is a 2.6 to 1 likelihood of incarceration versus hospitalization. Of the 40,000 people incarcerated, 17% have severe mental illness. According to the NIMH, one in 25 individuals struggle with a severe mental illness that may cause psychosis. NAMI reports that three out of 100 people will experience psychosis at some point in their lives.
And, according to the literature, psychosis can be a challenging situation to diagnose and to understand completely. In 2014, a health care provider diagnosed me as having ‘complicated grief,’ a diagnosis in the DSM. A psychiatrist later diagnosed me with depressive episode with psychotic features. I was put on an antipsychotic and an anti-depressant. After my second psychotic break in 2018, an evaluation labeled me psychosis NOS (not otherwise specified). Later, I was diagnosed with bipolar disorder with psychotic features. I currently take an antipsychotic and a mood stabilizer. Because of my traumatic experience, I have also been diagnosed with PTSD.
Recovery for me has been slow and steady. Right after my release from jail the second time, I found a community health clinic and began receiving services there. I see a therapist twice a month and a psychiatrist every other month and with both of their help, I have found medications that work for me. I have also found support in a meditation group where centering myself in the now quiets the flashbacks of the past and worries about the future. Yoga helps and I have also become an avid pickleball player. But I continue to experience a lot of shame about my ordeal and the stigma of having a mental illness is very real. I am most ashamed of the things I did and said, especially how I lashed out at friends and family.
My psychiatrist recommended I tell my story here to bring to light the intersection between mental illness and the criminal justice system. It is a conflict that needs to be addressed at the national, state and local levels. But I also write this to encourage others who have gone through psychosis that despite the tragedies and horrible experiences, recovery is possible.
Another step in my recovery process is to actively take steps in prohibiting this from happening again. Filling out an Advanced Psychiatric Directive (APD) with the help of my psychiatrist, therapist and a family member allows me to make treatment decisions about my care now. The APD also allows them to hospitalize me without my consent if warning signs appear. One problem with my psychotic breaks is that I had a severe case of anosognosia, the inability to see that I was ill. Even though I believed that my dead aunt was driving a spaceship to rescue me in my fight against dark matter, I could not see or understand that I was psychotic.
As many of the stories on this blog attest, getting help for a loved one when they are in crisis and do not recognize it often involves law enforcement and the criminal justice system. My hope is that by having an APD, my support system can help me avoid these encounters in the future.
Writing this blog helps me to take one step toward reforming the criminal justice system. If this blog was helpful, won’t you consider taking a step toward alleviating this conflict? At the local level, you can lobby for Crisis Intervention Training (CIT) for your police department. At the state level, you can contact your elected officials and encourage them to support mental health initiatives. And at the national level, you can donate to organizations like Treatment Advocacy Center, NAMI, and NIH who support efforts to decriminalize mental illness. A journey of a thousand miles begins with one small step.
*The writer’s last name has been changed to preserve anonymity.
Karla Jones is a writer, researcher and mental health advocate who holds a doctorate in religion.
