Learning Objectives
We will try to differentiate between the correctional practice settings and the levels of criminal justice incarceration, particularly with a look at how one enters into the criminal justice system and how they exit. Throughout the presentation, I will be bringing up evidence that will hopefully be supportive for you when developing your own practice models thinking about how occupational therapy can be rationalized effectively for practice in criminal justice. Then we will spend a fair amount of time talking about occupational deprivation, a phenomenon that happens quite a bit in imprisonment and incarceration, how that is related to the concept of occupational justice, and how it supports what I believe is very highly effective occupational therapy.
Background
Here is a little background of how incarceration works in the U.S. We unfortunately have a reputation, born out by the data, that we imprison a higher percentage of our citizens than any other country (Glaze and Kaeble, 2014). That number has been slowly decreasing since 2010. There was a jump in moving prisoners and decreasing jail sentences from 2010 to 2012 and into 2013. However, that has slowed down and I think it partly has to do with the economy and the fact that there was not as much money to house those prisoners. As the economy has improved, we are seeing an increasing number incarcerated again.
There is a stronger focus on punishment than rehabilitation in the prison systems (Jones and Weatherburn, 2011). One has to ask how effective criminal justice or incarceration is in actually correcting the crime problem we have in our country, when in five years, 75% of the people who have been released will re-offend and return back to jail or prison (Cooper et al., 2014).
The occupational deprivation that is experienced (Whiteford, 1995; 1997; 2000) is compounded by overcrowding in our correction system. Approximately 60% of the people incarcerated have a mental health condition and/or a co-occurring addiction (Justice Center, 2012). This is a poor use of human capital and we will talk about ways that we can use occupational therapy in corrections to can help correct some of that.
Mental Health and Criminal Justice
Prior to the ‘70s, the percentage of people with mental health conditions in jails and prisons was slightly higher, maybe double of what the occurrence of mental health conditions were in the population. Now it is about 65% of those incarcerated, and the percentage of people with serious mental illness who are incarcerated is 17% (White, et al., 2012). People with serious mental illness comprise only 2% of our general population. This goes back to a phenomenon called deinstitutionalization. You are probably familiar with this term. There was an effort to close the large state hospital systems where a lot of people with chronic mental health conditions were housed, and some very inappropriately.
There was a positive aspect to the deinstitutionalization movement and there was a plan for developing a network of community supports that would provide housing, healthcare, and particularly the mental health care needs of the population. Unfortunately, those community supports did not develop, and we ended up with a lot of people on the streets. In their attempts to self-medicate and manage their illness, they often came in contact with the law. Consequently we have a high percentage of people with mental health conditions and/or co-occurring addictions in the system. For a compelling account on this, I encourage you to look for the text, Crazy: A father’s search through America’s mental health madness. A journalist named Early wrote this about his son, who had a mental health condition, came in contact with the law, and was in and out of both treatment and jail throughout the process. This book shows the father’s difficulty with helping his son and working through it. Spoiler Alert: They did find a way to get the son stabilized, but not without a good bit of time incarcerated.
