Mental Illness and the Justice System

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Photo by Bong Sullano via Flickr

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Pradeep Reddy. Courtesy Reddy family.

In the late afternoon of April 12, Arathi Reddy heard the doorbell ring at her home in Manalapan, NJ, and went to answer it, not knowing that opening the door would change her life forever.

Her 39-year-old brother, Pradeep, stared back at her from behind the glass, a foreshadowing of the way they would communicate in the future.

She could tell something was wrong before he began speaking. Pointing behind him, Pradeep defensively exclaimed, “He tried to hurt me, so I tried to hurt him back.”

Confused, Arathi tried to make sense of his words. For weeks he had been saying outlandish things, suggesting signs of psychosis and mania, all symptoms of his mental illness―bipolar schizoaffective disorder. Until about a week earlier, for the past year he had been living in a group home, where he was receiving treatment.

As she scanned the driveway, her eyes immediately fell upon their 78-year-old father, Radhakrishna, who was lying unconscious on the ground.

Trying to search for a pulse, which she could not find, she noticed her father’s skin felt cold. She screamed for help, summoning her neighbors to call 911. While she continued to search for a pulse, Pradeep stood about ten feet away, chain-smoking cigarettes and staring blankly into space.

The paramedics managed to resuscitate Radhakrishna and sped him to a hospital, as Arathi began telling police what happened.

One of the first things she told them was that her brother suffered from mental illness. As she spoke with them, she saw that some officers had taken her brother to the police car, asking him if he wanted water or a warm blanket. They were responding to him as though he had experienced trauma or shock, Arathi noted.

However, once the questioning ceased, they told her they had to take her brother into custody.

Two days later, on April 14, her father died from the injuries he had sustained, and her brother was charged with first-degree murder. If convicted, he faces up to 30 years behind bars, a punishment Arathi wholeheartedly disagrees with.

“I love both my father and my brother, and I miss them both,” she said in an interview with The Crime Report.

“Both were taken from my life the same day. My brother was sent to the [correctional] facility the same day as my dad was sent to the hospital… I feel like I lost a whole family. [But] I don’t think 30 years [in prison] feels right.”

Until recently, Pradeep has been awaiting trial while housed in Monmouth County Correctional Facility in New Jersey. However, within the last month he has been transferred to a hospital to undergo a mental health evaluation to determine whether he’s competent to stand trial.

This move, in response to a request from his defense attorneys, has been the only glimmer of hope for Arathi.

“I think this was an accident…I don’t think he expected my dad to not wake up,” she said.

“He’s not a real murderer or a true criminal, but I also do not think it’s safe for him to be around people because of his instability. He shouldn’t be in a cage for the rest of his life.”

The case of Arathi’s brother raises some uncomfortable questions for our justice system.

To what extent should those who suffer from extreme mental illness be held accountable for their actions, and what consequences should they face?

Is a long prison sentence true justice?

According to the American Psychological Association (APA), between 10 percent and 15 percent of U.S. prisoners suffer from serious mental illnesses such as major affective disorders or schizophrenia.

Moreover, the U.S. Bureau of Justice Statistics found that 64 percent of inmates in state and federal prisons met the criteria for mental illness at the time of their booking or during the 12 months leading up to their arrest.

However, most of these incarcerated individuals fail to receive proper treatment for their disorders.

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Dr. Patricia Zapf via LinkedIn

“Prison does nothing for mental health,” says Dr. Patricia Zapf, a forensic and clinical psychologist specializing in criminal forensic psychological evaluation, who frequently testifies as an expert witness.

“Part of the problem with prisons and jails is that they’re understaffed in general. There’s not enough mental health providers to go around.”

Dr. Zapf’s direct experience with incarcerated people and systems trying to improve services allows her to shed light on the challenges of how prisons respond to mental illness.

“Many of them don’t have the [right prescriptions for medication], so if someone comes in and they’re on a particular psychotropic medication, if it’s not on the jail’s formulary, you don’t get that psychotropic medication,” She told The Crime Report.

“There’s no consistency in terms of treatment, and then there’s just no resources.”

Lack of Mental Health Treatment for Inmates

Pradeep Reddy is an example of someone who has not received proper treatment for his mental illness since he has been incarcerated.

“The last time I saw him was in June at the correctional facility,” recalled Arathi. “His mental health has declined rapidly…and it hasn’t gotten better. I think he’s not even showing lucidity.”

While reflecting on her brother’s nearly 15-year battle with mental illness, she explains, “The best care my brother [ever] had was at Center State Hospital (in Freehold, NJ) and Northbrook Behavioral Hospital (in Blackwood, NJ). They provided structure, they provided socializing, they provided the meds and medical care…He seemed a lot better with that treatment.”

However, although Pradeep received some kind of medication at the jail, he only receives what Arathi describes as weekly “casual counseling” now.

“There needs to be some kind of a merging of what I’ve seen at Northbrook and Center State with the correctional facility. I don’t think medication and just casual counseling is enough,” she said.

Dr. Eric Hickey, a senior core faculty member in Walden University’s Forensic Psychology doctoral program in Minneapolis, agrees.

“In prisons they might meet with someone once a month, depending upon their issues,” he told The Crime Report. “It’s a lot of paperwork, but there’s no real therapy done in prisons. It’s relatively rare that someone changes in prisons or gets better…There’s just not enough support for that in a prison setting.”

Echoing what Arathi envisions as the best option for her brother, Dr. Hickey continues: “A lot of people in prisons can be put into other kinds of facilities where there would be more mental health provided for them, and that can reduce crime when they get out as well.”

First Responders and Mental Health Crises

But when it comes to criminal acts, how much should mental health factor into the way that first responders initially respond?

“Most officers are not well trained or even comfortable with dealing with people who are mentally ill,” Dr. Hickey asserts.

Dismissing “radical” calls for defunding police, he argued that “what we really need to do is fund far more training for police in the area of mental health.

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Dr. Eric W. Hickey. via LinkedIn

“We don’t have to make them into psychologists—but [we need them] to understand mental illness better, so they’ll know what to do when they’re the first responders.”

Incidents where police responded with excessive force to an individual who exhibits behaviors associated with poor mental health have frequently made the news.

One example: on Sept. 12, 2020, Buffalo police shot a man wielding a baseball bat on the street, who was later identified as having a “severe mental disability.”

The man’s condition was in fact well-known to some officers—he was visited regularly by one officer at his treatment center—but not to the officers responding to the call.

If that particular officer have been responding to the call, “the shooting probably wouldn’t have happened,” a source told Spectrum News1.

A recent study conducted by the Treatment Advocacy Center, concluded that “People with untreated mental illness are 16 times more likely to be killed during a police encounter than other civilians approached or stopped by law enforcement.”

However, if more emphasis were placed during training on how to mediate a situation where poor mental health functions as a catalyst, this number would significantly decrease, experts suggest.

As Arathi reflects on how officers responded to her brother, she feels that although they displayed kindness, they overlooked the severity of Pradeep’s mental illness and how it might have caused him to act violently.

As he has moved through the criminal justice system at a snail’s pace, she believes that most people involved in his case have not acknowledged the impact his mental illness could have on his behavior.

“No matter how many people I told he has mental illness…I don’t think they responded properly,” she said. “I think they did what they did to protect society by putting him away until they can figure him out.

“They care to just get this case over [with].”

Can We Rehabilitate as Well as Punish?

The lack of sensitivity to mental health issues is common in most cases tried in America’s court system, and it should require immediate attention, says New York criminal defense attorney Hanna Shoshany.

“I believe that every single criminal defendant should be subjected to mandatory court-appointed mental evaluation, regardless of whether or not a claim has been made of the existence of a mental illness,” Shoshany said.

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Hanna Shoshany

She acknowledged that “this would be extremely expensive, time-consuming, and would prolong the life cycle of criminal cases in an environment where (especially after COVID) the courts are inundated with a backlog of cases.”

But Shoshany argued that it was a necessary step in changing the way American society thinks about crime and punishment―especially when it concerns those who suffer from serious mental illness.

Experts interviewed for this story agreed the step was long overdue.

Currently, America’s prison system leaves little to no room for rehabilitation, said Dr. Zapf.

“The United States is very much about retribution, an eye for an eye, a tooth for a tooth, go to your sentence and you serve it,” she said. “You don’t get treatment, you don’t get education, you don’t get anything to sort of give you skills to help you when you get released.

“It’s retribution, it’s warehousing, it’s keeping people locked up because they’re a threat to society, which may or may not be true.”

Experts argue that receiving resources for rehabilitation doesn’t mean they are not being held accountable for their crimes. Even in a situation where one knows right from wrong, mental illness may still be prevalent, just not severe enough to label that person insane.

More attention to the specific case, rather than a one-size-fits-all approach, would leave room for appropriate mental health treatment that could allow some individuals to return to society and lead productive lives, they said. However, even in extreme cases, in which mental illness may be too severe, making it impossible for someone to return to society, why must they live in a regressive environment that worsens their condition(s)?

“We call it the department of corrections, but I think that’s a misnomer,” said Dr. Hickey.

‘The Department of Punishment’

“We’re not trying to correct people in prisons; we’re containing them. Calling it the department of punishment is much more accurate.”

Dr. Zapf said it “would really take some significant thinking change and policy change to prioritize rehabilitation, but we have the information; we know what makes individuals successful, and we know how to successfully manage risk.”

The legal hurdles to policy change are still formidable, Shoshany stated.

“As much as I would like to say that mental illnesses should be regarded in the evaluation and consideration of sentences, the law would need to be re-codified and re-written which is obviously a task for the legislature and not the court system,” she explained.

Nevertheless, she was confident that changes in the law to accommodate the needs of individuals like Pradeep Reddy will happen over the next decade.

Training of law enforcement personnel is one element in reimagining the template in how we respond to mentally troubled individuals who become involved with the justice system, Dr. Mary Alice Conroy, a distinguished professor of psychology and clinic director at Sam Houston State University, said.

“Facilities in general need more resources for release planning, and legislatures need to review laws that might place conditions upon discharge, including mental health conditions. The most up-to-date psychotropic medications need to be widely available for those who need them.”

Dr. Conroy continued, “The message that treating impaired individuals with respect and concern needs to come from the top down, and in many jurisdictions, this is not the case.”

Turning to the judicial system, more cases should be diverted to mental health courts, adds Dr. Zapf.

“We see some really good research coming out of mental health courts, where the judge is educated with respect to the issues that individuals with mental illness have, (along with) the prosecutor and the defense attorneys,” said Dr. Zapf.

Measuring the Costs

Cost is another factor.

Improving coordination between mental health professionals and the court system can be expensive, but so is the current system which puts an added burden on taxpayers to house offenders with lengthy sentences.

“Many people with serious mental illness who should be hospitalized or in integrated community-based systems, have simply been moved into our prisons and jails as state budgets have slashed programs,” wrote Joel Miller in a blog posted by the American Mental Health Counselors Association.

Advocates point out that with proper treatment and resources for mentally ill persons who become involved with the justice system, recidivism rates would decrease, shrinking the number of people in prison.

As someone who sits on both sides of the debate, as a survivor of violence inflicted on a loved one with mental health issues, and as a person whose brother is in prison for that act, Arathi maintains a clear vision of what justice for her brother means.

“The legal system and the justice system and the health system should look at this glaringly,” she said.

“I don’t think he should be out in the streets if he’s this unstable…[But], ideally, I want him to be in a hospital, and I want him to be in the right hospital. I don’t want him to rot in jail, where his condition will just deteriorate.”

Maria DiLorenzo, based in Brooklyn, NY, is a contributing writer to The Crime Report. She recently started a blog called Beyond the Crime, which shares stories of those incarcerated for murder to gain a deeper understanding of criminal behavior and the criminal justice system.

One thought on “Mental Illness and the Justice System

  1. I was recently released from federal prison. The BOP does not do psychiatric care, nor do they have any intent to do so in the near future. The BOP only does psychological care, and only to some extent. There is a difference between the two. For example, psychiatric care would revolve around people who have autism, ADHD, etc. Psychological care uses behavior modification to achieve a desired result. This could be anything from changing the way a person thinks to the way a person acts, etc.
    Prisons needs to deal with the former since it can contribute to some form of criminal behavior just the same as psychological problems, especially when it comes to sex offenses where psychiatric problems arise more often.

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