Chronically underfunded, there’s simply not enough people or resources for, well, anything. Prisons are stuffed with the worst of the worst, the most violent criminals and the most severe mental health cases. In fact, once in the prison system, people with mental health issues tend to get much worse very quickly. In the best case scenario, the police are forced to incarcerate the person, knowing full well they won’t get the help they need in prison or ever get better. So in the worst case, a family (already burdened by lack of resources for people with mental health concerns) calls for the only help available to them, the police, when a loved one is in crisis, knowing they may well be signing a death warrant because such calls too often end in gunfire. But they don’t have the funding, training or support to actually help.

They know their training and engagement protocols don’t work with people who have mental health issues. Or worse.Īnd the police know this, at least according to Roth. Being yelled at and required to comply with shouted orders can confuse and befuddle, and suddenly a moment in which someone needed patience, support and their meds becomes a gateway interaction for a lifetime in prison. That simply doesn’t work for people who are in the midst of a mental health crisis. That approach usually involves aggressively taking control of the situation and requiring immediate compliance. Today’s police are trained to enforce laws and neutralize threats quickly and at the lowest risk of personal injury to themselves and others, and then move on to the next issue. In other words, we have the right solution for the wrong problem.

The book, then, is a balanced, nuanced and sympathetic look at what happens when we train, staff and fund police and prison systems to punish, incarcerate and hopefully rehabilitate criminals, when the actual “consumers” of these services are increasingly likely to be people with severe mental health issues. Regardless, we have created a system that has left the United States with by far the highest per capita incarceration rate of any large nation in the world.” “There is still little consensus about the rationale for incarceration: is it deterrence, rehabilitation or retribution? Given the dramatic overrepresentation in our jails and prisons of people of color and low-income people, it could be argued that the reality has as much to do with oppression and social control as it does with any coherent theory of punishment.

Roth is a journalist, with strong writing, interviewing and investigative skills, and she uses these skills to their fullest bringing the complex issue to tragic life. Insane: America’s Criminal Treatment of Mental Illness by Alisa Roth is a deep, disturbing examination of how people with mental health issues fare in our criminal justice system. A difficult look at a challenging topic a hard book but not hopeless

Insane by alisa roth