Institutionalized Persons
by Christopher Dodson,
Executive Director, North Dakota Catholic Conference
October 2002

Does North Dakota need to develop a comprehensive ten year plan for addressing the needs of the mentally ill and incarcerated persons? Consider the following.

•the state hospital’s average daily patient census has decreased from 300 patients in the 1990s to 160 in 2002.

•At the same time, the number of person’s in North Dakota’s prisons has doubled.

•The majority (54.4%) of the women admitted to a North Dakota prison facility in 2001 reported having a mental illness or condition. Only a slightly lower percentage (43.4%) of the men reported such an illness or condition. Considering that many inmates have never been diagnosed or treated for mental illness prior to being incarcerated, the actual percentage is probably much higher.

•One-half of the women and one-third of the men admitted in 2001 acknowledged that they daily used drugs before being imprisoned.

•Over a quarter of the state’s inmates are there because they were sentenced for drug offenses (possession or sale.) The percentage of inmates who were convicted for other crimes because of drug related behavior is estimated to be much higher.

•A whopping 43.4% of women incarcerated in 2001 were convicted for sale or possession of illegal drugs.

•A consultant team hired to examine the state’s prison system stated that they were “surprised” at the high number of inmates receiving medications for mental illness, noting it was higher than would be expected for the population of the size and nature of the state’s inmates.

•North Dakota has one of the lowest parole rates in the nation. While the number of inmates more than doubled between 1990 and 2001, the number of offenders paroled in 1990 was about the same as the number paroled in 2001.

•While the increased use of community based services has decreased the number of patients at the state hospital, the hospital’s numbers have recently leveled off, indicating that there is a certain number of patients that cannot be adequately treated through community services.

Now, less than four months before the next legislative session, the Department of Corrections and the Department of Human Services proposed a major shift in the provision of services at the North Dakota State Hospital and the James River Correctional Center. Under the proposed plan, the prison would take over a newly renovated building presently used by the state hospital as well as the hospital’s kitchen, dining, and laundry buildings. The plan would eliminate 104 jobs at the state hospital and add about 64 new positions at the prison. The laid-off state hospital employees could apply for those jobs.

Although the state hospital would lose employees, it would, under contract with the prison, provide chemical addiction services to the inmates. There is, however, no proposal to increase services or staff at the state human service centers, the community facilities expected to serve the mental health needs of those not in the state hospital or prison. A few weeks after the announcement, the Department of Corrections announced plans to change the parole system, increasing the number of paroled inmates and raising serious questions as to whether the prison system needs so many new beds.

Does all this seem sensible? Other states have tried what North Dakota is now proposing and found that the number of mentally ill in jails, prisons, and on streets increased. When we have to increase chemical addiction and mental health services in the prison -- services admittedly badly needed -- but reduce non-prison mental health services, are we sending a message that if you want treatment your best shot is to commit a crime?

The current system looks like a patchwork of short-term efforts involving different departments and often made in response to budget shortfalls. The state should develop a comprehensive plan for dealing with the full range of mental health, addiction, and criminal justice services. Such a plan would force the state to look at long term goals, see the interconnectedness of the services, and provide state employees and taxpayers with real notice of what to expect.

Community care, combined with a “safety net” at the state hospital, is a great goal. However, if it is not done right we risk criminalizing the mentally ill, endangering public safety, and failing to respect those suffering from mental illness and chemical addiction. Respect for life and human dignity and principles of justice demand that we do better.