I have been a forensic psychologist performing assessments for civil commitment for the mentally ill and chemically dependent, and I also have conducted assessments to determine if a patient is competent to stand trial or is not guilty by reason of insanity for almost 40 years.
Ever since the introduction of managed care, which has reduced services for psychiatric treatment, this has also been applied to individuals who suffer from a mental illness but engage in some type of unlawful behavior that potentially makes them a danger to self or others. Understandably, depending on the degree of aggression, most private psychiatric hospitals are unable to handle the mentally ill who are violent with the exception of a few hospitals that may have forensic beds, such as Ramsey County or Hennepin County, where they can be handled by correctional officers and psychiatric personnel.
However, more often than not, these individuals languish in a jail, sometimes for as long as 90 days or longer and do not necessarily receive psychiatric treatment. They are remaining in a psychotic state suffering from auditory and visual hallucinations as well as their paranoid delusions. Oftentimes, they have to be in restraints.
I always remember the most important ethical principle that we were taught as graduate students in psychology: “Do no harm.” In the whole concept of Black Lives Matter, the message I receive is that you are a person regardless of race, creed, color, or religion. And when you see an injustice, stand up and speak out.
Ten years ago, I was asked by Judge Jay Quam to develop a videotape to be sent to the Legislature discussing the incarceration of the mentally ill. There are many good men and women of all different professions who know this is wrong. More importantly, if you are a parent of an adult child who has a pervasive and severe mental illness and they periodically decompensate, you know this is wrong. More likely than not, you would be of financial means to make bail and to be sure that your adult child was treated appropriately.
Whenever I examine a patient in a jail who is in a psychotic state, and also is in restraints with no medication being given because they are refusing, I am bewildered and ask myself what country am I in and what time period.
In so many ways I have been so proud to live in Minnesota because of our multicultural religious and social heritage built on the principle that the strong should not exploit, enslave, and abuse the weak but the strong should take care, educate, and help the weak. The idea that professionals who work in state facilities are not as competent as professionals who work in the private sector is a myth.
The state of Minnesota hires the finest mental health professionals who are dedicated to treating these people. My intent is not to offer blind criticism because this problem is complex. Instead, I only wish to call attention so many other people of conscience will join in confronting this injustice that is occurring within the state of Minnesota. This type of action is not in the tradition of our civic ideals.
Paul M. Reitman, Ph.D., L.P., is a forensic psychologist in full time private practice. Learn more at his website, Paulreitman.com.