To diver dan: your views on severe mental illness (SMI) contribute to the miasmic stigma which surrounds the severely mentally ill. The biological/physiological evidence for SMI is freely available on the world wide web. I understand that you may not care to view it.

The figure of 40% SMI is correct for male prisoners; it approaches 50% for female prisoners. This is because, the processes of deinstitutionalization having been done so poorly by all states, with what should have been the first step never finished, prisons are now places of reinstitutionalization for the mentally ill. Since our legal system does consider persons may be of unsound mind, many should be in a forensic hospital for possible rehabilitation. Such placements are rare as beds are unavailable.

The life expectancy of the severely mentally ill is 25 years lower than that of other Australians (except for a majority of indigenous people)

Mindless cruelty/caroline93
There are factors to the argument that must be clarified.
1. Mental illness “the disease”?
This is the achilles heel of the profession: Its vagueness as a so called disease, and the innate ability of humans to imitate symptoms of mental illness on cue.
2. Resourcing
A Lack of scientific credibility verses the industry ability and willingness to petition for un-proportional resources.
3. Success of treatments:
The matching of vague illnesses to the unreliable credibility of patients.
4. Treatment verses care; the priority.
Are prisons the sensible and economic answer as outcomes to behaviour of the mentally ill?

DiverDan, "1. Mental illness “the disease”?
This is the achilles heel of the profession: Its vagueness as a so called disease, and the innate ability of humans to imitate symptoms of mental illness on cue.”

It’s unfortunate that in its beginnings, mental health was based upon a medical model, and a new model wasn’t created. However, we are stuck with that model and some of the terminological misgivings that it sometimes offers. That being said, if you can accept that different industries have differing jargon, and that differing sub-cultures use a differing vernacular, then it shouldn’t be too difficult to accept some of the terms used within mental health, and try to accept the connotations we apply to them. Disease in mental health cannot be thought of in the same context as disease in medical health.

What we must accept in something like psychology, is that these are conceptual terms that describe an affliction, and use a medical model to make that description. But that description cannot always be as clearly defined and determined as say, a broken bone, or a particular microbe.
For example, you cannot point to fear. You can point to a person that may appear to you to be fearful, but fear is a personal and a relative concept. Only the person suffering fear can tell you what they fear, and then attempt to substantiate some of the reasons why they believe it is so. So in point of fact, if there are 6.5 billion people on the planet, then there are 6.5 billion interpretations of what fear is, and what they fear. The Achilles heel of the industry is that, and the fact that few people truly understand and appreciate this! And yet we have only described one single facet of the human condition. We haven’t spoken of depression, joy, paranoia, neurosis, ad infinitum. Nor have we even begun to contemplate the myriad of manifestations that this fear may adopt.

Many emotional and psychological conditions have no singular cause, but are a culmination of many triggers over time.

TBC

The terminology of the industry must grapple with these facts, and then grapple with the personnel interested in the subject matter, that they are lateral thinkers, not black & white concrete thinkers, that the personnel has insight, emotional maturity, and life experience and understanding, as well as the academic knowledge and training. To have an understanding of some of the people that you encounter, you must also have an understanding of the society and that society’s sub-cultures at all levels, and some of the unique influences of those groups. It’s as much a path in personal growth as it is the study of the human condition and society. It is not only an intellectual pursuit. Some of the brightest people are poor at understanding some of the material, for you cannot always think of things in linear terms, nor take things on face value. Which brings us back to our inability to build a machine that can detect or determine levels of something as common in understanding conceptually, as fear. Which brings me back to insight and understanding….if you think you need a machine to make these determinations, then psychology/psychiatry is not the field for you. It can never work in such mechanical terms and parameters as “hard” sciences, for it is organic and dynamic, not static. Maths has little use other than as a statistic in this field.

TBC

The human condition is full of paradoxes and ironies, and terms like “reverse psychology” do not exist for nothing, but is a vague description of an application in psychological terms of an irony. Sometimes you have to walk backwards, to move forward. Sometimes, the very thing that you would normally expect to do, is the very thing you should not do. For example, the act of self-harming is an attention-seeking behaviour…it attracts attention to the act, that in turn for the observer, sparks the reaction of intervention. This in turn often sparks volatile conflict, with increased emotional and physical levels, for it is oppositional…it’s attention, albeit negative attention. So, the very thing TO do, is to ignore the act, but engage the person. This decreases the chances of escalation of emotions and volatility, and clearly, is not oppositional. They will cease the act after gaining your attention, not your intervention. But to the uninitiated, the first impulse is to intercede and attempt to disarm the person, creating conflict, therefore creating volatility due to its oppositional stance and the physical act of intervention. Don’t even look at, or talk about what they are doing, but talk about them and look them in the eyes. They’ll stop what they are doing and then volunteer the offending weapon in time, and then you may patch-up their wounds. There’s a lot more involved to stopping the behaviour permanently, but that will de-escalate the situation in the short term.

There are many such peculiarities.

“2. Resourcing
A Lack of scientific credibility verses the industry ability and willingness to petition for un-proportional resources.”
Resourcing…a valid point. Doing anything properly seems costly in financial terms, but it is not cost, but rather, investment. It’s a social attitude, as I have just demonstrated with use of the contrasting term of “investment”. While we view it as a cost, it will always be under-valued, whereas an investment reaps rewards.

No scientific credibility? Little understanding, and thus little credibility given, more to the point

“3. Success of treatments:
The matching of vague illnesses to the unreliable credibility of patients.”
Poor science is a reflection of poor practitioners, not the quality of the science and its success rates in particular conditions by better practitioners.

“4. Treatment verses care; the priority.
Are prisons the sensible and economic answer as outcomes to behaviour of the mentally ill?”
Yes…for you and your loved ones, it is. Or would you like to reconsider that statement? Or I could put it this way… I could call that statement indicative of a sociopathic tendency due its elitist and dispassionate suggestion for the management of people with certain afflictions, and its obvious lack of any sense of morality. So how should we deal with that sociopathic notion? Should we imprison you? Do you see the slippery slope that is easily created by such a suggestion? I don’t mean any of it to be personal, but a demonstration of how easily things can be made subject to interpretation, depending on what we like to emphasise. In this instance, I have manipulated understanding, but you never know when there is genuine misunderstanding, and when there is agenda, and how easily we may all fall under the receiving end of it. For example, it is not unusual to experience an acute psychotic episode from nothing more than a spike in body temperature . Would you like to be imprisoned under that circumstance? You had a bad inflammation of some sort and body temp spiked, got psychotic in a public place, and went to jail. You don’t have a mental illness, but for a few hours, possibly a day or two, you present as mentally ill.