Upon further reflection, I believe it was my encounter with the death penalty that caused me to change my approach in determining my stances. And I wouldn’t have challenged my stance on the death penalty were it not for my concern over mental health issues.

Everyone feels the repercussions of mental illness, whether they realize it or not. Even as these illnesses have been misunderstood, misdiagnosed, maligned, and stereotyped for decades, by virtually everyone, the consequences are glaring when you look at homelessness, healthcare costs, or violence. When I began working as a policy advocate for the National Alliance on Mental Illness, I quickly realized that the realities of trying to solve the problem were much harder and messier than I had assumed, especially when it came to the justice system.

Our system is rampant with mental health issues. Countless studies and articles have been devoted to the overwhelming number of people incarcerated with mental illnesses, the multiple problems that come from asking that law enforcement act as first responders for those in crisis, and the ways that we have shifted what should be a public health matter to the justice system.

The death penalty magnifies these problems. It is estimated that 20 percent of those on death row have a severe mental illness. Due to HIPAA laws, and other illness-related factors, it is unlikely we will ever know the true number. The problem is that those with mental illness are at a disadvantage from the moment they encounter the justice system. They are more likely to be wrongfully convicted, and they are more likely to receive harsher sentences.

Unfortunately, universal awareness of these problems does not mean a unilateral agreement to fix them, much less an agreement on how to fix them.

There is still a vast lack of knowledge amongst the general public on the intricacies of mental health. This affects the attitudes of voters towards those with mental illness, the ability for lawmakers to set good policy, and the judgement of jurors asked to determine guilt and sentencing.

Common misperceptions on mental illness become even more detrimental, and at times deadly, when they run up against the justice system. There are some who refuse to recognize that mental illness is even an illness at all, instead clinging to debunked notions that these medical diagnoses are signs of a spiritual problem, bad character, or even a choice. Some also believe them to be made-up, fakeable, or an excuse. Even those who carry a more educated view on the actualities of these illnesses are still susceptible to believing that they are indicators of a threat of ongoing violence, rather than a mitigating factor that should be weighed as part of the legal process.

This a subject that I could pour hundreds of pages into, but for the sake of space, there are a few factors I wish people knew when it comes to considering criminal justice reforms as they pertain to those with mental illness.

First and foremost, individuals with mental illness are ten times more likely to be a victim than they are to be violent.

Secondly, the presence of anosognosia (a component of severe mental illness that prevents the victim from being self-aware of their own illness) drastically increases the likelihood that a person will fire their attorney on a whim, seek to represent themselves, or attempt to prevent their illness from being brought up in trial because they deny its existence. Additionally, they are much more likely to have difficulty understanding their Miranda rights, far more susceptible to police pressure, and substantially more likely to confess to crimes they did not commit.

Lastly, the term “severe mental illness” (SMI) is a precise medical diagnosis classified in the "Diagnostic and Statistical Manual of Mental Disorder" that pertains to a very specific set of conditions and symptoms. These illnesses are far more extreme than depression or anxiety, and include disorders such as schizophrenia and bipolar disorder with psychosis. These disorders by definition cause a “functional impairment which substantially interferes with or limits one or more major life activities.”

Given how serious all of these disorders are, and how much research exists proving their existence and consequences, it is ludicrous to suggest that these impairments could be faked in order to excuse a person’s culpability. Typically, when proponents of reform discuss mental illness, they are referring to this classification of illnesses.

As I came to understand these systematic problems that linked mental health with criminal justice, I began to realize my position on the death penalty might require more nuance that I initially thought. If a system cannot even safeguard the most vulnerable among us, it certainly should not be determining matters of life and death.

Hannah Cox is the National Manager of Conservatives Concerned About the Death Penalty. Hannah was previously Director of Outreach for the Beacon Center of Tennessee, a free-market think tank. Prior to that, she was Director of Development for the Tennessee Firearms Association and a policy advocate for the National Alliance on Mental Illness. To read more of her reports — Click Here Now.