We have a huge crisis on our hands in the United States because our jails and prisons have become the nation’s largest psychiatric hospitals. There are now more severely mentally ill individuals in the Los Angeles County Jail, Chicago’s Cook County Jail, or New York’s Riker’s Island Jail than there are in any single psychiatric hospital in the nation. This is regrettable, as we are asking our prisons to do something they are ill-equipped to do. Prisons are designed for punishment rather than rehabilitation and they are not equipped to provide comprehensive mental health treatment. There is little question that people with mental illness who are imprisoned have their constitutional right to treatment violated on a regular basis.
You may be asking, “Just how big is this problem?” Let me tell you – It’s big!! Inmates have rates of mental illness that are up to four times greater than rates for the general population. According to the findings of a study by the Human Rights Watch, an estimated 70,000 inmates experience psychotic symptoms (e.g., hearing voices, seeing things) every day. In addition, anywhere from 200,000 to 300,000 prison inmates suffer from serious mental disorders such as schizophrenia, bipolar disorder and major depression. At a cost of approximately $19,000 per inmate per year, we are spending an estimated $3.8 to $5.7 billion incarcerating (rather than treating) people with mental illness every year.
This phenomenon of prisons becoming overcrowded with the mentally ill did not happen by accident. Ironically, the deinstitutionalization movement, which spanned the late 1970s into the early 1990s, started because activists exposed the deplorable conditions of the mental health hospitals. The problem with the deinstitutionalization movement was that the proper community supports were never established or properly funded. And now, three decades later, the mentally ill are still ignored and living in deplorable conditions, except now they are found in the corners of prisons, vulnerable to rape, assault, and exploitation, instead of cringing in the back wings of mental institutions.
Shifting the treatment of mental illness from prisons to community mental health centers is sound economic policy, especially considering that it costs twice as much to treat mental illness in prison than it does in the community. Unfortunately, the current trend is for state and local governments to cut the funding of mental health services. Instead of decreasing funding, we need to be funding programs that train police officers to identify mental illness so that minor offenders might be properly admitted to a psychiatric hospital rather than prison. We also need to increase funding for programs that allow for assertive and supportive case management for the severely mentally ill so as to prevent rehospitalization or reincarceration. I urge policymakers to increase funding for outpatient community mental health centers so that people with mental illness can receive the treatment they need regardless of their ability to pay.
As the events of the Virginia Tech massacre revealed, mental illness is a serious issue that can have a far-reaching impact on all of society if it is left undetected or untreated. Think of it this way – if a woman has cancer, we would not send her to prison to receive treatment from a prison guard. So why are we incarcerating people with schizophrenia and bipolar disorder and expecting prison staff to treat their illness?