For Many With Mental Illnesses, Jail's the Only Treatment Option

In Ohio's Summit County, Sheriff Drew Alexander says he's tired of his jail being treated as a "dumping ground." He's not complaining about overcrowding — not, at least, of the kind we traditionally think of. Instead, he's worried about how the jail has increasingly come to resemble a psychiatric ward: crammed with people who are there not because they're criminal, but because they're mentally ill.

He's not alone, either. Nationwide, someone who's seriously mentally ill in the U.S. is three times more likely to get shunted into jail than wind up in a hospital, says a new report by the National Sheriffs' Association and the Treatment Advocacy Center. In some states, like Nevada and Arizona, that figure is far worse: people with conditions like schizophrenia are nearly 10 times more likely to be locked up than hospitalized.

Since the 70s, state mental hospitals across the United States have been shuttered, funding has been cut and patients discarded back onto the streets in waves. And while the impulse behind such releases may have had its humanitarian rationale, in the meantime, prisons around the country have been forced to pick up the slack. As Pete Earley writes, back in 1955, about 560,000 Americans with mental illnesses were patients in state hospitals. If that patient-per-capita ratio stayed consistent, the U.S. would have 930,000 such patients in similar care today. Instead, though, there are fewer than 60,000.

Where are the rest? According to Earley, about 500,000 are on probation. Another 300,000 are in jail.

And at this point, states around the country — like Florida, for example — have reached a "crisis point" trying to handle them. In Florida, multiple prisoners with mental illnesses have died after guards tried to subdue them using brutal force. And in Clearwater, FL, one schizophrenic prisoner gouged out his eye after waiting fruitlessly for a hospital bed.

Past Justice Department studies have found that prisoners with mental illnesses are more likely than others to be convicted of violent offenses (for eg., robbery or assault). But many end up in prison for much less. As James Pavle, executive director of the Treatment Advocacy Center, notes: "All they have to do is step over a line — public urination, a misdemeanor. Then they get in jail, and the whole thing can spin out of control."

Photo Credit: RL Johnson