The nation's jails and prisons are turning into warehouses for the mentally ill, with the three largest jail systems housing more than 11,000 prisoners under treatment on any given day.
And the problem is growing, according to a report Thursday in The Wall Street Journal
"In every city and state I have visited, the jails have become the de facto mental institutions," Esteban Gonzalez, president of the American Jail Association, an organization that represents jail employees, told The Wall Street Journal.
The jails in Cook County, Ill., Los Angeles County, and New York City have the largest populations of mentally ill inmates, the Journal noted. The estimated 11,000 prisoners being treated daily in the three systems alone equals 28 percent of all beds in the 213 state-run psychiatric hospitals across the country, according to statistics from the National Association of State Mental Health Program Directors Research Institute.
The numbers are getting worse even as crimes go down. For example, in New York City the jail and prison population has fallen to 11,500 inmates, down from 13,576 in 2005. But the number of mentally ill inmates has risen to 4,300 from 3,319, Dora Schriro, the commissioner of corrections, told the Journal.
Cook County Sheriff Thomas Dart said the situation now mirrors years past when large numbers of the mentally ill were put in prison rather than institutions where they could be treated.
"Society was horrified to warehouse people in state hospitals, but we have no problem with warehousing them in jails and prisons," Dart said.
The Journal's report on jailing the mentally ill comes just as the debate on whether changes need to be made in the nation's mental health system is heating up. For example, many people believe that the system should have prevented Aaron Alexis from carrying out the Navy Yard shootings last week in which he killed 12 people before being shot dead by police. It's clear now, according to some psychiatric experts, that the Navy veteran was dealing with severe mental problems and should not have been free to roam the streets, much less work as a government contractor with a security clearance.
"Another mass shooting has been perpetrated by another mentally ill man who, every shred of my 20 years of experience as a forensic psychiatrist, tells me was under-treated or improperly treated," Dr. Keith Ablow
, a psychiatrist and Fox News contributor commented in an opinion piece following the shootings.
"Psychiatry, properly focused and deployed, and properly linked to the judicial system and deployed in our V.A. hospitals, is a miraculously effective safety net for those at risk for violence toward self or others. But we seem hell bent on not focusing this healing, helping art and not deploying it."
According to the Journal report, more people in need of psychiatric treatment and housing ended up on the streets after states started closing their mental institutions in the 1970s.
Many of them were put in jail or, depending on crime committed, ended up in prisons. Prisoners who require medication for serious issues, such as schizophrenia or bipolar disease, are now housed as mentally ill, as are inmates who demonstrate more serious functional impairments.
For its story, the Journal surveyed all 50 states regarding the number of mentally ill patients being held in their prisons. Twenty-three states provided detailed responses, indicating that for every 10 prisoners behind bars, at least one or two are being held and treated as mentally ill.
According to the U.S. Department of Health and Human Services, about five percent of all adults in the United States suffer from a serious mental illness.
Treating mentally ill inmates does not come cheaply. The National Alliance on Mental Illness says the cost to taxpayers runs about $9 billion annually.
While some prison and jail systems hire psychiatric staff and retrain their corrections officers, most say their facilities are simply not equipped to handle the mentally ill. And, Gonzalez told the Journal, many of the mentally ill inmates released from jail often end up returning because there are not enough resources outside the prison walls to deal with their problems.
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