USA: Criminalizing the Mentally Ill

The number of people with serious mental illnesses in America's jails and prisons today is 5 times greater than the number in state mental hospitals. Prisons, as an observer of a similar trend in Australia has noted, are "the new asylums of the 21st century." The criminalization of the mentally ill is inhumane. It is also emotionally and financially costly, and a testament to government failure at all levels.

Topping the list of public policy busts is a deinstitutionalization movement that closed state mental institutions without producing the promised follow-up care through community-based treatment programs. That washout has led the mentally ill through a revolving door of homeless shelters, hospital emergency rooms and jails -- institutional surrogates for community mental health centers that never quite materialized. Prisons have not only become mental hospital stand-ins; they are now expedient means for getting people with serious mental illnesses off the streets. And as far as high incarceration rates among the mentally ill are concerned, no jurisdiction is immune. Virginia, which emphasizes public safety in cases involving the mentally ill, stands out: Numbers of such individuals have spent years behind bars in state mental institutions for minor offenses. Referring to the nearly 200 criminally charged but psychiatrically ill people in the Fairfax county jail, Bob Simon, head of the Northern Virginia chapter of the National Alliance for the Mentally Ill, recently told The Post: "They're there for being sick."

The need for more mental hospital beds or community-based facilities is not at issue. That notwithstanding, the beds have disappeared: The District has lost 92 % Maryland 86 % and Virginia 84 %, all since 1955. There has not been a corresponding drop in the number of mentally ill, nor, for that matter, an analogous increase in community-based treatment facilities. The difference between now and then is that today the final destination of the mentally ill tends to be the criminal justice system, where costs are greater, the treatment setting is wrong and where there is a substantial probability the sick will be returned to the community without medication or rehabilitation programs to keep them out of trouble or from a return trip to jail.

As a society, we know better. Seriously mental ill people, especially those who commit minor offenses, don't need precinct holding cells or jails with untrained corrections officers. They should be diverted to mental health treatment. We know that, but we don't do it. We know that society is better off when the mentally ill are helped rather than turned out on the streets to reoffend, but we don't provide the help. We know what works and what doesn't; what helps and what hurts. But we don't act. There's no excuse for that.

(source: Editorial, Washington Post)