Many more seriously mentally ill in jails/prisons than psych hospitals

Every so often, I think it's good to bring up this topic. Though many of us have never spent time in jail or prison, an abnormally high percentage of prisoners are seriously mentally ill, and they often stay there longer than other prisoners. Many also find themselves in jail again and again, often for actions related to mentally ill behavior. Here are some statistics to note:

How Many Individuals with Serious Mental Illness are in Jails and Prisons?
(updated November 2014)

SUMMARY: Approximately 20 percent of inmates in jails and 15 percent of inmates in state prisons have a serious mental illness. Based on the total number of inmates, this means that there are approximately 356,000 inmates with serious mental illness in jails and state prisons. This is 10 times more than the approximately 35,000 individuals with serious mental illness remaining in state hospitals.

Torrey EF, Zdanowicz MT, Kennard AD et al. The treatment of persons with mental illness in prisons and jails: A state survey. Arlington, VA, Treatment Advocacy Center, April 8, 2014.

The nation’s jails and prisons have replaced hospitals as the primary facility for mentally ill individuals.

There are more seriously mentally ill individuals in the Los Angeles County Jail, Chicago’s Cook County Jail, or New York’s Riker’s Island Jail than in any psychiatric hospital in the United States. In fact, in every county in the US that has both a county jail and a county psychiatric facility, the jail has more seriously mentally ill individuals. A 2004–2005 survey reported that there were “more than three times more seriously mentally ill persons in jails and prisons than in hospitals.”

Torrey EF, Kennard AD, Eslinger D et al. More Mentally Ill Persons Are in Jails and Prisons than Hospitals: A Survey of the States (Arlington, Va.: Treatment Advocacy Center, 2010).

Mentally ill often stay longer than non mentally ill in prisons and jails

In Florida’s Orange County Jail, the average stay for all inmates is 26 days; for mentally ill inmates, it is 51 days. In New York’s Riker’s Island Jail, the average stay for all inmates is 42 days; for mentally ill inmates, it is 215 days. The main reason mentally ill inmates stay longer is that many find it difficult to understand and follow jail and prison rules. In one study, jail inmates were twice as likely (19 percent versus 9 percent) to be charged with facility rule violations. In another study in the Washington State prisons, mentally ill inmates accounted for 41 percent of infractions even though they constituted only 19 percent of the prison population. Another reason mentally ill inmates stay longer is that they are often held for months awaiting the availability of a bed in a psychiatric hospital.

Jails and mental illness, Criminal Justice/Mental Health Consensus Project,
Nothing found for Infocenter Factsheets Fafct_Jails, last accessed April 3, 2006.

Turner C, Ethical issues in criminal justice administration, American Jails, January/February
2007.

Butterfield F. Study finds hundreds of thousands of inmates mentally ill, New York Times,
October 22, 2003.

Miller CM, Fantz A. Special “psych” jails planned, Miami Herald, November 15, 2007.

Bender E. Community treatment more humane, reduces criminal-justice costs, Psychiatric
News 2003;38:28.

Gottschlich AJ, Cetnar G. Drug bills at jail top food costs, Springfield [OH] News Sun, August
20, 2002.

Guenther A. Family sues Camco over prisoner’s death, [NJ] Courier Post, June 14, 2006.

Mentally ill inmates are more likely to commit suicide.

Multiple studies have shown that approximately half of all inmate suicides are committed by inmates who are seriously mentally ill. A 2002 study in Washington State reported that “the prevalence of mental illness among inmates who attempted suicide was 77 percent, compared with 15 percent [among inmates] in the general jail population.”

In California in 2002, the Los Angeles Times headlined: “Jail Suicides Reach Record Pace in State,” and added: “Some experts blame the recent surge on forcing more of the mentally ill behind bars.” Goss JR, Peterson K, Smith LW et al.

Characteristics of suicide attempts in a large urban jail system with an established suicide prevention program, Psychiatric Services 2002;53:574–
579.

Johnson J. Jail suicides reach record pace in state, Los Angeles Times, June 16, 2002.

Issues relating to less frequent mental healthcare for many African Americans with mental health concerns

See Black & African American Communities and Mental Health | Mental Health America

A couple of years ago, during my last episode, I was locked up for a month in a maximum security forensic psychiatric ward. It was co-ed and I am a woman so it was particularly intimidating. During that time I was driven in the cage in the back of a van in shackles on both hands and feet. There was no seat belt or anything steady to sit in or try to hold on to as I bounced around in the back. I was stripped searched each time I came back from the downtown court house. The first night i had to sleep on the floor in a suicide smock, with a blanket made from the same coarse fabric. It was freezing and I hardly slept. At least they gave me a pillow and a thin mattress but the draft just blew through the gaps. It was like sleeping in a cardboard smock and blanket.

I had a stack of charges against me all of which were eventually dropped in favour of a mental health diversion. I did other things for which I was never charged too. I really didn't appreciate my rights or how the court system works or that I needed to get a lawyer. I had imagined I had famous lawyers working on my case, but that was a delusion. That is one of the reasons I think I was held for so long.

It makes sense to me that mentally ill prisoners would be held longer. A lot of the people I was locked up with considered the forensic psychiatric ward to be a step up from jail.

tecomsin, I am so sorry you and so many others have had to go through such a hell. It's so severely wrong and cruel! I thank you for sharing on this so people can gain awareness.

Thanks BirdDancer.

It is one of those situations that is almost impossible to imagine unless you have been through it. I refused to talk to the psychiatrist who had been assigned to me because I thought he was part of a conspiracy to lock me away forever in a mental institution. Indeed I still think if I had told people what I was actually thinking I would have been locked up for even longer than I was.

I believed I was part of a conspiracy to take over the world and that my home had not only been bugged with spy cameras and microphones but people had the ability to make noises in my house including clicks and bangs. Sometimes I could not sleep because of all the banging.

It was after I came down a few months after being released that I realized I had been very ill and went on an antipsychotic. The police had banged down my door while I hid in a closet, they ransacked my house tossing papers and clothes and stuff on the floor. There were maybe a dozen officers who took me away. Once I was handcuffed one officer squeezed my upper arm with his thumb and left a big bruise.

I was doing dangerous things and my paranoia had only escalated when the police car had chased me on a road the day before I was arrested. The police had been knocking on my door and shouting out my name dozens of times for months before that.

As I became more and more paranoid I started to do more and more destructive things and broke the law many times.

Paranoid psychoses can be very dangerous so it is right to take such people off the streets. The question is how to treat them.

I am not sure I would have become so ill if my neighbors hadn't been repeatedly calling the police to make so called 'wellness checks'. This amounted to armed men banging on my door sometimes many times a day shouting my name out loud. This just fed directly into my paranoia that the government of Canada was after me because i was part of a world wide conspiracy to take over the country.

I think this is a great topic to address, and more generally our broken prison and justice system. I mean, no rehabilitation happens in jail/prison -- it's punishment and holding cell, and they go right back out to the public, and in lots of cases end up doing it all again. Petty crimes and drug addicts aren't "helped" by being in jail. The rate of people committing another crime after incarceration is astounding. "According to an April 2011 report by the Pew Center on the States, the average national recidivism rate for released prisoners is 43%." (see source below) I won't get on that train-- back to the topic at hand.

This scenario is doubly true to the mentally ill in jails/prisons around the country. There isn't resources or enough help to even go around if services are available. It's really a sad sad thing to see. I wish we could find a better method of "helping" these individuals.



Public Safety Performance Project, State of Recidivism: The Revolving Door of America’s Prisons, The Pew Center on the States (April 2011), "Archived Copy" (PDF). Archived (PDF) from the original on 2014-06-11. Retrieved 2019-3-13.

This crisis is a by-product of Reaganomics.
He did so many cuts in the budget, that the hospitals had to close down.
You can also thank his memory for homelesness. He created it.

If you were not a threat to you or others, you were free to suffer in the streets.

Cheers.

tecomsin, you made so many important points that clearly demonstrate that prisons or prison-like facilities are definitely NOT the place for the mentally ill, despite them breaking laws as a result of it.

You wrote:

"Paranoid psychoses can be very dangerous so it is right to take such people off the streets. The question is how to treat them."

Definitely not like a criminal, in my view. I see such environments as totally counterproductive to mental health recovery.

You also wrote:

"This amounted to armed men banging on my door sometimes many times a day shouting my name out loud. This just fed directly into my paranoia..."

My goodness! Of course it would!

I became very interested and concerned about this topic when I read a book by journalist Pete Earley called "Crazy - A Father Search Through America's Mental Health Madness". His college age son experienced his first manic episode and as part of that broke into a house and destroyed things. The father had a huge fight keeping his young mentally ill son out of jail. That motivated him to do research on the topic of mentally ill in jail. If anyone is interested, his website is at:

Helpful Recommendations: Why Jails And Prisons Shouldn't Be Asylums - Pete Earley

Thank you, Brentus and pirilin for your additions to this topic. I had read about Reagan's statements and actions. It's so sad to say it, but his views are still extremely common.

The strategies to rectify the issues mentioned here are certainly complex, but the hardest part is getting some meaningful action started.

Insurance companies don’t make enough and pay out for a psych bed as they do with the state private owned prisons. Simple math for a crazy world

My cousin has been in and out of jail and prison at least 6 times since we were kids , he is 3 years older than me and is currently serving 15 years. Is he mentally ill ? Yes years or self medicating ( alcohol and every drug under the sun. ) hasn’t helped , he’s a very violent dangerous man. He tried to rape his mother numerous times. He is that evil not just mentally ill just evil , he deserves prison there is no rehabilitation for him at this point. Maybe 25 years ago but no longer at this point , it’s a shame he had a bright future at one point , his sister is the same way , I feel bad for them but they started drugs and alcohol by age 12 , hardstuff

Some people you simply can’t help.

That's a very sad story about your cousin, Christina.

I don't believe in the word "evil". Then again, I'm not religious.

In Canada we have implemented a new strategy called Mental Health Courts. The concept is quite new but the goal is to keep people who have committed minor offences and are mentally ill out of prisons and the court system and address their offences through the lens of their mental health. Often when you go to mental health court there is the judge who has special training in mental illness, a psychologist, social worker, psychiatrist and/or forensic psychiatrist, and community supports. Together they work to find the best way to make you accountable for your actions without ruining the rest of your life.

I wrote a paper on mental health courts last semester and at the time I took the position that I did not support them; that it was just a way to let people off the hook for their mental illness. I do, personally, lack empathy at times and when I wrote my paper I was taking the position of "mentally ill or not, you broke the law and should be subject to the same penalties as anyone else". I do still have that perspective to a certain point, however, I've done additional research on mental health courts and do feel they have the ability to make a positive impact on the offender, the court system and society.

I do think that if we are going to put mentally ill offenders behind bars we have an obligation to provide treatment. The justice system provides treatment for medical conditions. Why are they not held to the same standard for mental health conditions? I think there needs to be a huge focus on providing mental health care in the system and as follow-up when offenders are released to prevent recidivism.

I am happy you shared that about the strategy in Canada, piggy momma! That's great that you have done a lot of research into that system to understand its pros and cons. I am sure a perfect system is near impossible, but better and better is what needs to be aimed for.

In the book "Crazy" I mentioned, Pete Earley also described how the seriously mentally ill prisoners in the Miami prison he was given access to study were often put in particularly undesirable cells and were not allowed some of the same privileges as prisoners without mental illnesses. It is known that prison conditions and rehabilitation programs (or lack of) vary a lot in the US, especially since many are privatized. Are any prisons in Canada privately owned and operated? Or are they all provincial or federal types?

Yes, I saw a front line episode of this a couple of years ago. It is truly heartbreaking.

My son has psychotic disorder and there have been times when he's been violent and just miserable to live with. He pulled some of my hair out once, that's the only time he's actually touched me. But he's been really intimidating towards me too. All the mental health ppl said just kick him out. I didn't and I'll tell you why. I'm half Hispanic and Caucasian. He's a forth Hispanic and and 3 forth Caucasian. But he looks very Hispanic. He would have had no place to go for one, and the police around here can be racist. He would have ended up unmedicated and delusional and probably violent. I didn't want him to end up in the cycle of jail, psych hospitals. I didn't want him to have a record at such a young age.

For him it was he was donating plasma to get alcohol and weed (I'm not against weed at all, but for my son it makes him delusional ). He wasn't taking his meds right. He finally had a bad delusion on the weed after not smoking it for like a month and realized it was the weed. Since he's been off weed and taking his meds more consistently he's much better.

Sorry I'm rambling, but yes prisons and jails have become the new psych hospitals.

And BirdDancer, I'm not religious either and don't believe in 'evil' either.

Not to nick pick but my use of “ evil” was used because he tried to rape HIS mother. I think saying mental ill and Unwell “ just doesn’t cover it ...

Maybe I have been triggered so I’ll stfu

I am in Canada and can say there are no private prisons or jails in this country.

Also I was not put in a mental health court but the prosecutor referred me to mental health diversion. Upon completion of the diversion program, which just consisted of meeting a nurse twice and that nurse getting a letter from my psychiatrist, all remaining charges were dropped. Some of the charges were dropped early on, so I ended up with no charges.

I did other illegal things when I was ill that I wouldn't repeat even on an anonymous forum. They were not 'minor'. I feel lucky to have gotten out of that last episode with no criminal record. Of course it is in my medical record that I was 'cared for' in a forensic psychiatric hospital.

We also have homeless people in Canada, or in the depths of winter a lot of people in homeless shelters or hospitals. Various foundations have grouped together in my city for a 'housing first' initiative to get homeless people into permanent housing.

I met a man in a sitting area outside a hospital when I was sectioned once into a psych ward and was out on a smoking break (this is back when I used to smoke). He was missing all 4 limbs and had mechanical hooks for hands and got around in a wheel chair. When i asked him what had happened he said he had been homeless and got frost bite. That was why he had all 4 limbs amputated.

I'm sorry if what I wrote triggered you, Christina. I certainly didn't want you to feel angered, upset, or any other uncomfortable feeling by reading what I wrote. I understand that a person raping their parent or sibling, or a child, or anything like that seems particularly heinous. It is indeed a terrible thought to think that this can be, and is, a reality far too many times.

It's sometimes rather difficult to express one's view on certain ways of thinking. Definitely one simple statement doesn't cut it. But even when one tries to describe a viewpoint in a million words, it still may not be understandable. Perhaps because it isn't described well enough. Perhaps because we haven't gone down the same paths that allow us to see things from a very different vantage point. Maybe even then we'd see things differently. I would have felt the exact same way I THINK you do about "evil" perhaps even six years ago, but things happened in my life that changed my viewpoint. I described my view on pretty much this subject in a blog post I wrote a long while back. The title may not exactly sound like a discussion about evil. Perhaps ignore the title. I've been considering changing it. I don't know, if anyone is interested in my blog post, it's at Hating is not fair – Bird Flight

A couple people who responded to my blog post just referenced got mad at my viewpoint and expressed total disagreement. I understood. I do believe that even mental conditions like Antisocial Personality Disorder are illnesses. It's in the DSM-5. That can simply be a disorder of the brain because of nature, and/or nurture. A lot of mental issues are sparked by nature and nurture. Hate that leads to bad acts is also sometimes bred by upbringing and education, or being abused yourself. It really is sad!

I also have a cousin who has been in jail a number of times in the past. She has bipolar disorder, too, along with severe addictions, and many other challenges. Her mother left her when she was a little girl. My uncle was not the greatest parent. He just pawned her off on my grandmother, who barely paid attention to her. This cousin was only about 6 or 7 years old when my uncle's good friend started sexually molesting her. It went on for a long time until that man tried to sexually molest her young friend, too, but the young friend told her mother. That molester was jailed. He had even molested his own daughter. My cousin was permanently affected. Her later addictions and perhaps her bipolar disorder itself brought on crimes like stealing, selling and possessing drugs like heroin, and being violent in public. She stole many times from her own family. She had three children and then left them. My uncle, now in his early 70s, has been raising her three kids with his second wife for about 16 years. I guess some people could call my cousin a "horrible person". Well, she certainly has done a lot of really bad things. But I try to understand what brought about all of it. Nature and nurture issues and mental health stuff on top of it.

Thanks for answering my question, tecomsin!

I would like to do a bit of research on homelessness and the many reasons why some people become homeless. I know there are a lot of reasons. I don't believe the topic is as straightforward as I once thought in the past. Being homeless in an extremely cold place must be really horrible! I once lived in the Berkeley, California near San Francisco. There were a lot of homeless people there, but I remember thinking that at least it never gets THAT cold or hot there. It's still a hard life to imagine.

I read your blog post BirdDancer. Thanks for sharing.

Yeah it is literally a matter of life and death in some places like where I live. Here is a good article about homelessness in a city in Canada from Jan 2019. Some of it may surprise you.

Calgary homeless population and Calgarians at risk of homelessness | Calgary Herald

Sorry, didn't mean to trigger you.