Severe mental illnesses, like schizophrenia and bipolar disorder, are brain diseases—biological conditions like heart disease or epilepsy. Yet in this country, the institutions most likely to be treating people with these illnesses are not hospitals, but rather jails and prisons.
According to a new report from the Treatment Advocacy Center TAC, a nonprofit advocacy organization, the United States has fully returned to the 18th-century model of incarcerating the mentally ill in correctional institutions rather than treating them in health care facilities like any other sick people. In 2012, there were roughly 356,268 inmates with severe mental illnesses in prisons and jails, while only 35,000 people with the same diseases were in state psychiatric hospitals.
For every $2,000 to $3,000 per year spent on treating the mentally ill, $50,000 is saved on incarceration costs.
Prisoners with mental illness cost the nation an average of nearly $9 billion a year.
In 1955, there was one psychiatric bed for every 300 Americans. In 2010, there was one psychiatric bed for every 7,100 Americans—the same ratio as in 1850.
The numbers of incarcerated mentally ill have been growing, and TAC reports that their treatment in the corrections system is nothing less than abominable. Mentally ill inmates are more likely to become the victims of sexual assault and abuse. They’re also overrepresented in solitary confinement, and they are much more likely than other prisoners to commit suicide.
Putting the mentally ill in jails instead of hospitals isn’t saving the government any money. In Washington state, for instance, in 2009, the most seriously mentally ill inmates cost more than $100,000 a year to confine, compared with $30,000 for others. One reason for the disparity: According to the report, mentally ill people tend to stay in jail longer than other prisoners because they aren’t likely to get bail and also because they are often chronic rule-breakers.
For example, according to the report, in Florida’s Orange County jail most inmates stay an average of 26 days, but mentally ill inmates are there for 51 days on average. Even worse is New York’s Rikers Island jail, where last month a homeless, mentally ill veteran, who’d been arrested for sleeping on the roof of a public housing project, “basically baked to death” in his cell. The average stay for an inmate at Rikers is 42 days. Mentally ill inmates get stuck there for an average of 215 days.