New study shows more people with mental illnesses in U.S. prisons, jails than hospitals

From the Treatment Advocacy Center:

ARLINGTON, Va. — Americans with severe mental illnesses are three times more likely to be in jail or prison than in a psychiatric hospital, according to "More Mentally Ill Persons Are in Jails and Prisons than Hospitals: A Survey of the States," a new report by the Treatment Advocacy Center and the National Sheriffs’ Association.

“America’s jails and prisons have once again become our mental hospitals,” said James Pavle, executive director of the Treatment Advocacy Center, a nonprofit dedicated to removing barriers to timely and effective treatment of severe mental illnesses. “With minimal exception, incarceration has replaced hospitalization for thousands of individuals in every single state.”

The odds of a seriously mentally ill individual being imprisoned rather than hospitalized are 3.2 to 1, state data shows. The report compares statistics from the U.S. Department of Health and Human Services and the Bureau of Justice collected during 2004 and 2005, respectively. The report also found a very strong correlation between those states that have more mentally ill persons in jails and prisons and
those states that are spending less money on mental health services.

Severely mentally ill individuals suffering from diseases of the brain, such as schizophrenia and bipolar disorder, often do not receive the treatment they need in a hospital or outpatient setting. The consequences can be devastating – homelessness, victimization, incarceration, repeated hospitalization,and death.

“The present situation, whereby individuals with serious mental illnesses are being put into jails and prisons rather than into hospitals, is a disgrace to American medicine and to common decency and fairness,” said study author E. Fuller Torrey, M.D., a research psychiatrist and founder of the Treatment Advocacy Center. “If societies are judged by how they treat their most disabled members, our society
will be judged harshly indeed.”

Recent studies suggest that at least 16 percent of inmates in jails and prisons have a serious mental illness. According to author and National Sheriffs’ Association Executive Director Aaron Kennard, “Jails and prisons are not designed for treating patients, and law enforcement officials are not trained to be mental health professionals.”

Ratios of imprisonment versus hospitalization vary from state to state, as the report indicates. On the low end, North Dakota has an equal number of mentally ill individuals in hospitals as in jails or prisons.

By contrast, Arizona and Nevada have 10 times as many mentally ill individuals in prisons and jails than in hospitals.

Among the study’s recommended solutions are for states to adopt effective assisted outpatient treatment laws to keep individuals with untreated brain disorders out of the criminal justice system and in treatment. Assisted outpatient treatment is a viable alternative to inpatient hospitalization because it allows courts to order certain individuals with brain disorders to comply with treatment while living in
the community. Studies show assisted outpatient treatment drastically reduces hospitalization, homelessness, arrest, and incarceration among people with severe psychiatric disorders, while increasing adherence to treatment and overall quality of life.

Data on prisoners for “More Mentally Ill Persons Are in Jails and Prisons than Hospitals: A Survey of the States” were obtained from the Bureau of Justice Statistics’ report, “Prison and Jail Inmates at Midyear 2005.” Data on the number of inpatients in public psychiatric hospitals, private psychiatric hospitals,
and the psychiatric units of general hospitals were obtained from the 2004 Inventory of Mental Health Organizations, carried out by the Substance Abuse and Mental Health Services Administration under the U.S. Department of Health and Human Services.