By Brian Dawe
“Currently, the three largest inpatient psychiatric facilities in the country are jails: Los Angeles County Jail, Rikers Island Jail in New York City, and … Cook County Jail in Chicago. Each individually house more persons with mental health conditions than any psychiatric institution in the United States.”
Housing psychiatric patients in our prisons and jails is an important public safety issue. Of course, we cannot simply excuse unlawful, violent or predatory behavior because of an individual’s mental capacity. However, we must also realize that traditional incarceration techniques are mostly ineffective in securing, treating, and protecting the growing population of the mentally ill in America.
Throughout history, we have struggled with treating mental illness. By the mid-1950’s psychiatry had concluded that when dealing with the mentally ill, incarceration-absent-treatment often exacerbated the situation. Various treatment reforms were initiated, and by 1955 there was one mental health bed available for every three hundred citizens, but unfortunately by 2005 that number was reduced ten-fold to one bed for every three thousand. In most instances individuals who could have been helped with a bed in an accredited institution have not gotten “better” –although new drugs and treatments have helped, many have simply been shifted from treatment to incarceration. As a result, our prisons and jails have become the nation’s largest mental health facilities. There are three times as many seriously mentally ill individuals in our prisons and jails than in psychiatric hospitals.
The challenges this population presents, and the dangers of improper classification and housing assignments are well known. According to a 2014 report by the Treatment Advocacy Center, “Ten times more mentally ill people are now in jails and prisons than in state psychiatric hospitals: In 2012, approximately 356,268 inmates with severe mental illness were in prisons and jails, while about 35,000 severely ill patients were in psychiatric hospitals.”
According to the Department of Justice:
- 705,600 inmates in state facilities, or 56% of the population, had a mental health problem, with 15% of them meeting the criteria for a psychotic disorder.
- 479,000 inmates in local jails or 64% of the population were diagnosed with a mental health issue, with 24% of those inmates meeting the criteria for a psychotic disorder.
- 78,800 federal inmates were diagnosed with a mental health issue, 45% of the population.
- 70% of juvenile offenders, “suffer from mental disorders, at least 20 percent are experiencing disorders so severe that their ability to function is significantly impaired.”
Within the female inmate population, the numbers are worse:
- 73% of female inmates in state facilities have a reported mental health issue.(75% of these inmates met the criteria for substance dependency or abuse.)
- 75% of female inmates in jail facilities have reported mental health issues.
Of the state inmates diagnosed with a mental health disorder 49% had a “violent offense as their most serious offense.” In addition, these inmates on average spend five months more time behind the walls than inmates without these disorders. 
“……we spend far more on imprisonment of the mentally ill than we would otherwise spend on treatment and support.”
So, what’s the answer to this problem? When crimes are committed, society demands reciprocity. That reciprocity can come in many forms: fines, community service, programming (such as AA and NA), probation, or incarceration. But what does society want or expect when the accused are mentally ill? What do they expect and want of us?
How are we to treat this population? As law enforcement officials, we do not choose who is sent behind those walls every day, nor are we empowered to make the policy decisions on where these men and women are to be housed, or the treatment prescribed. An ACOIN survey found only one state where correctional officers are trained to deal with a mentally ill population, Michigan.
This is an issue that needs to be addressed. With the nation ready, and our politicians looking for broad based criminal justice reform, this is an issue everyone should agree on; mentally ill inmates belong in designated secure housing units designed specifically for that purpose, complete with properly trained officers and psychiatric staff. At the next possible encounter, ask your elected officials how they suggest dealing with a mentally ill individual in our environment. If nothing else, the question will make them think, something very few have done on this issue.
The burden and expectations placed upon correctional staff is unreasonable due to a lack of training. This is an area that demands to have more research done to understand the physical, emotional and spiritual impacts being placed on correctional professionals.
 Crane’s Chicago Business, “When Mental Illness is Diagnosed at the Jail”, MICHELLE MBEKEANI-WILEY, Dec 28, 2017
 Treatment Advocacy Center, “More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of States.” E. Fuller Torrey, M.D., May 2010 page 8
 “Prisons Have Become America’s New Asylums”, Dahlia Lithwick, Slate Magazine, Jan 5, 2016
 Bureau of Labor Statistics; “Mental Health Problems of Prisons and Jail Inmates” Sept 2006, NCJ 213600
 DOJ BJS “Mental Health and the Treatment of Inmates and Probationers” 1999
 The Office of Juvenile Justice and Delinquency Prevention, “Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth with Mental Health Needs in Contact with the Juvenile Justice System”, KR Skowyra, JJ Cocozza, Ph.D., 2007 Policy Research Associates, Inc.
 Bureau of Labor Statistics; Mental Health Problems of Prions and Jail Inmates. Sept 2006, NCJ 213600
 Darrell Steinberg, David Mills, and Michael Romano, “When Did Prisons Become Acceptable Mental Healthcare Facilities?”, Stanford Law School Three Strikes Project, February 19, 2015.
 American Correction Officer Intelligence Network, Intel Request: May 2014.
Brian Dawe, Executive Director, American Correctional Officer Intelligence Network
Former Massachusetts State Correctional Officer May 1982-July 1998.
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