But the sad truth is that some of the country's most vulnerable individuals are not better off -- though the number of institutionalized people has dropped by more than half a million since the 1950s -- and many are landing in prisons and jails, where they fail to receive proper, and often humane, treatment.
Across the country, correctional facilities are struggling with the reality that they have become the nation’s de facto mental healthcare providers, although they are hopelessly ill-equipped for the job. They are now contending with tens of thousands of people with mental illness who, by some counts, make up as much as half of their populations.
Little acknowledged in public debate, this situation is readily apparent in almost every correctional facility in the country. In Michigan, roughly half of all people in county jails have a mental illness, and nearly a quarter of people in state prisons do. In 2016, the state spent nearly $4m on psychiatric medication for state prisoners. In Iowa about a third of people in prison have a serious mental illness; another quarter have a chronic mental health diagnosis.
A few fast facts:
- Almost half of individuals executed across the U.S. from 2000 to 2015 had a mental illness diagnosis or substance abuse disorder in their adult lives.
- A U.S. Bureau of Statistics study found that 75% of women incarcerated in jails and prisons had a mental illness, as compared with just over 60% and 55% of men.
- Another study showed that "20% of women in jail and 30% in prison had experienced “serious psychological distress” in the month before the survey, compared with 14% and 26% of men, respectively."
- The proportion of prisoners with mental illness is on the rise: "In 2010, about 30% of people at New York’s Rikers Island jail had a mental illness; in 2014, the figure rose to 40% , and by 2017, it had gone up to 43%."
The racial inequity of the criminal justice system has been widely noted: it is estimated that one out of every three African American men and one of every six Hispanic men born in 2001 will be arrested in their lifetimes.
But for Americans with serious mental illness, it is estimated that as many as one in two will be arrested at some point in their lives. It’s not just arrests. One in four of the nearly 1,000 fatal police shootings in 2016 involved a person with mental illness, according to a study by the Washington Post. The Post estimated that mental illness was a factor in a quarter of fatal police shootings in 2017, too.
Prisons and jails have increasingly become the primary means of receiving mental healthcare -- inadequate or otherwise -- for vast numbers of mentally ill Americans.
These same individuals are also:
- Less likely to make bail;
- More likely to face longer sentences;
- More likely to find themselves in solitary confinement;
- Less likely to be granted parole;
- And more likely to commit suicide.
Any discussion of criminal justice reform must include the issue of mentally ill Americans caught up in a system that does not and cannot adequately address the mental and physical well-being of one of society's most vulnerable populations.