Far too Many Mentally Ill People are Behind Bars

Law enforcement experts and mental health care advocates have long been sounding the alarm about how dysfunctional the mental health care system is in the United States. As the situation worsens, many claim that jails are being used as a substitute for mental health hospitals. And also note that “having mentally ill people in jail is almost a human rights issue.”

Fastest-growing Prison Population

“In America today, the fastest-growing population in prison is not Blacks, Hispanics, or toothless methamphetamine addicts. It is the mentally ill….We are criminalizing our brothers and our sisters, our neighbors and our friends at an alarming and increasing pace.” – Sheriff Tony Thompson

Sheriff Thompson is a 30-year law enforcement veteran and author of the book ‘Anyplace but Here: The Uncomfortable Convergence Between Mental Illness and the Criminal Justice System’. At his jail (Black Hawk County jail) he estimates that about 60% have a history of mental illness, which is similarly found in other jails across the country.

Petty crimes that are somewhat common amongst the mentally ill lead to higher rates of mentally ill inmates in jails than in prisons (20% higher). But with many jails being more punitive than rehabilitative, the outlook for the mentally ill isn’t always positive.

Is Jail the best option?

For both families and law enforcement, finding the right way to handle a mentally ill person (particularly while in crisis) can be a challenge. Families are often conflicted when they can’t help them, or there are delays in accessing services, yet at times know that jail can be a better option than the streets.

When law enforcement is called to help manage a relative or friend in mental health crisis, they often will end up taking them into custody. Once in the jail system, officials are faced with a challenge of keeping the inmate safe and getting them the care that is needed.

While sometimes mentally ill inmates can be violent or cause harm to others, jail officials are also concerned about them being harmed by others. They worry that these mentally ill inmates may be perceiving as weak by other inmates and taken advantage of. Another concern can be how jail staff apply “use of force”.

Use of Force with the Mentally Ill

A recent investigation of Pennsylvania jails in the last quarter of 2021 found that nearly 1 in 3 “use of force” incidents involved a person in mental health crisis, or with a known mental illness. This meant that tactics such as pepper spray or stun guns were used to subdue prisoners. These tactics were used to control a situation and get inmates to follow orders. Yet, while in a mental health crisis–many may not have been able to follow orders, with or without the use of force.

Similarly, being in jail can worsen existing mental health conditions. Without access to crisis support, this can lead to self-harm or suicide attempts by inmates. For example, an inmate with bipolar and anxiety disorder was experiencing increases in paranoia and anxiety while in jail. After repeated attempts were ignored for access to a mental health professional, the inmate choked himself until passing out. Only then were they able to access medical services, but still didn’t receive mental health support.

Instances of self-harm often need to be de-escalated which is at odds with use of force tactics. Inmates often need help, compassion and professional care which can be hard to provide in these settings.

Inadequate Mental Health Care

Medical providers recognize that jail is not an ideal setting for treating mental illness. However, many mental health crises in jail result from not receiving care ahead of time. Inmates are either not identified with a mental health condition during intake and/or are not receiving services in time. Eventually this can lead to even less serious mental health issues becoming severe.

For those with severe mental health issues, they often need inpatient and long-term care. This type of care is not always available through a jail system. And the services that are available frequently are in short supply. When they can’t get these services, some are kept away from other inmates which can mean they are isolated up to 23 hours a day. Isolation can often be detrimental to those in a mental health crisis, and leave lasting psychological damage.

Keeping mentally ill inmates separated in mental health wings, or scoring the level of mental health needs at intake are some strategies jails are using. However, the ACLU recently highlighted instances where this separation contributed to extremely harsh living conditions.

There are a number of policy level initiatives that jail systems are trying to implement to potentially solve this problem. This issue is incredibly complex and multifaceted though, so will likely need many more efforts and advocates in the years to come.

If you or a loved one has faced challenges with handling a mental illness while in jail, consider reaching out to one of our experienced attorneys to see if we can help.

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