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Mental Health and Prison Systems in Major Need of Reform

Bao said that although driven by noble ideas, governments failed to replace mental health institutions with an immediate effective alternative, resulting in conditions that contributed to higher incarceration rates. People with mental illness are 4.5 times more likely to be arrested than others and their proportional presence in prisons has exceeded the rate of the general population by a factor of somewhere between three and six. In addition, prisons and jails do not have the mental health facilities or personnel necessary to properly treat these individuals. Bao called this a pseudo-criminalization of illness.

The report stated that the system provoked great ethical concerns. The Center for Prisoner Health and Human Rights Director Scott Allen described it as counter-therapeutic. He said, “This is the wrong environment to try and treat people with mental illness. Very likely isolating people from their outside community and confining them to the criminal justice setting has harms, so that when someone returns ... they may be worse off than they were, even if mental health care was provided in the facility.”

He asserted that this perpetuated the mentally ill’s cycle of arrest and incarceration.

Bao discussed the continuity of community care. A patient’s caregiver is not normally contacted when a patient is incarcerated. The arresting department is not given the patient’s diagnosis and history. Intake is a brief interaction with the patient. Most process through and are out again pending court in just a few hours. It is difficult to determine who needs treatment and who does not.

The mentally ill have been found to be 15 percent more likely to recidivate within five years. They make up more than half the prisoners who commit suicide in correctional facilities. Incarcerating the mentally ill costs taxpayers about $15 billion per year.

Several communities are now attempting new programs to address the problem. Mental health-care professionals are pairing with police to help de-escalate situations involving the mentally ill. Many have developed crisis stabilization centers as safe alternatives to hold mentally ill patients.

Miami-Dade County of Florida launched a pilot program a decade ago created by Eleventh Judicial Circuit Judge Steve Leifman. Called the Criminal Mental Health Project, it diverts individuals with mental illness from serving time over minor offenses with the use of voluntary community-based treatment plans and law enforcement training to resolve crises.

The report by Bao stated, “While increasing efforts for reform are spreading across the country, deliberate and widespread change is still beyond reach. Establishing a sustainable alternative for the seriously mentally ill will require collaboration between multiple sectors and systems.”