a prison inmate in an orange jumper is pictured through a window of a prison cell in the U.S.

By Christopher Zoukis

It’s hard to track how many people in America suffer from mental illness. The term covers a broad range from manageable depression to very serious personality disorders. Even worse, since the stigma around mental illness is just now easing, the number of reported cases falls below the number of those that require treatment.

According to the National Alliance on Mental Illness, approximately 18.5 per cent, or one in every five, adults in America experiences mental illness. Of those, four per cent of the cases are serious (defined as where it limits major life activities). A strong correlation also exists between substance abuse and mental illness. There is also a correlation between chronic medical issues and mental illness.

Even though mental illness is treatable, Americans suffering from severe mental illness die an average of 25 years earlier than their peers. This could be linked to a lack of seeking treatment, and lack of available treatment due to location, costs, socio-economic factors, etc.

If mental illness is such a problem in America, what does this disease look like behind bars?

In more than 40 states, prisons house more mentally ill offenders than the area’s largest state psychiatric hospital. Between 15-20 per cent of people who are incarcerated have a serious mental illness, according to a study by the Treatment Advocacy Center.

The study also shows mentally ill prisoners remain incarnated much longer than other inmates. In Orange County Jail, for example, the average stay is 26 days for a mentally sound inmate, and 51 days for a mentally ill one. On Riker’s Island it is 42 days versus 215 days. Reasons for the longer stays vary, including an inability to understand and follow the rules, and delays due to needing an evaluation to see if the inmate is fit for trial. Wait times in state hospitals for pre-trial evaluations range from 30 days in most states, to a year in others.

Now, here is where things get very interesting. The Treatment Prospects for Persons With Severe Mental Illness in an Urban County Jail report by H. Richard Lamb, M.D., Linda E. Weinberger, Ph.D., Jeffrey S. Marsh, M.D., and Bruce H. Gross, J.D., Ph.D. notes: “A large percentage of persons with severe mental illness received their acute psychiatric inpatient treatment in the criminal justice system rather than in the mental health system.”

Despite mental illness being a very widespread problem in America, the larger share of the mentally ill are receiving treatment while incarcerated instead of in the health care system.

The report continues: “Many mental health, law enforcement, and legal professionals are concerned that the criminal justice system has become a predominant disposition for large numbers of persons with severe mental illness who are in need of treatment. Various reasons have been cited for this phenomenon. They include the lack of access to adequate treatment for persons with mental illness in the community, deinstitutionalization and the limited availability of psychiatric hospital beds, the interactions between persons with severe mental illness and law enforcement personnel, and more formal and rigid criteria for civil commitment.”

Those with a mental illness are more likely to go to jail – and more likely to get treatment inside the system than without. It’s kind of a wash and a very ironic one.

So what’s the solution? Better care and more robust understanding and treatment of the mentally ill in the community, which will help prevent the mentally ill from being incarcerated in the first place. While it’s great that treatment is available in jail, treatment outside of prison walls will make even more of an impact on the community, and would go a long way in saving and turning around lives without the stint (and cost, and stigma, and trauma) of jail.

Christopher Zoukis is the author of Federal Prison Handbook: The Definitive Guide to Surviving the Federal Bureau of Prisons, (Middle Street Publishing, 2017), and College for Convicts: The Case for Higher Education in American Prisons (McFarland & Co., 2014). He regularly contributes to New York Daily NewsPrison Legal News and Criminal Legal News. He can be found online at ChristopherZoukis.comPrisonEducation.com and PrisonerResource.com.

About Christopher Zoukis, MBA

Christopher Zoukis, MBA, is the Managing Director of the Zoukis Consulting Group, a federal prison consultancy that assists attorneys, federal criminal defendants, and federal prisoners with prison preparation, in-prison matters, and reentry. His books include Directory of Federal Prisons (Middle Street Publishing, 2020), Federal Prison Handbook (Middle Street Publishing, 2017), Prison Education Guide (PLN Publishing, 2016), and College for Convicts: The Case for Higher Education in American Prisons (McFarland & Company, 2014).