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Severely Mentally Ill Persons More Likely to be in Jails than Hospitals


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Treatment Advocacy Center

Treatment Advocacy Center Study Reveals Severely Mentally Ill Persons More Likely to be in Jails than Hospitals

As the nation observes the 49th annual Mental Health Month, the Treatment Advocacy Center is bringing awareness to America's shameful 50-year trend of exiling severely mentally ill persons out of hospitals and into the oblivion of the criminal justice system.

"Over the past five decades the needs of Americans suffering from severe mental illnesses have been forgotten," said James Pavle, executive director. "With little exception, incarceration has replaced hospitalization for thousands of individuals with severe mental illness in every single state."

"More Mentally Ill Persons Are in Jails and Prisons than Hospitals: A Survey of the States," a new report released today by the Treatment Advocacy Center and the National Sheriffs' Association, reveals that Americans with severe mental illnesses are three times more likely to be in jail or prison than in a psychiatric hospital.

"If societies are judged by how they treat their most disabled members, our society will be judged harshly indeed," said study author E. Fuller Torrey, M.D., a research psychiatrist and Treatment Advocacy Center founder. "The present situation, whereby individuals with serious mental illnesses are being put into jails and prisons rather than into hospitals, is a disgrace to American medicine and to common decency and fairness."

The odds of a seriously mentally ill individual being imprisoned rather than hospitalized are 3.2 to 1, state data shows. The report compares statistics from the U.S. Department of Health and Human Services and the Bureau of Justice Statistics collected during 2004 and 2005, respectively.

Ratios of imprisonment versus hospitalization vary from state to state, as the report indicates. On the low end, North Dakota has an equal number of mentally ill individuals in hospitals as in jails or prisons. By contrast, Arizona and Nevada have 10 times as many mentally ill individuals in prisons and jails than in hospitals.

Recent studies suggest that at least 16 percent of inmates in jails and prisons have a serious mental illness.  According to author and National Sheriffs' Association Executive Director Aaron Kennard, "Jails and prisons are not designed for treating patients, and law enforcement officials are not trained to be mental health professionals."

Once a part of America's dark past, criminalizing severely mentally ill people has returned.  Five decades of closing psychiatric hospitals has forced large numbers of deinstitutionalized patients into the criminal justice system. "America's jails and prisons have once again become our mental hospitals," Pavle said.

In 1955, there was one psychiatric bed for every 300 Americans.  By 2005 there was just one psychiatric bed for every 3,000 Americans.  Compared to statistics from 1850, when there was only one public psychiatric bed available for every 5,000 Americans, America is heading in the wrong direction when it comes to caring for the severely mentally ill.

"Jails and prisons are not places to treat someone with a brain disease - people with mental illnesses who are incarcerated have high rates of victimization, assault, and suicide," said report author and Seminole County (FL) Sheriff Donald F. Eslinger. "Not to mention that the cost of this widespread incarceration of people with severe mental illnesses is enormous."

Among the study's recommended solutions are for states to adopt effective assisted outpatient treatment laws to keep individuals with untreated brain disorders out of the criminal justice system and in treatment.  Assisted outpatient treatment is a less restrictive alternative to inpatient hospitalization because it allows courts to order certain individuals with brain disorders to comply with treatment while living in the community. Studies show assisted outpatient treatment drastically reduces hospitalization, homelessness, arrest, and incarceration among people with severe psychiatric disorders, while increasing adherence to treatment and overall quality of life.

Data on prisoners for "More Mentally Ill Persons Are in Jails and Prisons than Hospitals: A Survey of the States," were obtained from the Bureau of Justice Statistics' report, "Prison and Jail Inmates at Midyear 2005."  Data on the number of inpatients in public psychiatric hospitals, private psychiatric hospitals, and the psychiatric units of general hospitals were obtained from the 2004 Inventory of Mental Health Organizations, carried out by the Substance Abuse and Mental Health Services Administration under the U.S. Department of Health and Human Services.

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The Treatment Advocacy Center is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illnesses. The Treatment Advocacy Center promotes laws, policies, and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.

The Treatment Advocacy Center takes no money from pharmaceutical companies. The American Psychiatric Association awarded the Treatment Advocacy Center its 2006 presidential commendation for "sustained extraordinary advocacy on behalf of the most vulnerable mentally ill patients who lack the insight to seek and continue effective care and benefit from assisted outpatient treatment

Treatment Advocacy Center

200 N. Glebe Road, Suite 730, Arlington, VA 22203
703 294 6001/6002 (phone) | 703 294 6010 (fax) |


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