Send the Sick to the Hospital, Not to Prison

Issue Brief Beca-Lin Kelly

Mental illness is invading our prison systems. It is three times more likely for an
individual that has a mental illness to be placed into a prison or jail rather than a mental health
facility.i Roughly 40 percent of those who suffer from a mental illness will wind up in a
prison, jail, or correctional facility.ii The National
three times more Alliance for Mental Illness (NAMI) put out that nearly 2
million individuals who are booked into jails each year
likely for an individual suffer from a mental health problem.iii The real problem is
that has a mental illness that these numbers are not changing any time soon.
to be placed into a prison
or jail Budget Reconciliation Act basically took
over and cut most of the spending for non-
Where It All Started defense appropriations.v Meaning, he cut
In 1979 President Jimmy Carter the spending that President Carter had just
proposed to the Congress the Mental Health put in place, and put it towards military
Systems Act which stated that it seeks to needs. MotherJones stated that this act had
assure that the chronically mentally ill no decreased federal funded mental health
longer feel the cruel alternative of facilities by 30 percent.vi
unnecessary institutionalization or Since the deinstitutionalization, the
inadequate care in the community.iv In mentally ill needed to find other options.
other words, President Carter proposed to Within these options, they found the prison
fund mental health institutions. He wanted system. PBS quoted Alex Briscoe, the health
to give federal money to these programs and director for Alameda County in northern
hospitals to keep them alive. It was in 1981 California, Weve, frankly, criminalized
when President Ronald Reagan repealed this the mentally ill, and used local jails as de
act. His proposition of the 1981 Omnibus facto mental health institutions.vii The truth
of the matter is that there are three times
more individuals with mental illnesses
incarcerated in the United States than in
hospitals.viii

Weve criminalized
the mentally ill
The United States Correctional
Facilities are not equipped to help those with
mental illnesses. Huffington Post speculated
on this further by stating that many of the
mentally ill inmates get sent to solitary
confinement, for their safety and the safety
of other inmates.ix Unfortunately, solitary
confinement is considered by many
individuals as painful torture. Youre
alone for days, weeks, months with no
outside interaction whatsoever. It can
mentally and physically harm you. And in
these acts of keeping those and others safe,
due to a mental illness, the system is
increasing their likelihood of a fatality.
How Does Prison Become an Option?
NAMI has noted that most of
the crimes that get them arrested are not
violent crimes.x While they may not be
violent, they are enough for an arrest.
An arrest may cause an even larger
problem within the prison or with the
illness itself. Many whom are arrested
cannot truly defend themselves. Some
mental illnesses like schizophrenia or a
personality disorder could cause the
individual to disconnect with the world.
This meaning that they may not realize
they were the one to commit this crime.
If this is the case, I believe that they should
still be punished for their actions, but they
serious
also need
psychological help.
The arresting officer not being
trained to manage a situation where they
encounter an individual with mental illness
is also a large reason why so many are
arrested. In some of my findings, it seems to
be the most common problem between
cities, counties, and states. Police officers
are not trained in this way or they do not
recognize the signs/symptoms of someone
who is suffering from a mental illness. Its
hard to decipher, but once you have the
proper training, it may radically reduce
arrest rates.
Why Is This Important?
It is important for all of those
individuals who live with a mental illness. It
is important for their families. It is important
for those who are currently imprisoned and
suffering. It is important for you and me and
everybody else. The importance lies within
the community. Individuals with mental
illnesses come out of prison worse than
when they entered. Nobody would willingly
arrest somebody with cancer, would they?
So why would a mental illness be different?
This invisible illness is something that many
people live with. Many people that you may
encounter every day could be living with a
mental illness. I know that a prisoners
mental state is not at the forefront of your
mind. Just think about your friends, your
family, or anybody that you love. Im sure
that one of these people have encountered
the police for something and at least one of
them has a mental illness, whether treated
or untreated. Think about the best interest
for not only the individual themselves, but
for their families and for yourself as well.
What is it going to do by putting those with
mental illnesses behind bars? Worsen their
symptoms and cause more harm, Im sure.
This is a problem for everyone,
because it involves how taxpayers spend
their money. They spend a good bit of their
money to run and uphold prisons and jails.
These jails are being overpopulated and a
great portion of those individuals live with a
mental illness. Taking those with mental
illnesses out of the prison system
completely, and giving them the proper
treatment that they need, is a way for
taxpayers to properly spend their money. It
seems senseless to waste money on the
prisons when they cant help those with
mental illnesses. That is not what they were
created for and that is not what they
should be used for.
created to help police recognize a
mental health problem and get
people to treatment. It is much like
the programs that are being placed in
the Miami-Dade County.xii

What Is Out There

There are a couple programs that
have already been implemented in order
to stop this problem. Their efforts have
made a large impact on the police, the
courts, and the correctional facilities.
What is already implemented is a great
starting point for future changes, and
each program has done its share in
diminishing the issue.
Miami-Dade County, Florida
has implemented a program for
their police officers to undergo
crisis intervention training. With
this training, the county saw a
major decrease with the arrests of
mentally ill individuals. This simple
NAMI, along with Paton Blough, an
training program reduced their arrest
individual who has been struggling
rates from over 800 to just with bipolar disorder since his late
teens and was incarcerated for a
9 within the first year that it was large portion of his life due to this,
implemented. If more counties are working together to create jail
implemented this in their police diversion programs.xiii These
stations, I believe that many more programs are for those who
individuals with mental illness would committed a crime, but for certain
not be arrested.xi reasons, like mental illness, do not
NAMI partners with many local law deserve to be thrown in jail. These
enforcements around the country to programs help these individuals
create Crisis Intervention Team without hurting them by placing
(CIT) programs. These programs are them within the prison system.
The Stepping Up Initiative is a
program ran by multiple respected
I credit that program, he said. organizations. NAMI, the Council of
I could be dead or in prison if it State Governments Justice Center,
the American Psychiatric
werent for a program like that. Foundation, and the National
Paton Blough on diversion programs. Association of Counties are just a
few that have collaborated on this
 initiative. The point of it is to
challenge local community members
to come up with a response to this
problem. They are asking the
communities to find a solution
potentially save all those who could
be hurt by this. They provide local
leaders ideas and ways to reform.
They also bring communities
together to try and solve this issue.xiv
A National Campaign is being led
by the Council of State Governments
Justice Center, the American
Psychiatric Foundation, and the
National Association of Counties to
further reduce the numbers of
mentally ill within the prison
system.xv This campaign was created
to encourage local jurisdictions to
collect data on the jailed mentally ill
and adopt strategies to avoid
incarceration. These efforts have not
gone unnoticed, it has caused
multiple jurisdictions to change and
reform their policies. In addition,
many individuals are even offering
grants to those who wish to reform
their community and be a part of the
initiatives.
The Council of State Governments
Justice Center has implemented
drug and mental health courts in over
300 cities around the United States.
These types of special courts help
the individuals in question to receive
a better assessment of their health
and lead them to the proper
treatment.xvi
Assertive Community Treatment
(ACT) programs have been
implemented in the state of Illinois.
These programs include teams of
mental health specialists that
coordinate treatment and housing
and employment support for those
suffering from a mental illness.
These programs have led to a
reduction of 89% when it
comes to the arrested individual
being one with a mental illness.xvii
Are More Programs Even Possible?
With time and money constraints, it
is difficult to implement multiple programs
like these all over the country. Looking at
the past few years, it seems like a lot of
government spending has gone towards jail
administration. Due to the high risk of those
with a mental illness and the amount of
surveillance needed, many jails are receiving
much of the money that could go towards a
mental health facility in its entirety. There
are psychiatrists and medicine given to those
who need it when they are in prison, but the
overall quality of their lives would improve
more in a hospital rather than in a jail. Many
say that those with mental illnesses are
worse off when they leave than when they
come in, strictly due to the hostile
environment that prisons have.xviii
The program that was implemented
in Florida has actually reduced the amount
of money that they spend each year. Since
having this crisis intervention program in
place and in turn reducing their amount of
arrests by exceptionally high numbers, they
were able to go from 7,500 inmates to only
5,000.xix While this does not seem like
much, this 2,500-inmate difference allowed
them to close a jail altogether, meaning that
they save twelve million dollars a
year.xx
A few years ago, the MacArthur
Foundation said that they were willing
to donate 75 million dollars to
jurisdictions that were interested in reducing
the unnecessary incarceration of people,
specifically mentally ill.xxi This donation is a
lot of money that many jurisdictions need to
implement these types of programs. This
proves that grants and donations are
available to willing participants. If more
jurisdictions were willing to spend the time
to train police officers or implement other
necessary programs, there are people willing
to give money in order to make these things
happen.
Solutions?
There are many ways that we can fix
these problems and most of the programs
that are already out there seem to be doing a
good job of that. The only issue with this is
that there is not a single widespread program
to ensure that each prison, jail, court, and
police station in this country is on the same
page. Some possible solutions to consider
are those as follows:
Crisis Intervention Trainingxxii
Drug and Mental Health Courtsxxiii
Diversion Programsxxiv
Community Involvementxxv
There are many solutions set forth
and many that could possible come about.
But as a country, for our safety and the
better part of our well-being, we need more.
We need to have a country-wide
implemented policy or program that will
change things.
I propose that the best solution to be
put in action is that of crisis intervention.
Crisis Intervention within the Miami-Dade
County impacted the arrest rates greatly.xxvi
With more crisis interventions in place
worldwide, less individuals with mental
illnesses will be arrested. We need police to
be trained and know the signs/symptoms of
someone with a mental health disorder.
Though it is hard to know everything, its a
start. With this type of training, they would
know how to help these individuals when
faced with a situation that involves them,
and they would know the proper way to find
help for them. The right
treatment is what is needed.
When police know how to deal
with this, they will know how to
guide to the right treatment.
For the reforms to be put
in place, we need the U.S
Department of Justice on our
side. We need you to see that
this problem can be solved if
these types of solutions are put
in order. The money can be
donated or granted for this type
of reform. It is not something
that would take up much of the
officers time, it could be
implemented during any of their
other police training programs.
It is, however, a very vital training that I, as
well as many others, believe needs to be out
there. Its hard for police to know who has
and who does not have a mental illness. It
may not be the first thing that they think of
when they see someone acting out. It is
important to know the signs, to know how to
respond, and to know that prison is not
where these individuals need to be.
The sad reality is that many
individuals wouldnt be in this situation if
their mental health was taken care of. With
the lack of mental health facilities available,
it is hard for these people to get the help that
they need. If they dont gain that help, they
act as if everything is fine and normal. What
theyre doing may not be normal, and it may
be hurting others. The police need to be
aware of the signs to lend their helping
hand, not hurt these individuals. It may seem
hard, but it is possible. I believe that
implementing this type of training for police
all over the country would greatly reduce the
number of individuals with mental illnesses
being arrested.
Overview
Overall, I believe that implementing
this type of training country-wide could
benefit everybody from the individuals
themselves, the government, and taxpayers.
It could reduce the amount of money spent
on prisons and it could reduce the number of
inmates, which would reduce the likelihood
of overpopulation.
With the many other programs
already in place, I believe that we are on the
right track, we just need a little bit more.
With the help of the Department of Justice, I
think that the goal of greatly reducing the
number of inmates with a mental illness will
be in sight. It is possible and I think that this
country can get there. The statistic of It is
three times more likely for an
individual that has a mental
illness to be placed into a prison
or jail rather than a mental health
facilityxxvii can change.
It is important for us all to recognize
and realize the signs and symptoms of
somebody with a mental illness. Having that
knowledge could help every single one of us
in the long run. It could lead us to safety as
well as giving the individual with the illness
the best possible care that they need.

i
Aufderheide, Dean. Mental Illness in Americas Jails and Prison: Toward a Public
Safety/Public Health Model. Health Affairs. Project HOPE: The People-To-People Health
Foundation, Inc, 01 Apr. 2014, http://healthaffairs.org/blog/2014/04/01/mental-illness-in-
americas-jails-and-prisons-toward-a-public-safetypublic-health-model/ Accessed 07 Apr. 2017
ii
Aufderheide, Dean. Mental Illness in Americas Jails and Prison: Toward a Public
Safety/Public Health Model. Health Affairs. Project HOPE: The People-To-People Health
Foundation, Inc, 01 Apr. 2014, http://healthaffairs.org/blog/2014/04/01/mental-illness-in-
americas-jails-and-prisons-toward-a-public-safetypublic-health-model/ Accessed 07 Apr. 2017
iii
Jailing People with Mental Illness. NAMI: National Alliance on Mental Illness.
http://www.nami.org/Learn-More/Public-Policy/Jailing-People-with-Mental-Illness. Accessed 07
Apr. 2017
iv
Jimmy Carter. Mental Health Systems Legislation Message to the Congress Transmitting the
Proposed Legislation. The American Presidency Project. Gerhard Peters and John T. Woodley.
15 May 1979. http://www.presidency.ucsb.edu/ws/?pid=32339. Accessed 07 Apr. 2017
v
1981 Omnibus Budget Reconciliation Act. Slaying the Dragon of Debt Regional Oral History
Office. http://vm136.lib.berkeley.edu/BANC/ROHO/projects/debt/1981reconciliationact.html.
Accessed 07 Apr. 2017
vi
Deanna Pan. TIMELINE: Deinstitutionalization and Its Consequences. Mother Jones and the
Foundation for National Progress. 29 Apr. 2013.
http://www.motherjones.com/politics/2013/04/timeline-mental-health-america. Accessed 07.
Apr. 2017
vii
Sarah Varney. By the Numbers: Mental Illness Behind Bars. PBS Newshour. Newshour
Productions LLC. 15 May 2014. http://www.pbs.org/newshour/updates/numbers-mental-illness-
behind-bars/. Accessed 07 Apr. 2017
viii
Sarah Varney. By the Numbers: Mental Illness Behind Bars. PBS Newshour. Newshour
Productions LLC. 15 May 2014. http://www.pbs.org/newshour/updates/numbers-mental-illness-
behind-bars/. Accessed 07 Apr. 2017
ix
Dustin DeMoss. The Nightmare of Prison for Individuals with Mental Illness. The Huffington
Post. TheHuffingtonPost.com, Inc. 25 Mar. 2015. http://www.huffingtonpost.com/dustin-
demoss/prison-mental-illness_b_6867988.html. Accessed 07 Apr. 2017
x
Jailing People with Mental Illness. NAMI: National Alliance on Mental Illness.
http://www.nami.org/Learn-More/Public-Policy/Jailing-People-with-Mental-Illness. Accessed 07
Apr. 2017
xi
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xii
Jailing People with Mental Illness. NAMI: National Alliance on Mental Illness.
http://www.nami.org/Learn-More/Public-Policy/Jailing-People-with-Mental-Illness. Accessed 07
Apr. 2017
xiii
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xiv
Jailing People with Mental Illness. NAMI: National Alliance on Mental Illness.
http://www.nami.org/Learn-More/Public-Policy/Jailing-People-with-Mental-Illness. Accessed 07
Apr. 2017

xv
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xvi
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xvii
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xviii
Dustin DeMoss. The Nightmare of Prison for Individuals with Mental Illness. The
Huffington Post. TheHuffingtonPost.com, Inc. 25 Mar. 2015.
http://www.huffingtonpost.com/dustin-demoss/prison-mental-illness_b_6867988.html. Accessed
07 Apr. 2017
xix
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xx
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xxi
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xxii
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xxiii
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xxiv
Jailing People with Mental Illness. NAMI: National Alliance on Mental Illness.
http://www.nami.org/Learn-More/Public-Policy/Jailing-People-with-Mental-Illness. Accessed 07
Apr. 2017
xxv
Jailing People with Mental Illness. NAMI: National Alliance on Mental Illness.
http://www.nami.org/Learn-More/Public-Policy/Jailing-People-with-Mental-Illness. Accessed 07
Apr. 2017
xxvi
Michael Ollove. New Efforts to Keep the Mentally Ill out of Jail. The Pew Charitable Trusts.
19 May 2015. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/19/new-
efforts-to-keep-the-mentally-ill-out-of-jail. Accessed 07 Apr. 2017
xxvii
Aufderheide, Dean. Mental Illness in Americas Jails and Prison: Toward a Public
Safety/Public Health Model. Health Affairs. Project HOPE: The People-To-People Health
Foundation, Inc, 01 Apr. 2014, http://healthaffairs.org/blog/2014/04/01/mental-illness-in-
americas-jails-and-prisons-toward-a-public-safetypublic-health-model/ Accessed 07 Apr. 2017