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Who Cares? People with Mental Illness Overwhelm US Justice System


Americans just don’t seem to care that we’ve moved treatment of serious mental illness from inpatient hospitals to jails. We’re the only industrialized nation to do this on the kind of massive scale that we have. Instead of getting people with serious mental illness into treatment, we’re perfectly content as a society to spend more imprisoning them, and restricting their access to needed treatment.

Perhaps because it’s a state issue, people don’t realize this change has happened slowly but systematically over the past two decades. It’s seemingly accelerated in recent years, as state funding for public mental health treatment has dried up.

But there’s ultimately a price to pay for this not caring. And it’s a much higher cost than many of us are aware of.

Kevin Johnson, writing over at USA Today, has the story, in the form of an in-depth series about mental illness and the criminal justice system.

From police departments and prisons to courthouses and jails, the care of those who are mentally ill weighs heaviest on law enforcement authorities, many of whom readily acknowledge that they lack both resources and expertise to deal with the crushing responsibility.

In a series of stories in the coming months, USA TODAY will explore the human and financial costs the country pays for not caring more about the nearly 10 million Americans with serious mental illness.

Every major prison system in the US is currently overwhelmed by the amount of people who have a mental illness who take up space in their prisons. Few receive any kind of regular, standard-of-care treatment. The numbers are, in a word, overwhelming:

In one of the largest detention systems in the nation, Chicago’s Cook County Jail, the problem is so persistent that Sheriff Tom Dart keeps a running tally of the incoming mentally ill cases on his Twitter account.

On average, at least 30% of the 12,000 inmates suffer from a “serious” mental illness, though the sheriff said the estimate is “a horrifically conservative number.” One of those inmates, Dart said, was a “chronic self-mutilator” who has been arrested more than 100 times, ringing up more than $1 million in repeated arrest- and detention-related costs.

The problem? Too few inpatient psychiatric beds. In an effort to close all those public state mental hospitals in the 1980s, our country has gone way too far in the other direction. This means treatment simply isn’t available to most poor Americans who are in crisis:

In cases when officers encounter people in need of emergency care — those who represent a danger to themselves and/or others — police are required to transport them to the nearest available treatment facility.

Oklahoma Department of Mental Health Commissioner Terri White said that because the need is so great and there are so few emergency beds available in the state’s second-largest city, police regularly crisscross the state, sometimes in the middle of the night, to find appropriate care for those in crisis.

Oklahoma police spent over a half million dollars last year in transportation costs alone, just to get people to the nearest treatment facility with an open bed.

Worse, although police are the first responders to anyone in a psychiatric crisis, few of them receive specialized mental health training. It’s no wonder that if you’re crazy in America, you’re more likely to be shot or taken into police custody than in any other place in the world.

“It is simply overwhelming,” said Tulsa police Maj. Tracie Lewis, who manages the department’s transport system. “Police should not be involved in this process at all, but nobody else can or wants to do it.”

Sadly, I agree. People with mental illness should be treated in a humane, least-restraining environment. We’re collectively spending hundreds of millions of dollars each year foisting such people in need on our law enforcement system, rather than within the healthcare system — where they belong. Not only do they belong there, they would receive treatment and care — at a fraction of the cost of what it costs to incarcerate someone.

Today, America is sadly failing its citizens in providing the minimum standard of care all of its citizens deserve.


Read the full series: Mental illness cases swamp criminal justice system

Who Cares? People with Mental Illness Overwhelm US Justice System

John M. Grohol, Psy.D.

Dr. John Grohol is the founder of Psych Central. He is a psychologist, author, researcher, and expert in mental health online, and has been writing about online behavior, mental health and psychology issues since 1995. Dr. Grohol has a Master's degree and doctorate in clinical psychology from Nova Southeastern University. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member of the Society for Participatory Medicine. You can learn more about Dr. John Grohol here.

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APA Reference
Grohol, J. (2018). Who Cares? People with Mental Illness Overwhelm US Justice System. Psych Central. Retrieved on October 27, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 26 Jul 2014)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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