Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails

The Problem

The number of people with mental illness in U.S. jails has reached crisis levels. In counties across the nation, jails now have more people with mental illnesses than in their psychiatric hospitals.

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The People

The situation is hurting real people. But communities, judges, police officers, mental health professionals and others have already started stepping up to combat the problem.

What You Can Do

Stepping Up asks communities to come together to develop an action plan that can be used to achieve measurable impact in local criminal justice systems of all sizes across the country. Learn More

 

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Shameful Numbers: There are 10 Persons with Serious Mental Illness in Jail for Every One In a Hospital

Prison Industrial Complex #occupysanquentin

Prison Industrial Complex #occupysanquentin (Photo credit: @bastique)

From Psychiatric News Alert: Ten times more individuals with serious mental illness are residing in state prisons and county jails today than in the nation’s state psychiatric hospitals, according to a new study released today by the Treatment Advocacy Center (TAC). “The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey” found that in 44 states the largest institution housing people with severe psychiatric disease is a prison or jail. Nationwide, the study reports that there are an estimated 356,000 mentally ill inmates compared with 35,000 public-hospital patients.

The survey provides state-by-state illustrations of how protocols for treating mentally ill inmates who are deteriorating or acutely ill create obstacles that leave inmates without treatment for extended periods or indefinitely, especially in county jails. The report also contains several recommendations, including use of court-ordered outpatient treatment—deemed by the Department of Justice to be an evidence-based practice for reducing crime and violence—to help at-risk individuals live more safely and successfully in the community. 

“The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” said psychiatrist E. Fuller Torrey, M.D., founder of TAC and lead author of the study. “This is especially true for individuals who – because of their mental illness – are not aware they are sick and therefore refuse medication.” 

In comments to Psychiatric News, Torrey said:

Prison doors

Prison doors (Photo credit: rytc)

“It is remarkable that we have let this situation deteriorate to this point. Jails and prisons are not built to be mental hospitals, and corrections personnel are neither hired nor trained to be mental health workers. We have returned to the situation that existed in the 1830s when Dorothea Dix began the reform movement to get mentally ill persons removed from jails and prisons and put into hospitals. The fact that we are where we were almost 200 years ago should give us all pause.” 

To read more on this subject, including strategies to reverse the trend, see the Psychiatric News article, “Judges, Psychiatrists Confer on Handling Mental Illness in Justice System.” Also see “Prevalence of Mental Illnesses in U.S. State Prisons: A Systematic Review” in Psychiatric Services in Advance.

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CBS 60 Minute Show – “Untreated Mental Illness an Imminent Danger”

Please CLICK HERE to visit CBS’s site to view the segment on mental illness that appeared last night on the 60 minute show. Correspondent Steve Kroft interviewed two experts on the subject—Jeffrey Lieberman, M.D., president of APA and chair of psychiatry at Columbia University, and E. Fuller Torrey, M.D., executive director of the Stanley Medical Research Institute. Dr. Torrey Fuller, a nationally known psychiatrist, frequent contributor on national television shows, NAMI award winner, and one of the founders of the Treatment Advocacy Center provides comment on mental illness and recent tragic events involving persons with a mental illness. The segment is also available through YouTube, embedded below:

Several major points emerged from the segment, including:

  • That schizophrenia is a brain illness. Lieberman documented this knowledge with brain images showing changes in the brains of people with schizophrenia. He also explained that the illness, which “usually emerges in late adolescence and early adulthood, affecting perception and judgment,” may cause a person to hear voices, among other symptoms.
  • There are effective treatments for the hallucinations that individuals with schizophrenia experience, but not all of those individuals have access to such treatments.
  • The vast majority of individuals with schizophrenia do not commit violence. They are the ones who suffer the most from their illness. And the tragic fact is that many people with serious mental illness are not receiving treatment in the community and end up in jails and prisons.

Dr. Fuller is also the author of Surviving Schizophrenia: A Manual for Families, Consumers and Providers (Harper Perennial). Since its first publication in 1983, Surviving Schizophrenia has become the standard reference book on the disease and has helped thousands of patients, their families and mental health professionals. In clear language, this much–praised and important book describes the nature, causes, symptoms, treatment and course of schizophrenia and also explores living with it from both the patient and the family’s point of view.

The present edition is the Fifth Edition. It is completely updated and includes the latest research findings on what causes schizophrenia, information about the newest drugs for treatment, and answers to the questions most often asked by families, consumers and providers.