Jails and prisons not solutions for mentally ill people

Finding the most appropriate setting to treat our mentally ill population is not a new challenge.

From the asylum-building movement of the 1800s to the failed attempt at deinstitutionalization in the 1950s, society has seen changing perspectives on how to best serve some of our most vulnerable citizens.

Jails and prisons are clearly not the best solutions, though that is exactly where many of these people have ended up.

How did this happen?

Though the idea of deinstitutionalization was noble, it never truly materialized.

The number of mentally ill patients in public psychiatric hospitals peaked at 560,000 in 1955.

Opinions had begun to shift about how to best care for the mentally ill, though, and deinstitutionalization sought to care for these patients in the least restrictive setting possible.

Attempts were made to provide funding for private, community based facilities, but the Vietnam War and economic downturn made them unsuccessful.

Once Medicaid passed in 1965, states were financially incentivized to move patients out of public facilities. Unfortunately, most had nowhere to go.

In 1968, the number of mentally ill people in the criminal justice system doubled.

The problem is more prevalent today than ever.

Over the last several years we have seen a steady decline in funding and options for some of our most vulnerable people.

In 2009, states cut $4.35 billion in mental health spending, the largest reduction since deinstitutionalization.

The reality is the criminal justice system is now the mental health institution.

There are five times more severely mentally ill people in jails and prisons than in hospitals today.

Jails in most cities like here in Nashville are the largest mental health facility in the area. Many inmates with mental health issues are charged with relatively minor infractions.

Many are in jail after committing crimes that could have been prevented had they had access to adequate treatment while on the street.

This only masks the real issue for society. It is easy for the general public to see the mentally ill person “off the streets” and believe the situation is being addressed, but our correctional facilities are not the best location to address this serious and complicated matter.

The cost of treating the mentally ill is dramatically higher in a correctional institution than it would be in a mental health facility.

The taxpayers are paying for a person to be arrested, booked, secured and housed as a security threat inside of a facility that is not designed with mental health in mind.

It costs over $100 per day just to house a person in jail, not including the cost of his/her mental health treatment.

The criminal justice system is enabling society by allowing this to continue.

It is time that we bring this issue out from behind the bars of jails and prisons and deal with it as a mental health crisis, not as a hidden criminal justice component.

Incarceration of people who are charged and convicted of crimes has become increasingly more difficult.

Inmates are medically sicker, more addicted and the potential for violence has increased.

This is not the environment to best treat our mentally ill.

The solution is to address the needs of the mental health community outside of the criminal justice arena.

Individuals who suffer mental illness need to be treated and addressed in a mental health model of care in facilities designed specifically for that purpose.

Until we all realize that the problem exists, we will continue to underserve those who need our help the most.

Daron Hall is sheriff of Davidson County.