The survey, which focused on county jails, sought to understand the point of view of front line workers at county jails, including sheriffs, deputies and other staff who have to care for mentally ill inmates during their incarceration. The report describes the numerous challenges faced by county jail staff, as well as the limited training they are given, to address the needs of inmates with serious mental illnesses.
The incarceration rate for Americans with serious mental illnesses has reached a critical stage because many of these individuals are predisposed by their illnesses to committing minor crimes (such as trespassing or shoplifting), landing in jails and racking up prolonged time in jail awaiting a state psychiatric bed. Many of them receive no or inadequate mental health treatment during their incarceration, which worsens their conditions.
The survey obtained responses from 230 sheriffs' departments in 39 states that operate jail facilities or detention centers. These survey data constitute the most thorough national feedback on the perspective of county jail staff in more than two decades.
"The problems faced by county jail staff in housing, treating and safely overseeing the well-being of inmates with serious mental illnesses is pervasive and unyielding and spans the entire country. The problems are particularly acute in large jails and those with high numbers of these inmates," said Dr. Azza AbuDagga, health services researcher of Public Citizen's Health Research Group and the report's lead author. "This growing problem is not solely a criminal justice problem. At its heart is the unacceptable failure of our public mental health system, which began when the country embarked on the deinstitutionalization movement more than half a century ago, resulting in disastrous downsizing and closures of state psychiatric hospitals without providing the necessary levels of community-based treatment alternatives."
Added John Snook, executive director of the Treatment Advocacy Center, "The horror stories from family members and law enforcement alike should galvanize the country to make substantial reforms to our mental health system that would allow necessary and appropriate treatment before people become entangled in the criminal justice system."
The majority of our county jail respondents were located in the Midwest (39 percent) and South (38 percent), while the remaining jails were located in the West and Northeast (18 percent and 5 percent, respectively).
"The devolution of jails into the largest American mental health providers is morally reprehensible and fiscally irresponsible," said Cook County Sheriff Tom Dart. "This data makes abundantly clear that the most vulnerable among us belong in community-based care, not behind bars."
The survey also showed that: