Corrections and Mental Health: An Unholy Marriage

In a recent editorial in the New York Times, Chicago’s Cook County Jail, which is the largest single-site jail in the country, was cited as also being the country’s largest mental health institution. With sometimes more than half of its inmates self-reporting they suffer from a diagnosable mental illness, the surreal overlap of health needs and incarceration is a problem not just in Chicago, but across the country. According to the United States’ Justice Department, more than half of all inmates in the criminal justice system have a mental health issue that is not being addressed — except through arrest and incarceration — and oftentimes arrest and incarceration only exacerbate an individual’s mental health. As states, cities and counties continue to tighten their budgetary belts, treating and preventing mental illness isn’t falling to the wayside — it’s landing in our jails.

It’s a remarkably unfortunate situation that both mental health professionals and those who choose to work in the criminal justice system are struggling to mitigate. Not only is the criminal justice system ill-equipped to meet the mental health needs of its prison population, but using corrections as a last-ditch effort to avoid spending money on community and individual mental health due to budget constraints is more expensive in the long run.

What Happened?

The economic downturn led states to cut mental health services by $4 billion between 2009 and 2011, which is the largest decrease to the nation’s mental health spending since deinstitutionalization was enacted in the 1970s. In Chicago, a combination of state, city and county budget cuts has led to the closing of half of the city’s mental health clinics. Other publicly and privately funded clinics have closed as well, leaving many marginalized individuals in already vulnerable populations — especially on the city’s south and west sides — without access to mental health care, and therefore, ripe for correctional picking.

The Costs

Incarcerating a person in the U.S. costs on average upward of $23,000 per year. In Cook County Jail, each inmate costs taxpayers about $143 per day. That daily price tag goes up to $190 for the mentally ill, putting Chicago’s incarceration math ahead of the national average: more than $52,000 per year per inmate and almost $70,000 per year for mentally ill inmates. The majority of those being held are simply awaiting trial, and some end up waiting on the taxpayer dime for as long as two years. For more than the cost of tuition, room and board at Harvard University, people — many of them mentally ill and in need of treatment — are languishing in Cook County Jail.

The high financial costs of directly jailing an individual are just the tip of the iceberg. Taxpayers foot the bill for the social services, childcare, welfare, education and more that are a result of incarceration. These needs — especially when untreated mental illness is part of the problem — often become a difficult cycle where people become trapped in a system that straps families, neighborhoods, communities and taxpayers beyond their social and economic means.

While it isn’t illegal to be mentally ill in the United States, being mentally ill — especially if untreated —can lead to behavior that warrants arrest. The current state of affairs has effectively criminalized mental illness. While federal, state, city and county budgets are certainly in need of lowering costs, cuts to mental health services’ funding have not resulted in less spending. Instead, it has merely redirected an even larger amount of money in a less efficient and less humane way to another budget line item.

What Can Be Done

One way to address the problem is to re-fund vital and necessary mental health services — both in the community at large, and in jails and prisons. It could be accurately considered preventative spending. Offering mental health services in jail and prison has also been proven to reduce recidivism rates. Some states and cities are also working to keep non-violent mentally ill offenders out of jail by placing them in treatment and rehabilitation centers. Of course, access is an increasingly difficult problem to solve. In 1955, there was one psychiatric bed for every 300 beds across the country. Today, there is one for every 3,000. If there is nowhere to be treated, what’s someone in need of mental health treatment to do?

The U.S. correctional system — due to budget cuts and other constraints — is the place where the mentally ill are kept away from society. It is not an ideal pairing for anyone except people who make money off the escalating prison population. From the excessive costs to taxpayers to the inhumanity of punishing someone for being sick, something needs to change.

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