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Jails have become warehouses for people with mental illness. Nationwide, nearly half a million inmates with mental illness are in local jails, and an estimated 10-25% have a serious mental illness, such as schizophrenia. In Los Angeles County alone, at least 3,200 inmates with a diagnosed severe mental illness crowd the jails on a typical day, which constitutes about 17% of the jail population. These numbers capture only the number of inmates with a diagnosed severe mental illness: the actual number may well be higher. Former Los Angeles County Sheriff Lee Baca has called L.A.'s jail system "the nation's largest mental hospital." The war on drugs and other law enforcement policies have resulted in mass incarceration of low-level drug and other non-violent offenders, many of whom are arrested for behaviors related to a mental illness. In L.A., roughly 1,100 inmates with mental illness are behind bars on an average night for charges or convictions for nonviolent offenses. And many of the behaviors that lead to such charges are rooted in mental illness. According to the Vera Institute of Justice, drug offenses make up the largest portion of charges for this inmate population, nearly 27%. "Mental illness frequently becomes de facto criminalized when those affected by it use illegal drugs, sometimes as a form of self-medication, or engage in behaviors that draw attention and police response."
Law enforcement responses to people with mental illnesses are among the most complex and time-consuming calls for officers, threaten the safety of officers and residents alike, and have the potential for tragic outcomes. And when people with mental illnesses and co-occurring substance use disorders who could be safely treated in the community are incarcerated, the impact on their lives is staggering. The research is clear: People with mental illnesses who are referred to behavioral health treatment by law enforcement officers experience fewer subsequent contacts with the criminal justice system than those who were not referred to treatment. Law enforcement and behavioral health agency leaders across the country are increasingly partnering to develop Police-Mental Health Collaboration (PMHC) programs as part of a comprehensive approach to improve outcomes for this population, but also to help communities prioritize resources to have the greatest impact on public safety.
Millions of Americans have one or more forms of mental illness. These conditions have wide-ranging health, economic, and social consequences. For example, mental illness is a major factor in homelessness and incarceration. And serious mental illness - defined as a mental, behavioral, or emotional disorder that causes significant functional impairment that substantially interferes with or limits one or more major life activities - costs the country about $200 billion in lost earnings annually.
There is growing public recognition that the number of people diagnosed with serious mental illness in the U.S. criminal justice system has reached unprecedented levels. In 2007, there were more than 2 million jail bookings of people with serious mental illness. Although prevalence estimates of serious mental illness in jails and prisons vary widely depending on methodology and setting (jail or prison), recent research estimates that approximately 15 percent of men and nearly one-third of women in jail settings have a serious mental illness and that rates of serious mental illness in state prison populations are at least two to four times higher than community populations. This reality places a significant strain on institutional and community resources, including increased expenditures on incarceration. And it sheds light on why so many formerly incarcerated people face daunting prospects for successfully reintegrating into society. Seeking to mitigate these corrosive outcomes, local and state governments have developed a range of programs over the past two decades to serve people with serious mental illness in contact with the criminal justice system.