We Don’t Treat Mental Illness — We Lock It Up

1. Alarming Numbers: A Hidden Epidemic

• Nearly half of the incarcerated individuals live with a mental illness. Around 44% of people in local jails, and 43% in state prisons, report a diagnosed mental disorder.

• Serious mental illness is disproportionately common behind bars. An estimated 20% of jail inmates and 15% of state prison inmates live with serious mental illness such as schizophrenia, bipolar disorder, or major depression.

• People with mental illness are overwhelmingly funneled into jails. Each year, nearly 2 million people with serious mental illness are booked into U.S. jails.

  
  

2. Why This Crisis Persists

a) Deinstitutionalization + Underfunding. Psychiatric hospitals were shut down starting in the 1960s, but promised community-based services never fully arrived. Now, prisons have become the default “treatment” setting.

b) Criminalization of Illness. Police often respond to symptoms of untreated mental illness with arrest rather than medical care—leading to jail time for behaviors like trespassing or public disturbance.

c) Failing Safety Nets. Underfunded housing programs, inaccessible outpatient treatment, and fragmented systems leave people with nowhere to turn until a crisis erupts.

d) Prisons That Worsen Health. Behind bars, people with mental illness often get worse due to solitary confinement, trauma, poor treatment access, and stigma from staff and inmates alike.

e) The Perfect Storm. With fewer psychiatric beds, more police involvement, and limited services, the U.S. has recreated a carceral version of the asylum—minus the care.

3. The Ripple Effects

• Human cost: Increased risk of suicide, violence, and trauma in custody.

• Community cost: A revolving door between homelessness, jail, and emergency rooms.

• Financial cost: Jailing a person with mental illness is 2–3 times more expensive than supportive housing or treatment.

  
  

4. What Needs to Change

Reform	Impact
Expand community services	Prevent crises, reduce incarceration risk
Crisis intervention teams (CIT)	Train officers to de-escalate and divert to treatment
Mental health courts	Offer treatment alternatives instead of jail time
Fund in-prison psychiatric care	Improve outcomes and reduce recidivism
Policy/funding shifts	Redirect money from jails to healthcare and housing

6. Final Thoughts

Until we stop punishing people for having an illness, America’s jails will remain its most prominent

—and most brutal—mental health institutions. Real change starts by moving care out of cells and into communities.

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📚 References

National Alliance on Mental Illness. (n.d.). Criminalization of people with mental illness. https://www.nami.org/advocacy/policy-priorities/stopping-harmful-practices/criminalization-of-people-with-mental-illness/

National Alliance on Mental Illness. (n.d.). Mental health treatment while incarcerated. https://www.nami.org/advocacy/policy-priorities/improving-health/mental-health-treatment-while-incarcerated/

New Yorker. (2024, April 21). Starved in jail. https://www.newyorker.com/magazine/2025/04/21/starved-in-jail

Prison Policy Initiative. (2022). Mental illness in prisons. https://www.prisonpolicy.org/reports/mentalhealth.html

Treatment Advocacy Center. (2023). Serious mental illness prevalence in jails and prisons. https://www.treatmentadvocacycenter.org/reports_publications/serious-mental-illness-prevalence-in-jails-and-prisons/

New York State Bar Association. (2020). Unjust punishment: The impact of incarceration on mental health. https://nysba.org/unjust-punishment-the-impact-of-incarceration-on-mental-health/