Inside a Mental Hospital Called Jail

CHICAGO — THE largest mental health center in America is a huge compound here in Chicago, with thousands of people suffering from manias, psychoses and other disorders, all surrounded by high fences and barbed wire.

Just one thing: It’s a jail. The only way to get treatment is to be arrested.

Psychiatric disorders are the only kind of sickness that we as a society regularly respond to not with sympathy but with handcuffs and incarceration. And as more humane and cost-effective ways of treating mental illness have been cut back, we increasingly resort to the law-enforcement toolbox: jails and prisons.

More than half of prisoners in the United States have a mental health problem, according to a 2006 Justice Department study. Among female inmates, almost three-quarters have a mental disorder.

In the jail here, some prisoners sit on their beds all day long, lost in their delusions, oblivious to their surroundings, hearing voices, sometimes talking back to them. The first person to say that this system is barbaric is their jailer.

“It’s criminalizing mental illness,” the Cook County sheriff, Thomas Dart, told me as he showed me the jail, on a day when 60 percent of the jail’s intake reported that they had been diagnosed with mental illness. Dart says the system is abhorrent and senseless, as well as an astronomically expensive way to treat mental illness — but that he has no choice but to accept schizophrenic, bipolar, depressive and psychotic prisoners delivered by local police forces.

People are not officially incarcerated because of psychiatric ailments, but that’s the unintended effect. Sheriff Dart says that although some mentally ill people commit serious crimes, the great majority are brought in for offenses that flow from mental illness.

One 47-year-old man I spoke to, George, (I’m not permitted to use last names for legal reasons) is bipolar, hears voices and abuses drugs and alcohol. He said he had been arrested five times since October for petty offenses. The current offense is criminal trespass for refusing to leave a Laundromat.

The sheriff says such examples are common and asks: “How will we be viewed, 20, 30, 50 years from now? We’ll be looked on as the ones who locked up all the mentally ill people.

“It really is one of those things so rich with irony: The same society that abhorred the idea that we lock people up in mental hospitals, now we lock people up in jails.”

A few data snapshots:

• Nationwide in America, more than three times as many mentally ill people are housed in prisons and jails as in hospitals, according to a 2010 study by the National Sheriffs’ Association and the Treatment Advocacy Center.

• Mentally ill inmates are often preyed upon while incarcerated, or disciplined because of trouble following rules. They are much more likely than other prisoners, for example, to be injured in a fight in jail, the Justice Department says.

Citizens for Criminal Justice Reform – New Hampshire