Mental Illness Is Rampant In American Jails And Prisons


By Christopher Zoukis

There is an epidemic of mental illness in America's jails and prisons. On the low end, research indicates that at least 25 percent of all prisoners have a serious mental illness. Anecdotal evidence suggests that the numbers are much higher.

Prisons are designed and thought of as places where law-breakers are held, away from the rest of society. As such, one may wonder why prisons have such high rates of mental illness. Are people who commit crimes more predisposed to mental illness? Or are the mentally ill more likely to commit crimes?

And perhaps more importantly, is a prison the right place for a person with mental illness?

These questions are difficult to answer. But there are some things that we do know about the correlation between mental illness and incarceration. For instance, we know that dedicated, long-term institutional care for the mentally ill was virtually done away with decades ago. In fact, between 1960 and 1980, 80 percent of all U.S. long-term psychiatric hospital beds were eliminated.

We also know that mental illness didn't suddenly disappear just because long-term psychiatric care went the way of the dinosaur. No, the mentally ill still exist, and in fact often end up institutionalized. But that institution is no longer a hospital, it's a prison.

The policy-driven transfer of the seriously mentally ill from mental health care facilities to secure punishment facilities is so pervasive as to have earned its own descriptive term. James Gilligan dubbed this travesty "trans-institutionalization."

Prisons are not equipped to manage the seriously mentally ill. Health care of any kind in most American jails and prisons is substandard. And mental health care, if available at all, is often limited to one or a few very overworked mental health professionals who are unable to focus beyond whether a patient (or prisoner, as it were) is going to commit suicide in the near future.

Incapable of managing mentally ill inmates, prison administrators resort to barbaric methods of controlling these vulnerable individuals. According to E. Fuller Torrey, isolation has become the primary tool for managing the mentally ill population in prison. The usage of solitary confinement to manage the mentally ill then perversely reinforces the need for isolation and supermax prisons. Given the large number of mentally ill prisoners, it is no surprise that using isolation to manage the population creates a demand for more isolation units.

Confining the seriously mentally ill in isolation instead of treating them is a national disgrace. Isolation has long been considered a form of torture by international authorities. Even here in America, isolation was abandoned in the 1800's as barbaric. In 1842, Charles Dickens went so far as to say that extended isolation is "worse than any torment of the body."

But isolation is still regularly used in American jails and prisons. According to University of California-Irvine, School of Law professor Keramet Reiter in her book 23/7: Pelican Bay Prison and the Rise of Long-Term Solitary Confinement, more than 400,000 prisoners experience isolation each year. Thirty-three to 50 percent of those prisoners in isolation suffer from a serious mental illness. And the data suggests that at least 50 percent of all prisoner suicides take place in isolation, despite holding a fraction of the incarcerated population.

Policy makers and administrative officials must step up and address the scourge of mental illness in jails and prisons. Long-term incarceration is not the answer, and torturous management solutions such as isolation only serve to exacerbate the problem. The economic cost of incarcerating the seriously mentally ill is astronomical. But the human cost is incalculable.

Christopher Zoukis is the author of College for Convicts: The Case for Higher Education in American Prisons (McFarland & Co., 2014) and Prison Education Guide (Prison Legal News Publishing, 2016). He can be found online at, and