In the United States, our system for treating mental illness is so broken that sometimes people with mental health issues will break the law so that they can get treated in jail. People used to think putting the mentally ill in asylums was unacceptable, but now we lock them up. Mental illness is the only physical ailment we treat as criminally punishable.
One person who has a lot to say about the mentally ill in jail is Los Angeles County Assistant Sheriff Terri McDonald. She oversees the Los Angeles County Jail System, the largest in the United States. It is also the largest mental health facility in the nation, with one in five inmates suffering from mental illness. McDonald stated, "The mentally ill often come into the jails for crimes of poverty, homelessness, and addiction." Community-based settings would be better for them, but because those programs have disappeared, jail has become the only place for the mentally ill to go. "This is one of the most shameful parts of criminal justice across America," said McDonald. The assistant sheriff further explained that when mentally ill citizens are stealing, yelling, and acting out, police officers do not have any place to put them, and, therefore, they bring them to the jails. The jails are not designed and staffed to treat the mentally ill, so they are strained. The mentally ill are stabilized in jail, but they have often only committed small crimes, so they are released after a short while into the community where wraparound (individualized community-based) services are lacking for them. Also, mixing the mentally ill with hardened criminals can be very harmful. What McDonald would like to see is a great deal of attention put into community treatment for mentally ill individuals with criminal records. This can be difficult because oftentimes community members do not want these types of individuals in their communities. There needs to be better education in the community and better reentry services upon release.
We could downsize jails and increase treatment in the community. The problem with this is that communities oftentimes have a difficult time accepting facilities where the mentally ill live. If they feel this way, it is difficult to teach them compassion. McDonald shared that if you were in a room with 100 people and you asked them if they know someone who is mentally ill or has substance abuse problems, most of them would say they do. Most citizens realize we do not need to put these individuals in jail or prison. People just say "not in my neighborhood."
To change people's minds, McDonald shared that it is important to explain to them that most people with mental illness are not inherently violent and dangerous. People are scared of the mentally ill, so they need to be educated about them. The National Alliance on Mental Illness is a great resource for this. Some with mental illness may alarm others because they might be disheveled or yelling. They are American citizens who are suffering in our streets. They have a right to live that way because the laws about being a danger to self and others protect them from being placed in a setting against their will.
There is quite a bit of evidence that suggests that healthy homes reduce instances of mental illness. A significant number of inmates who are mentally ill have a cooccurring substance abuse issue. The drugs either led to the mental illness or the mentally ill are using drugs to self-medicate. Synthetic drugs and methamphetamines are changing the makeup of people's brains, and they are bringing more people with mental illness into jail. As Los Angeles County District Attorney Jackie Lacey explained, officials got in this field to protect people from violent people, not to punish the sick. She has taken a massive leadership role on the Mental Health Task Force. Additionally, the L.A. County Board of Supervisors has taken a leadership role through the Office of Diversion, and it has invested some additional resources in the jail for diversion and reentry planning. McDonald says there is a lot going on, but it will take "a Herculean effort to turn the tide on what's been happening." It is essential to have the communities' understanding and support. Friends and family members of the mentally ill need to help them get treatment, and they can be part of their treatment plan. McDonald states, "L.A. County is a county of scale because everything is so big. If L.A. can do things better, then the nation can follow. L.A. can do it because it has some of the smartest, creative, committed leaders who do not use bureaucracy as an excuse for not getting things done."