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Monday, September 19, 2011

Nation's Jails Struggle With Mentally Ill Prisoners

By NPR staff

Three hundred and fifty thousand: That's a conservative estimate for the number of offenders with mental illness confined in America's prisons and jails.

More Americans receive mental health treatment in prisons and jails than in hospitals or treatment centers. In fact, the three largest inpatient psychiatric facilities in the country are jails: Los Angeles County Jail, Rikers Island Jail in New York City and Cook County Jail in Illinois.

"We have a criminal justice system which has a very clear purpose: You get arrested. We want justice. We try you, and justice hopefully prevails. It was never built to handle people that were very, very ill, at least with mental illness," Judge Steve Leifman tells Laura Sullivan, guest host of weekends on All Things Considered.

A failing system

When the government began closing state-run hospitals in the 1980s, people with mental illness had nowhere to turn; many ended up in jail. Leifman saw the problem first-hand decades ago in the courtroom. When individuals suffering from mental illness came before him accused of petty crimes, he didn't have many options.

"What we used to do, which I tell people was the definition of insanity [...] was they would commit an offense, the police would arrest them, they'd come to court, they'd be acting out so we would order two or three psychological evaluations at great expense, we would determine that they were incompetent to stand trial and we'd re-release them back to the community and kind of held our breath and crossed our fingers and hoped that somehow they'd get better and come back and we could try them," he says.

Instead, many disappeared and got re-arrested. Sometimes within minutes.

"They'd walk out the door, they were ill, they'd act out, because [the jail] is next to the courthouse there are several officers out there, and they'd get re-arrested," he says.

Not only was the system inefficient, it was costly as well. When Leifman asked the University of South Florida to look at who the highest users of criminal justice and mental health services in Miami-Dade County, researchers found the prime users were 97 people, individuals diagnosed primarily with schizophrenia.

"Over a five-year period, these 97 individuals were arrested almost 2,200 times and spent 27,000 days in the Miami-Dade Jail," Leifman says. "It cost the tax payers $13 million."

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