The Mental Health Crisis in America’s Jails

Rikers Island, America's largest psychiatric facility (photo: Paul Lowry)

In Cedar Rapids, Iowa, a family recently filed a civil rights complaint alleging their mentally ill relative is receiving inadequate treatment in a county jail. By itself this may seem like a run-of-the-mill civil rights claim, but it illustrates an important reality about the criminal justice system: Jails have become, by default, the primary mental health providers in many communities. As Time reported a few years ago, the country’s largest psychiatric facility is New York City’s Rikers Island jail. Los Angeles County Sheriff Lee Baca calls the jail system he oversees “the largest mental health provider in the country.”

In smaller communities, too, jails end up housing men and women with a variety of mental illnesses — often because they’ve caused some sort of public disturbance and there’s nowhere else for police to take them. Some of the most tragic cases in the field of prison law arise out of situations where a mentally ill person was arrested, and during his or her time in jail, deteriorated, suffered injury, or even committed suicide. Sometimes these cases involve negligence on the part of jail staff; but all demonstrate the inevitably poor results of expecting county lock-ups to do double duty as emergency mental hospitals. Studies have found that access to health care of all kinds is worst in local jails, where as many as 64% of detainees suffer from a mental illness of some kind. According to newly released numbers from the Bureau of Justice Statistics, the suicide rate in small jails (50 or fewer inmates) was 169 per 100,000 for the years 2000-07, compared to 27 per 100,000 in the largest jails. (By way of comparison the suicide rate for the U.S. overall is about 11 per 100,000, but there is a lot of variation by gender and age.)