Study Finds Hundreds of Thousands of Inmates Mentally Ill
As many as one in five of the 2.1 million Americans in jail and prison are seriously mentally ill, far outnumbering the number of mentally ill who are in mental hospitals, according to a comprehensive study released Tuesday.

The study, by Human Rights Watch, concludes that jails and prisons have become the nation's default mental health system, as more state hospitals have closed and as the country's prison system has quadrupled over the past 30 years. There are now fewer than 80,000 people in mental hospitals, and the number is continuing to fall.

The report also found that the level of illness among the mentally ill being admitted to jail and prison has been growing more severe in the past few years. And it suggests that the percentage of female inmates who are mentally ill is considerably higher than that of male inmates.

"I think elected officials have been all too willing to let the incarcerated population grow by leaps and bounds without paying much attention to who in fact is being incarcerated," said Jamie Fellner, an author of the report and director of United States programs at Human Rights Watch.

But, Ms. Fellner said, she found "enormous, unusual agreement among police, prison officials, judges, prosecutors and human rights lawyers that something has gone painfully awry with the criminal justice system" as jails and prisons have turned into de facto mental health hospitals. "This is not something that any of them wanted."

Reginald Wilkinson, director of the Ohio Department of Rehabilitation and Correction, said the "mere fact that this report exists is significant."

"Some people won't like it, and the picture it paints isn't pretty," Mr. Wilkinson said. "But getting these facts out there is progress."

Many of the statistics in the study have been published before by the Justice Department, the American Psychiatric Association or states. But the study brings them together and adds accounts of the experiences of dozens of people with mental illness who have been incarcerated.

The study found that prison compounds the problems of the mentally ill, who may have trouble following the everyday discipline of prison life, like standing in line for a meal.

"Some exhibit their illness through disruptive behavior, belligerence, aggression and violence," the report found. "Many will simply — sometimes without warning — refuse to follow straightforward routine orders."

Where statistics are available, mentally ill inmates have higher than average disciplinary rates, the study found. A study in Washington found that while mentally ill inmates constituted 18.7 of the state's prison population, they accounted for 41 percent of infractions.

This leads to a further problem — mentally ill inmates who cannot control their behavior are often, and disproportionately, placed in solitary confinement, the study found.…

http://www.nytimes.com/2003/10/22/national/22MENT.html