When Summit County, Ohio, Sheriff Drew Alexander was a police officer in Akron in the 1970s, he knew exactly where to take someone he arrested who was acting deranged: Falls View Hospital.
"In my day on the street, it was automatic - Falls View," Alexander said as he drove by there one recent afternoon.
But Falls View is now Falls Village, an office park. The state mental hospital closed as part a national movement toward de-institutionalization that began in the 1960s.
"The cop on the street will tell you -- we dump them at the jail," Alexander said.
Sheriff Alexander believes his county jail has become a dumping ground for the mentally ill who have no place else to go.
"It's almost like putting them in the dungeon and chaining them to the wall. The only thing different is we try to feed them," he said.
A majority of Americans told a USA Today/Gallup Poll this week that a "failure of the mental health system" was to blame for a disturbed gunman being able to carry out the shootings in Tucson two weeks ago that left six dead and 13 wounded, including Congresswoman Gabrielle Giffords. But advocates say the mentally ill in America are slipping through the cracks in other ways.
A study by the Washington-based Treatment Advocacy Center released last year found there are three times more mentally ill people in U.S. jails than in hospitals, and that 15 to 20 percent of inmates in American jails suffer from a mental illness.
When police pick up the mentally ill in the Akron area, those arrested often end up at the Summit County Jail, where there is a special pod for them.
"There are 12 cells on the upper tier, 12 on the lower," said Chief Gary James, who runs the jail. One cell has a bed with four point restraints for inmates who are out of control.
James said 17 percent of his inmates have mental issues.
"Probably about 110 prisoners out of 654 in our jail that have been in the mental health system, and most of them are taking psychotropic medication," he said.
A nurse dispenses medication twice a day on the mental health pod. Antidepressants and mood stabilizers like Depacote are common.
But there is only one part-time psychologist available for counseling, Dr. James Orlando, President of Summit Psychological Associates, who believes mentally ill inmates would usually be better off in a hospital.
"The medication is the same medication here as in the psychiatric hospital. Our counselors here are just as good," Orlando said. "But the environment here is not therapeutic."
Most mentally ill inmates are incarcerated for minor offenses such as creating a public disturbance or urinating on public property.
That was the case with Dennis Bindell, 51, who was arrested for public indecency and spent 63 days in the Summit County Jail last year.
"False arrest. I am a male stripper, and they woke me up with three hours of sleep," Bindell said during a long, rambling interview.
Diagnosed with mania, Bindell has a hard time controlling his thoughts. A court has since committed him to Northcoast Behavorial Health psychiatric hospital for competency restoration.
Another inmate in Akron, Georgeo Jacobs, 21, spent 46 days in the jail also for a public indecency misdemeanor before being released. Jacobs has schizophrenia.
"I don't really know what it means to have it," he said in an interview at the time. Five days after his release, he was rearrested on the same charge, a frequent problem among the mentally ill.
For example, in the Los Angeles County Jail, 90 percent of mentally ill inmates are repeat offenders, a study by the Treatment Advocacy Center found. In Memphis, one woman was arrested 259 times before being committed to a state mental hospital.
"The fact is these folks need treatment, these folks have to be addressed in some way. Unfortunately, they are too often addressed by incarceration." said Jim Pavle, executive director of the Treatment Advocacy Center. "When they are released, all too often if they're not properly handled and given the opportunity to get treatment, what happens? They cycle back into the system."
While Akron has more mental health facilities than most cities -- several hospitals that can accommodate a total of 350 psychiatric patients -- across the country, the number of psychiatric beds has shrunk dramatically in recent decades.
The Treatment Advocacy Center's study pegged the decline at nearly 90 percent -- from one psychiatric bed for every 300 Americans in the 1950's to one bed for every 3-thousand today:
Although most mentally ill inmates not accused of violent crimes, their average jail stay is longer, as they often have a hard time following jail rules. For example, at New York's Riker's Island Jail, where the average stay is 42 days, it is 215 days for inmates diagnosed with a mental illness.
In Akron, 22-year-old Sharton O'Neal, who has been diagnosed with bipolar disorder and schizophrenia, was arrested last year for child endangerment, a misdemeanor, but while in custody, he got info a fight with two deputies and found himself charged with felony assault.
"I don't like to hurt people, I really don't. I'd rather hurt myself than hurt other people. That's what people don't understand. They look at me as an animal. I'm not an animal," O'Neal said in an interview at the jail.
Chettori Beasley, a schizophrenic who thinks she hears the voices of demons, spent a year in a special pod for mentally ill women at the Summit County Jail.
"Big faces, big eyes," she explained in an interview. "They growling all the time."
Beasley would plead guilty to stabbing someone on the street and receive an 18-month sentence to the state prison in Marysville.
"I seen the demon, I stabbed it in the chest," she said.
At 38, her medical records show she has been afflicted since she was 12. She spent most of her days in the Akron jail under the covers in her cell.
"I know I need help," she said, fighting back tears. "Everybody keeps talking about you could get help. Where would you go to get it?"
Dr. Orlando said her case illustrated why the stress of incarceration may aggravate mental illness.
"Sort of imagine what it's got to be like being mentally ill and being in that position where you're trapped, literally trapped, in a small cell with your own demons?" he said. "Certainly, there's no way you're going to get better under those circumstances."
Sheriff Alexander, who was elected sheriff 11 years ago, is pushing his community to develop another facility to house some of his mentally ill inmates.
"My deputies," he said, "are people that signed up for this job to fight crime, not the mentally ill."
Frustrated by seeing a section of his jail become a de facto mental ward, Alexander is threatening to tell the 26 police departments in his county to stop bringing the mentally ill in, because he may turn them away until those arrested get some medical treatment first.
"We won't take these mentally ill until they're released from the hospital, they're on their meds, and they're not sick any longer, or they're controllable. Then we'll take them if there's a crime involved," Alexander said. "As a society, I think we have dropped the ball."