In New York City, six inmates killed themselves in local jails in fiscal 2003. Six killed themselves the year before.
The interaction of the U.S. law enforcement system with the mentally ill has grown dramatically, with increasingly tragic results — not to mention considerable expense to state and local governments.
An estimated 16 percent of U.S. prison and jail inmates are mentally ill, compared to only 5 percent of the general population. A study by the U.S. Justice Department found nearly half the mentally ill inmates were imprisoned for a nonviolent crime.
The mentally ill are more expensive to incarcerate, stay behind bars longer and return more frequently than sane inmates.
The state of Pennsylvania spends $140 a day on inmates with serious mental illness, compared to $80 a day on average inmates.
Florida's Miami-Dade County spends $4 million a year on overtime to manage mentally ill prisoners because "they have to be checked every 15 minutes," Miami-Dade Circuit Judge Steven Leifman said in an interview Monday.
"Often we have to put a guard right outside their door, not because they are dangerous but because they are suicidal," said Michael Lawlor, a Democratic representative from Connecticut.
These advocates want the U.S. Congress to step in, and the idea has drawn unusually bipartisan support.
Lawmakers from both parties are supporting a bill to provide $100 million each in 2004 and 2005 to states and localities that devise programs in which criminal justice agencies collaborate with a mental health agency.
"Our justice resources need to be dedicated to violent criminals and homeland security, not to low-level offenders with mental illness who could be better served in treatment, at significant savings to taxpayers," said Robert Thompson, a Republican senator from Pennsylvania.
Leifman said the problem is that "we've criminalized mental illness in this country."
In 1955, there were 560,000 people in U.S. state psychiatric hospitals; there are fewer than 40,000 today, he said. But there are now 300,000-400,000 people behind bars with severe mental illness.
"We took the population from state hospitals, which were horrible, and put them in jails, which are even worse," he said.
In addition, state budget cuts shrunk programs providing assistance to the mentally ill, Lawlor said. "Ironically, we've put the mentally ill in a prison system where you have to pay a lot more than in the older programs that were cut," he said.
The increase in the number of mentally ill people behind bars mirrors a rise in the general prison population. According to the federal Bureau of Justice Statistics, at the end of 2001 some 2,166,260 people were incarcerated in the United States. Most of them were in state prisons (1.2 million) or local jails (665,000).
A 2003 report by Human Rights Watch found that, "across the nation, many prison mental health services are woefully deficient, crippled by understaffing, insufficient facilities, and limited programs."
"All too often seriously ill prisoners receive little or no meaningful treatment," HRW said. "They are neglected, accused of malingering, treated as disciplinary problems."