The Great Recession, in conjunction with states’ propensities to cut Medicaid benefits in the face of the rising cost of health care services, led to some of the biggest cuts to state mental health care services in U.S. history between 2009 and 2011. Of course, the population of Americans with mental health problems didn’t just disappear in that time. Facing a shortage of adequate medical resources, many of them are now ending up in the only place that will take them: America’s jails.
According to CBS News, a shortage of mental health facilities and adequate treatment resources — particularly in large states like Illinois and California — has produced an untenable status quo in which the prison system serves as an alternate pipeline to funnel through sick Americans, who have nowhere else to go:
Police logs in twelve cities revealed that mental health crisis calls have increased an average of 37.5 percent over the last four years.
Los Angeles County Sheriff Lee Baca says more mentally-ill people end up in jail when they’re not getting the medications they need. [...]
”I believe it is, I think that medication is the stabilizer for most mentally-ill people,” said Baca. ”The money for that dried up with our California economy going south and when they go off their meds, they go back to the behavior that leads to a law enforcement solution.”
Kathryn Wooten of Los Angeles called 911 for help when her 23-year-old son Terrence suffered a mental breakdown in October 2011.
”The police came and I thought they were going to take him to the hospital but he wind up in county jail,” said Wooten.
Police say with few mental health beds available at state facilities, they have no choice but to leave the fate of people like Terrence Wooten to the criminal justice system.
”They have a mental ward in county but he wasn’t really getting the counseling and the therapy that he needed,” said Wooten.
To state the obvious, prisons are not treatment facilities, and guards are not professionally trained medical personnel — a fact that law enforcement authorities understand all too well. ”This is something that happens all the time here and the heart of it is, we’re not a mental health facility. These people should not be here,” said Cook County Sheriff Tom Dart. “These people by and large are not criminals. They’re people with mental illness but when they act out they end up in the jails because it’s the only place that’ll take them.”
California could serve as the poster child for what happens when slashes to mental health care funding — particularly through cuts to public insurance programs such as Medicaid — meets a sprawling industrial prison complex bursting at the seams. Patients become prisoners, reminiscent of a time when ignorance regarding mental illnesses perpetuated a system of asylums and involuntary commitment that public health advocates spent decades fighting, as it treated mentally ill Americans as dangerous vagrants to be locked up rather than patients to be cured. In fact, the mentally ill are not predisposed to violence, and are more likely to be the victims of violent acts than anything else.
But now, poor access to facilities in the face of states’ budget cuts have left the mentally ill — particularly the low-income mentally ill, who have access to even fewer resources than their wealthier counterparts — with few places to go. It’s a particularly devastating dynamic considering that states’ spending on prisons is the fastest growing budgetary item behind Medicaid. However, while Medicaid costs have risen due to the general rise of health care costs, states’ decisions to invest more in prisons in order to incarcerate — rather then rehabilitate — increasing numbers of Americans is a conscious and deliberate choice.