Cook County Sheriff Tom Dart isn’t mincing words when it comes to his frustrations with Chicago’s — and America’s — broken and underfunded mental health care system.
“Every single day, I am faced with the mental health crisis in this county,” said Dart during testimony before the House Energy and Commerce Committee’s Subcommittee on Oversight and Investigation on Wednesday. “The unfortunate and undeniable conclusion is that because of dramatic and sustained cuts in mental health funding, we have criminalized mental illness in this country, and county jails and state prison facilities are where the majority of mental health care and treatment is administered.”
Illinois made the fourth-largest cuts to mental health services of any state in the country between 2009 and 2012, including the shuttering of two state-run psychiatric facilities. Combined with a lack of affordable housing units, those cuts have propagated a system wherein Americans with mental illnesses wind up in jails rather than clinics.
Dart said that the Cook County Jail houses approximately about 3,500 inmates with serious mental illnesses on any given day (about a third of its total inmate population), making it the largest de facto mental health provider in the nation.
To be clear, these inmates shouldn’t be in a jail setting. The most common illnesses that Dart encounters are mood and psychotic disorders, including severe depression, bipolar disorder, and schizophrenia. And many wind up in jail because they’re simply trying to grapple with a mental health safety net riddled with holes. “While some mentally ill individuals are charged with violent offenses, the majority are charged with crimes seemingly committed to survive, including retail theft, trespassing, prostitution and drug possession,” said Dart.
Keeping the inmates in jail is a pricey endeavor, as caring for a prisoner with mental illness is “easily” two or three times as expensive as the $143 per day that it costs to keep an average person in jail, according to Dart. The care isn’t particularly effective, either. Dart told ThinkProgress that the doctors who treat inmates with mental illnesses are more focused on simple triage rather than holistic care. “Their mission is to get [the inmates] stabilized, make sure they’re on their meds, and when they’re on their way out, [the doctors] give them a plastic baggie with two weeks’ worth of meds,” he said.
Dart also recounted several tragic stories about sick prisoners who were released into a society where they had little recourse for medical care or even simple housing during Wednesday’s hearing. “We’ve had inmates get released and try to break back into the jail so they can keep getting treatment,” he told the House committee. He then urged the committee to consider legislation that would make it easier to keep track of severely mentally ill patients’ cases.
One bill that might go a long way toward achieving that goal has actually already been proposed by the head of the Oversight and Investigation subcommittee, Rep. Tim Murphy (R-PA). Murphy’s Behavioral Health IT Act, introduced right around the one-year anniversary of the massacre at Sandy Hook Elementary School, would increase community mental health treatment funding, appropriate more money for emergency psychiatric care facilities, set up screening programs in schools, and create electronic infrastructure to keep track of available mental health beds — an infrastructure that only about half of all states currently have — and the sickest patients’ records.
That electronic records system alone would “help in terms of identifying people who are becoming ill, who are actively psychotic, and allow for an emergency room to electronically transmit to a community agency information on someone they need to follow up on,” according to Linda Rosenberg, president and CEO of the National Council for Behavioral Health.