Prisons and the Mentally Ill

colson2In the 16th century, London’s mentally ill were often kept at Bethlem Royal Hospital. The conditions inside the hospital were notoriously poor. Patients were often chained to the floor and the noise was so great that Bethlem was more likely to drive a man crazy than to cure him.


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The conditions were so infamous that the nickname locals gave the hospital—Bedlam—has come to mean any scene of great confusion.


Unfortunately five hundred years later, we’re still treating the mentally ill more like prisoners than patients.


Fifty years ago, more than 550 thousand people were institutionalized in public mental hospitals. Today, only between 60 and 70 thousand are, despite a two-thirds increase in the country’s population.


Since there’s no evidence that the incidence of mental illness has dropped precipitously, the mentally ill who previously had been institutionalized had to have gone somewhere.


While some are being treated successfully in their communities, at homes and groups homes, but for many that “somewhere” is behind bars.


This last part shouldn’t come as a surprise. Five years ago, the Washington Post told the story of “Leon,” a one-time honor student, who had 17 years in and out of jail on various drug-related charges. It was only after several suicide attempts, including drinking a “bleach-and-Ajax cocktail,” that Leon was diagnosed with bipolar disorder.


Leon’s story was a microcosm of a larger problem: “Prisons and jails are increasingly substituting as mental hospitals.” As one advocate for the mentally-ill told the Post, “a lot of people with mental illness are charged with minor crimes as a way to get them off the streets.” In effect, they are behind bars for “being sick.”


Fast forward five years and little, if anything, has changed. A few weeks ago, another piece in the Post discussed the same problem. Psychiatrist Marcia Kraft Goin told readers something that should shock and outrage them: “The Los Angeles County Jail houses the largest psychiatric population in the country.”


As with the earlier Post piece, the conclusion was inescapable: “People with [untreated] mental illnesses often end up with symptoms and behaviors that result in jail time.”


You don’t have to be a “bleeding heart” to understand that this is an injustice—any kind of heart will do. Not only are the mentally ill not getting the help they need, they are as lambs to the slaughter in our crowded and violent prisons. They are being victimized twice over.


They’re not the only ones being victimized. At a time when most state prisons are unlawfully overcrowded, there are better uses for prison beds than as makeshift mental hospitals. As Goin wrote, “treating” mental illness as a criminal justice problem costs “more than treating patients appropriately in their community.”


As part of its ministry to prisoners and their families, Prison Fellowship supports community-based alternatives to incarceration. Not only because it makes “financial sense” but because it’s what Christ would have done. In Matthew 25 he called the ill and the prisoner his “brothers” and he expects us to offer them something more than bedlam.



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For Further Reading and Information

Marcia Kraft Goin, “The Wrong Place to Treat Mental Illness,” Washington Post, 8 July 2007.

William Branigin and Leef Smith, “Mentally Ill Need Care, Find Prison,” Washington Post, 25 November 2001.


Rusty Selix, “Mentally Ill Need Treatment, Not Prison Time,” San Jose Mercury News, 1 August 2007.


Report: Jails Shoulder Cost of Mentally Ill,” Associated Press, 16 July 2007.


Jamie Fellner, “Keep Mentally Ill Out of Solitary Confinement,” Human Rights Watch, 20 July 2007.


Kristine Steakley, “Helping the Mentally Ill,” The Point, 27 September 2006.


Breakpoint Commentary No. 070109, “A Story Fit to Print: Christians and Criminal Justice.”