The Greenville, South Carolina, resident
was arrested six times in three years, each for an episode related to his illness. Instead of receiving treatment, he was thrown in jail. In the rough prison environment and without proper treatment, he ended up with two felony convictions for crimes committed while incarcerated.
Blough managed to find a path to treatment. That makes him one of the lucky ones. Today, mentally ill Americans are disproportionately more likely
to be arrested, incarcerated, suffer solitary confinement or rape in prison and commit another crime once released.
Quick: Name the largest provider of mental health care in America. If you guessed "our prisons and jails," you would be right.
A 2006 U.S. Department of Justice study
found that three out of four female inmates in state prisons, 64% of all people in jail, 56% of all state prison inmates and 45% of people in federal prison have symptoms or a history of mental disorder.
America's approach when the mentally ill commit nonviolent crimes -- locking them up without addressing the problem -- is a solution straight out of the 1800s.
When governments closed state-run psychiatric facilities in the late 1970s, it didn't replace them with community care, and by default, the mentally ill often ended up in jails. There are roughly as many people in Anchorage, Alaska, or Trenton, New Jersey, as there are inmates with severe mental illness in American prisons and jails, according to one 2012 estimate.
The estimated number of inmates with mental illness outstrips the number of patients in state psychiatric hospitals by a factor of 10.
Today, in 44 states and the District of Columbia, the largest prison or jail holds more people with serious mental illness than the largest psychiatric hospital. With 2 million people
with mental illness booked into jails each year, it is not surprising that
the biggest mental health providers in the country are LA County Jail, Rikers Island in New York and Cook County Jail in Chicago.
Our system is unfair to those struggling with mental illness.
Cycling them through the criminal justice system, we miss opportunities to link them to treatment that could lead to drastic improvements in their quality of life and our public safety. These people are sick, not bad, and they can be diverted to mental health programs that cost less and are more effective than jail time. People who've committed nonviolent crimes can often set themselves on a better path if they are provided with proper treatment.
The current situation is also unfair to law enforcement officers and to the people running our prisons, who are now forced to act as doctors or face tense confrontations with the mentally ill while weighing the risk to public safety. In fact, at a time when police shootings are generating mass controversy, there is far too little discussion of the fact that when police use force, it often involves someone with a mental illness.
Finally, the current approach is unfair to taxpayers, because there are far more cost-effective ways for a decent society to provide care to the mentally ill. Just look at Ohio
, where the Department of Rehabilitation and Correction is projected to spend $49 million this year on medications and mental health care, on top of nearly $23,000 per inmate per year.
Paton Blough is proof that there is a better way. After eventually getting the treatment he needed, he is out of jail and now helps teach law enforcement officers effective ways to intervene with people with mental health needs.
His focus is just one of a surprising number of proven, effective solutions with broad support. Both advocates for the mentally ill and the law enforcement community have lined up in support of increased training for officers. The psychiatric community as well as those focused on reducing crime can all agree on expanding mental health courts, crisis intervention teams, and veterans' courts.
A new initiative, "Stepping Up,
" unites state and local governments and the American Psychiatric Foundation to promote research-based practices to tackle our overreliance on jail as mental health treatment, such as in-jail counseling programs that reduce the chances of repeat offenders.
State and local officials have shown us the way.
We've seen large communities such as Miami-Dade County, Florida, completely redesign their systems at every level, training police officers in crisis intervention, instituting careful assessments of new jail admissions and redirecting their mentally ill populations into treatment, effectively reducing the rates of re-arrest.
We've seen smaller rural counties faced with tight budgets collaborate with neighboring communities to pool their limited resources to pay for new programs and properly track progress to promote accountability.
Perhaps most surprisingly in these partisan times, Republicans and Democrats in Congress are standing shoulder-to-shoulder to support mental health reform. The bipartisan Comprehensive Justice and Mental Health Act, co-sponsored by Sen. Al Franken, D-Minnesota, and Sen. John Cornyn, R-Texas, in the Senate, passed unanimously out of the Senate Judiciary Committee earlier this month.
The legislation includes simple measures that would fund alternatives to jail and prison admissions for those in need of treatment and expand training programs for law enforcement personnel on how to respond to people experiencing a mental health crisis.
The notion of bipartisan, comprehensive criminal justice reform is not just idle talk. It is happening.
Both sides see practical alternatives to incarceration that can reduce prison populations, improve public safety, save lives and save money. If Congress moves swiftly to pass the great ideas now percolating in the House and Senate, it will become a reality.
Take it from a conservative and a liberal: A good place to start is by addressing the needs of our mentally ill citizens in jails and prisons.