Mentally Ill Inmates Often Leave Jail Sicker Than When They Entered, New Study Finds

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In few places are the consequences of non-treatment more visible than our jails and prisons, said the Treatment Advocacy Center.

The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society.

Ten times more individuals with serious mental illness are residing in state prisons and county jails today than in the nation’s remaining state mental hospitals, according to a new study from the Treatment Advocacy Center.

The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey” found that, in 44 states, the largest institution housing people with severe psychiatric disease is a prison or jail. Nationwide, the study reports an estimated 356,000 mentally ill inmates compared with 35,000 public hospital patients.

The survey provides state-by-state illustrations of how protocols for treating mentally ill inmates who are deteriorating or acutely ill create obstacles that leave inmates without treatment for extended periods or indefinitely, especially in county jails.

The consequences of failing to treat mentally ill inmates are “usually harmful and sometimes tragic,” according to the report, which represents the first compilation of state laws and practices governing such treatment. Without intervention, symptoms worsen, leading inmates to behave in disruptive and bizarre ways and become vulnerable to being beaten, raped or otherwise victimized, to mutilating themselves or committing suicide, the study found. Inmates whose symptoms are uncontrolled also are more likely to be confined in isolation or placed in restraints and, as a group, contribute to the overcrowding of prisons and jails and the increased cost of corrections for both states and counties.

“The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” said Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center and lead author of the study. “This is especially true for individuals who – because of their mental illness – are not aware they are sick and therefore refuse medication.”


  •     Maintain a functional public mental health treatment system so people with mental illness do not end up in prisons and jails
  •     Reform mental illness treatment laws and practices to eliminate barriers to timely treatment before people commit crimes
  •     Reform jail and prison treatment laws so prisoners with mental illness receive appropriate and necessary treatment, just as inmates with other medical illnesses already do
  •     Use court-ordered outpatient treatment – deemed by the Department of Justice to be an evidence-based practice for reducing crime and violence – to help at-risk individuals live more safely and successfully in the community
  •     Implement and promote jail diversion programs
  •     Institute mandatory release planning. A recent study reported that inmates who are not treated following release are four times more likely to commit additional violent crimes than those who receive treatment.

“The mistreatment of inmates in jails in prisons, including the denial of proper medical care, is a national embarrassment and has led to international condemnation,” Torrey said. “Mentally ill individuals who end up in prison or jail should be treated for their mental illness just as they should be treated for their diabetes or hypertension.”

The full report is available at:

The Treatment Advocacy Center is the only national nonprofit dedicated exclusively to eliminating legal and other barriers to treatment for people with severe mental illness. The organization does not accept funding from companies or entities involved in the sale, marketing or distribution of pharmaceutical products.

The American Psychiatric Association awarded the Treatment Advocacy Center its 2006 presidential commendation for "sustained extraordinary advocacy on behalf of the most vulnerable mentally ill patients who lack the insight to seek and continue effective care and benefit from assisted outpatient treatment.”

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Jamie Mondics
Treatment Advocacy Center
+1 (703) 294-6003
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