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Fact Sheet:
PEOPLE SUFFERING FROM MENTAL ILLNESS
SHOULD BE IN TREATMENT NOT JAIL

California’s current law for court-ordered treatment, the Lanterman-Petris-Short Act (LPS), was drafted 30 years ago--when little was known about the biological basis of mental illness and the how it can effect the brain. The LPS Act only allows a court to order a person to maintain treatment if they are dangerous to self (including gravely disabled) or others because of their illness. That is not a clinical standard. It does not allow treatment for people who have substantially deteriorated in their cognitive functioning due to mental illness or those who have lost the capacity to be aware of their need for treatment. As a result, such people do not receive early and vital medical services early enough to provide for recovery and to prevent the social tragedies that result from untreated brain diseases. In short, LPS allows many to hit rock bottom before giving them help.

The number of mentally ill individuals entering California’s jails nearly doubled in the first year after the Lanterman-Petris-Short Act went into effect. The sharp influx into jail of mentally ill people who were no longer in a state hospital or under the supervised structure of its conditional discharge program was astounding. Santa Clara County’s jailed mentally ill population jumped by 300 percent in the four years following the closing of the state hospital in its vicinity. By 1975, counties throughout California were experiencing a similar increase in inmates with mental illness in their jails. A study eight years after the change in the commitment standards found a five-fold increase in the arrest rate of mentally ill individuals.

The criminalization of the mentally ill was not restricted to jails; the number of inmates with mental illness in our prisons rose just as startlingly. One prison psychiatrist summarized the early problem, "We are literally drowning in patients, running around trying to put our fingers in the bursting dikes, while hundreds of men continue to deteriorate psychiatrically before our eyes into serious psychoses the crisis stems from recent changes in the mental health laws allowing more mentally sick patients to be shifted away from the mental health department into the department of corrections." By 1972, task forces were being set up to promote the diversion of mentally ill people from county jails and into treatment. Few were successful. To date very few programs in California have been able to reduce the number of people with mental illness in our jails and prisons.

Jail and prison are but one part of the revolving door, which started when California removed "need for treatment" as a criterion for involuntary psychiatric hospitalization. Hospitals are another. Short-term stays without structured community reintegration programs only lead to more ineffective hospitalizations. In the hospital, patients stabilize on medication but after release many stop taking it, and decompensate, becoming again overtly psychotic and eventually dangerous.

Conservative estimates place the number of mentally ill individuals in California jails and prisons today at 20,000 to 30,000. Research shows that between 8 to 20 percent of state prison inmates and 7.2 to 15 percent of county jail inmates are seriously mentally ill.

Conversely, California state hospitals house slightly less than 4000 patients, of which only 900 are on civil commitments. The others are on a variety of forensic (i.e., criminal justice related) commitments. Most civil hospitalization today is short term (less than 14 days) and in acute care community hospitals.

The financial impact of the criminalization of the mentally ill is astounding to the State of California. Overall the cost to catch, adjudicate and incarcerate people with mental illness in California is between $1.2 to $1.8 billion annually.

The criminal justice system is not designed to treat people with mental illness. Law Enforcement officers average 4.5 hours training on mental illness, but must respond to calls involving mental health crisis as frequently as they do those of burglary. Never intended to be hospitals, California’s prisons remain in violation of the Constitution for failing to provide mental health treatment to its mentally ill inmates. Los Angeles County Jail is under investigation by the Department of Justice over its treatment of inmates with mental illness.

When a person with mental illness is arrested in California the charges are usually minor: loitering, disturbing the peace, simple assault and similar simple misdemeanors. Unfortunately there are also significant numbers of crimes involving violence, which is usually directed towards family or friends.

The key to criminal behavior resulting from mental illness invariably relates to a lack of treatment and structure in the person’s community living. Generally the jailed population is an uncured for group of people stuck in a revolving door of psychiatric hospitalizations, homelessness and jailing. One California study found one third of the mentally ill inmates it studied were transients; with four-fifths displaying overt signs of mental illness such as delusions and hallucinations. Ninety nine percent had previous psychiatric hospitalizations and 92 percent arrest records (75% for felonies). More than 50 percent were charged with felonies and 39 percent with crimes of violence. Three-fourths met current standards for civil commitment. Of those charged with misdemeanors, more than half had been living on the streets, on the beach, in missions, or in cheap hotels, compared with less than a fourth of those charged with felonies.

Police, when confronted with a person experiencing symptoms of mental illness generally can leave the person in the community, initiate involuntary hospitalization or arrest him or her. When the criteria for hospitalization is too stringent, the behavior too bizarre to leave in public scrutiny, or the charge a potential felony, arrest becomes the most likely disposition. Many researchers believe that a narrow definition of dangerous to self (including gravely disabled) or others promotes the use of criminal arrest in lieu of treatment for persons with mental illness. Put simply, waiting for danger as criteria for hospitalization before providing needed medical treatment is too late and leads to dangerous activities that result in arrest and death.

***This document was compiled by the California Treatment Advocacy Coalition***

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