Two hundred years ago, American jails were commonly used to house seriously mentally ill citizens. The inhumanity of that system led advocates in the 1800s to undertake reforms in the care of the mentally ill. Modern mental hospitals run by State governments evolved in mid-20th century America with the promise of professional medical treatment and rehabilitation.
Dramatic shifts in state psychiatric and penal populations have occurred in the last 20 years. For example, in the early 1970s, Michigan’s mental institutions held about 28,000 patients, while its prisons held 8,000. Today there are less than 3,000 patients in Michigan mental hospitals, while the state’s prisons hold more than 45,000 inmates.
Nationally, state mental hospital populations peaked at 559,000 persons, in 1955.
By contrast, 70,000 individuals with severe mental illnesses are housed in public psychiatric hospitals today, 30% of whom are forensic patients referred by the courts.
In the 1990s, it has become common once again to find the mentally ill in jails and prisons: The federal Bureau of Justice Statistics (BJS), in a 1998 survey, found that 238,800 mentally ill individuals are incarcerated in U.S. jails and prisons.(4) The study indicates that overall, “nearly a third of all inmates reported they had a current mental condition or had received mental health services at some time.” Some mental health experts say the number is probably higher, due to under-reporting by people who don’t disclose the information or are unaware of their illness.