Mental Illness and the Criminal Justice System: Issues and Considerations

Abstract

Mass incarceration and lack of appropriate mental health care have created a public health crisis in the United States (U.S.). The U.S. is now treating individuals who most require mental health care as criminals; the approach to the criminalization of mental illness is not that different from the approach taken in the 1800s, when the mentally ill were imprisoned rather than treated. Also, the seriously mentally ill impose a substantial financial and resource burden on the system. People with serious mental illness require medical treatment and access to stable, supportive housing. Instead of meeting these necessities, the U.S. system makes it more likely that the most severely impaired individuals will be incarcerated. Incarceration further worsens mental health symptoms and functioning. The goals of any justice system include deterrence, rehabilitation, reparation, and protection of the public. However, the U.S. emphasis on increasingly harsh and punitive measures for individuals with mental illness does little to address these goals. Instead, it is more likely to worsen psychological symptoms, resulting in mental decompensation and crisis, and less protection of the public when the individual is released from prison. There have been some recent efforts to address these issues, including enhancing pre-arrest and pre-trial diversion strategies facilitated by technology and analytics, improving coordination between social and health services, mental health courts, and in-jail alternatives to harsh punishment for those with mental illness.