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Mental Health Care’s Connection with the World’s Largest Inmate Population





Most Americans are surprised to learn that the United States has five percent of the world’s population and twenty-five percent of the world’s inmates. presented an infographic last year on the United States having the record for being number one for most inmates, prisons, and prisoners held in solitary confinement. The infographic focused on the following factors which did not include the important issue of mental health:

1. After the late 1970’s, government policy was focused on winning the so called “War on Drugs.” In 1980, nonviolent drug offenders were less than 10% of the prison population. Now nonviolent drug offenders are 25% of the prison population. In Europe, most drug users are not jailed, but sent to outpatient clinics.

2. Although violent crime has decreased, mandatory sentencing and the three strike laws have removed discretion from many courts in sentencing offenders who were not true candidates for long sentences. For example, In Rummel v. Estelle, the Supreme Court upheld a life sentence with the possibility of parole for William James Rummel. Rummel’s felony fraud crime amounted to $120.75. It was Mr. Rummel’s third offense. He had refused to return money received as payment for unsatisfactory repairs of an air conditioning unit.

3. Private prisons are big business in the United States. Profits for the major private prison companies are massive and the private companies are even paid for empty beds. There is also a lack of effective rehabilitation programs in our prisons and insufficient support for reentry programs which have contributed to the high recidivism rate.

Since the early 1980’s, the treatment of Americans with mental health issues contributed significantly to the dramatic rise in our inmate population. According to a 2006 Justice Department study, over fifty percent of the inmates in United States jails have a mental health problem, Women incarcerated have a much higher rate than men.During the Reagan decade, government aid to state mental hospitals was drastically reduced and/or eliminated. Because of these reductions, many state hospitals were closed. A may 2010 joint study by the Treatment Advocacy Center and the National Sheriffs’ Association found. “It is thus fact, not hyperbole, that America’s jails and prisons have become our new mental hospitals.” The 2010 study further noted in 1955, there was one bed in a psychiatric ward for every 300 Americans; now there was only one for every 3,000.

Sheriffs and prison wardens are concerned that jails and prisons were poor substitutions for appropriate mental health facilities. Yavapai County Sheriff Scott Mascher stated, “Should the jails be the de facto mental health treatment centers? I don’t think we should be,” he said.

Studies have shown that approximately one million state hospital beds were lost due to the closing of the state hospitals. During the following decades, our prison population increased by more than one million even though crime was not increasing as a whole for the United States. The overall crime rate is less than 60 percent of what it was in 1980. Despite the growth in population in the United States over the past 30 years, there are actually fewer crimes committed now than in 1980.

Based on my personal observations, I was surprised to see so many arrested who were not on any medications and were delusional. Many of the arrested were charged with minor crimes such as trespassing and disorderly conduct. They needed mental health care and not jail or prison.

The 2010 report was very candid: “… the emptying of state mental hospitals, has been one of the most well-meaning but poorly planned social changes ever carried out in the United States.” We have to reverse the policies of not providing mental health care for Americans who cannot afford such care. The federal government and the states need to open up the state hospitals. By bringing back what we had for mental health care before 1980, we will see great reductions in the crime rate, inmate population, and the number of prison, in the United States.

By Bradley D. Schwartz
Founder of

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PrisonPathAnne Pratt, Ph.D. Recent comment authors
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Anne Pratt, Ph.D.

This message is very important and thanks for publicizing it! The growing numbers of mentally ill in jails and prisons, where it is very difficult to treat them, is a travesty. The state hospitals were downsized or closed as a result of terrible conditions, and a movement to increase community-based treatment instead of warehousing the mentally ill. Unfortunately, once the hospital beds were reduced, funding for the community programs was cut (and cut, and cut). The results are visible on our streets and in our jails. Increasing inpatient beds is part of the answer. Increasing funding for innovative and effective… Read more »