The document investigates the strong correlation between mental illness and incarceration in the United States, revealing that mentally ill individuals are incarcerated at rates significantly higher than those without mental disorders. It discusses the implications of deinstitutionalization and how correctional facilities have effectively become the primary care institutions for many mentally ill individuals, often lacking adequate treatment. The paper aims to explore the reasons behind the high incarceration rates of mentally ill individuals and potential solutions to this systemic issue.

1. Running head: MENTAL ILLNESS AND INCARCERATION
1
MENTAL ILLNESS AND INCARCERATION
2
Mental illness and incarceration
Name:
Institution:
Date:
Table of Contents
Introduction2
Literature review3
Theory of application11
Data and Methods.12
Expected Results13
References.14

2. Relationship mental illness and incarcerationIntroduction
There is a strong relationship between being mentally ill, and
incarceration. People with mental disorders are being
incarcerated at a higher rate compared to those without mental
problems. Combined, the number of mentally ill adults in the
correctional facilities are more than those in the mental state
hospitals in the whole of the United States (Wallace, Fahmy,
Cotton, Jimmons, McKay, Stoffer, & Syed, 2016). The rate of
adult incarceration in the United States is the highest among the
developed nations, with more than 2 million adults currently in
prisons and jails. Adults having mental disorders have been
increasingly incarcerated during the past thirty years, and this
has been attributed to the deinstitutionalization of the state
mental health systems.
In effect, the correctional facilities have generated to become de
facto state health facilities, and there exists more persistently
and seriously mentally ill in prisons than in all state hospitals in
America. In 2006, the United States Department of Justice
conducted a study which revealed that more than 50 percent of
all the jail and prison inmates have mental health problems
compared with an estimated 11 percent of the total population
(Wallace, Fahmy, Cotton, Jimmons, McKay, Stoffer, & Syed,
2016). In spite of this, only one in three of those in prisons and

3. one in six of those in jails get any form of mental health
treatment.
This paper will explore this strong relationship and look for
solutions. Additionally, the paper will address why so many
mentally ill patients end up in prisons and jails, and what the
percentage of those behind bars suffering from mental
problems. The other question that will be addressed by the
paper is the relationship between mental illness and the length
of sentences, if it exists. Literature review
Cloyes, K. G., Wong, B., Latimer, S., & Abarca, J. (2010). Time
to prison return for offenders with serious mental illness
released from prison a survival analysis. Criminal Justice and
Behavior, 37(2), 175-187.
The four authors of this article, Kristin Cloyes, Bob Wong, Seth
Latimer and Jose Abarca all from the University Of Utah
College Of Nursing set out to conduct a survival analysis of the
time to prison return for offenders with serious mental illness
released from prison, a significant component of rates of
incarceration of mentally ill people in state prisons in the
United States. In the article, the authors begin by explaining
how serious mental illness poses such a major risk for repeated
incarceration (Cloyes, Wong, Latimer, & Abarca, 2010). In the
wake of all these, studies in recidivism are silent on a
comparison between the seriously mentally ill and the non-
seriously mentally ill criminal offenders.
The study found that mentally ill offenders who have been
released from the prisons have a higher rate of returning to the
jails having committed similar or different crimes for which
they had been initially detained. Further, the study supports the
earlier position on the high rates of incarceration for the
mentally ill. If five offenders, drawn from SMI and non-SMI
were released from a prison setting according to the study, three
from the SMI group would end up returning to the prison
(Cloyes, Wong, Latimer, & Abarca, 2010). This article is
relevant to the study since the high rates of recidivism for the
mentally ill contributes to their large numbers in jails and

4. prisons.
Fazel, S., & Seewald, K. (2012). Severe mental illness in 33 588
prisoners worldwide: systematic review and meta-regression
analysis. The British Journal of Psychiatry, 200(5), 364-373.
This article reviews severe mental illnesses in prisoners
globally. The background of the article is based on the levels of
psychiatric in prisoners in several countries of the world, and
whether the mental illness rates have been increasing over time.
The article identified studies from 1966 to 2010 using reference
lists and bibliographic indexes. 109 samples were identified
from 24 countries, including 33588 prisoners from the same
population of countries (Fazel, & Seewald, 2012). Using
random effects, the data were meta-analyzed. The results were
in favor of the research topic, which in the population of
mentally ill prisoners selected, their inclusion in the prison
systems were largely connected with their conditions.
Fields, G., & Phillips, E. E. (2013). The new asylums: jails
swell with mentally ill. Wall Street Journal, 25. Retrieved
From:
http://www.wsj.com/articles/SB10001424127887323455104579
012664245550546
Field and Phillips set out to explain that jails and prisons have
become the new asylums for the mentally ill. America’s jails
and lockups, they say, have become the new asylums (Fields, &
Phillips, 2013). After several state mental health facilities were
closed in the start of the 1970s, few alternatives remained.
Many of those afflicted ended up on different streets, where
they are untreated and have become increasingly vulnerable to
crime, drug abuse and joblessness. Three biggest jail systems
in the country- New York City, Los Angeles County, and Cook
County lead with the numbers(Fields, & Phillips, 2013). These
jail systems have more than 11, 000 inmates or prisoners under
mental treatment each single day, and are representing the
biggest mental-health treatment facilities in the whole of the
United States. The three largest state-administered mental
health facilities have 4,000 beds, which is way lower than the

5. figure in the three jail set ups.
Hawthorne, W. B., Folsom, D. P., Sommerfeld, D. H.,
Lanouette, N. M., Lewis, M., Aarons, G. A., ... & Jeste, D. V.
(2012). Incarceration among adults who are in the public mental
health system: Rates, risk factors, and short-term outcomes.
Psychiatric Services.
This article addresses the influx of people with mental problems
in the criminal justice department. Persons with mental
problems have flooded the correctional facilities in the country,
and the general population of the prison system is being reduced
because of overcrowding concerns. The study also addresses the
reclassification of drug possession which has been a major
concern for people with mental problems (Hawthorne, Folsom,
D. P., Sommerfeld, Lanouette, Lewis, Aarons, & Jeste, 2012).
In the recent years, the mental health system in the country did
not have to face the problems associated serious mental
illnesses, especially because several of them were incarcerated
in prisons and jails. However, with the release of such people in
the offing, the mental health system is likely to handle biggest
numbers than before.
Johnston, E. L. (2013). Vulnerability and just desert: a theory
of sentencing and mental illness. Journal of Criminal Law and
Criminology, 103(1).
Lea Johnson appreciates the high rates of incarceration for the
mentally ill persons, and focuses his study on the risks of
serious problems posed to inmates and prisoners with major
mental problems, and then digs dipper into investigating their
import of sentencing mentally ill people under the just desert
analysis (Johnston, 2013). The author explains how the several
prisoners with mental illness are more likely to suffer sexual
and physical assaults experience psychological deterioration,
endure housing in solitary confinement during their carceral
terms (Johnston, 2013). The article turns to the just desert
theory, and the principles of cardinal and ordinal
proportionality to point out three ways through which
vulnerability to serious problems or harm may be factored into

6. sentencing (Johnston, 2013).
Lamb, H. R., & Weinberger, L. E. (2014). Decarceration of US
jails and prisons: where will persons with serious mental illness
go?. Journal of the American Academy of Psychiatry and the
Law Online, 42(4), 489-494.
Richard Lamb and Linda E. Weinberger, both writing for the
American Academy of Psychiatry and the Law explore
decarceration of the United States Prisons and Jails, and where
people with severe mental disorders are likely to go (Lamb, &
Weinberger, 2014). Decarceration is decreasing the number of
prisoners in the United States prisons and jails. According to
the article, an approximated number of 350,000 people suffering
serious mental illnesses are among those incarcerated in
America, and many of them are likely to be released(Lamb, &
Weinberger, 2014).
Metzner, J. L., & Fellner, J. (2010). Solitary Confinement and
Mental Illness in US Prisons: A Challengefor Medical Ethics.
Journal of the American Academy of Psychiatry and the Law
Online, 38(1), 104-108.
Jeffrey L. Metzner and Jamie Fellner Esq. acknowledge the fact
that because of the large numbers of mentally ill persons in jails
and prison settings, the correctional officers have turned to
solitary confinement as way through which dangerous and
difficult mentally ill prisoners can be managed (Metzner, &
Fellner, 2010). Many of them are subjected to isolation, and in
the process, develop severe mental problems (Metzner, &
Fellner, 2010). Additionally, the article explains that when the
conditions of solitary confinement provoke recurrence or
exacerbate their symptoms, the consequences can be detrimental
to the mental status of the affected people.
Prins, S. J. (2014). Prevalence of mental illnesses in US state
prisons: A systematic review. Psychiatric Services, 65(7), 862-
872.
In “the prevalence of mental illnesses in U.S. State Prisons; A
systematic Review,” by Seth J. Prins is focused on determining
the population of mentally ill people in the correctional

7. facilities. In the abstract, Prins opens by saying that people with
mental illnesses are overrepresented in the United States
criminal justice system (Prins, 2014). Further, estimated figures
for the prevalence of mental disorders in correctional settings
are critical for planning and implementing diversionary and
preventive programs and policies (Prins, 2014). The systematic
review investigates studies that have been assessing the
prevalence of mental problems in the United States state
prisons, so that a broader description and picture of the prison
prevalence, and then identify the setbacks to obtaining
consistent and accurate estimates.
Raphael, S., & Stoll, M. A. (2013). Assessing the contribution
of the deinstitutionalization of the mentally ill to growth in the
US incarceration rate. The Journal of Legal Studies, 42(1), 187-
222.
This article, authored by Raphael and Stoll, and published in
2013 assesses how deinstutionalization of the mentally ill has
contributed to their high incarceration rates in the United
States. The two remarkable authors explain that historically, the
reduction in the mental health care populations owing to the
psychiatric deinstitutionalization has led to the increased of the
imprisonment rates countrywide since the early 1980s, and late
70s. In the article, Michael A. Stoll and Steven Raphael explain
how transinstitutionalization, or the number of mentally ill
patients released from the mental hospitals in the middle of the
20th century ended up behind bars. The two uses United States
Census data gathered between 1950 and 2000, and they
concluded that those who were likely to be incarcerated were
largely attributed to the deinstitutionalization between 1950 and
2000.
Reingle Gonzalez, J. M., & Connell, N. M. (2014). Mental
health of prisoners: Identifying barriers to mental health
treatment and medication continuity. American journal of public
health, 104(12), 2328-2333.
The study found out that people with mental problems are
overly represented in the criminal justice systems in the United

8. States such as parole, probation, prisons and jails. The authors
further explain that such kind of settings are not appropriate for
the treatment of such people(Reingle Gonzalez, & Connell,
2014). For patients suffering mental disorders, who face
unemployment, victimization, crime, physical health problems,
homelessness and family breakdown, substance abuse and
stigma, contact with the justice system can disrupt linkage to
service systems and treatment, exacerbate prevailing social
marginalization, and represent the first occasion for treatment
interventions.
Rossman, S. B., Willison, J. B., Mallik-Kane, K., Kim, K., &
Sherrill, P. (2012). Document Title: Criminal Justice
Interventions for Offenders with Mental Illness: Evaluation of
Mental Health Courts in Bronx and Brooklyn, New York.
The article discusses mental the use of isolation in confining
prisoners with serious mental problems, the psychological
effects of such isolation, and the response by human rights
experts and United States courts, especially in Bronx and
Brooklyn, New York. The authors then address the setbacks and
the human rights roles of physicians confronting this practice in
prison settings(Rossman, Willison, Mallik-Kane, Kim, &
Sherrill, 2012). The article concludes by encouraging
professional firms to adopt formal strategies and positions in
addressing prolonged isolation of offenders with serious mental
problems. This article is important to the study since it
addresses incarceration of mentally ill persons and the
treatments they are subjected to when in the prisons and jails.
Roy, L., Crocker, A. G., Nicholls, T. L., Latimer, E. A., &
Ayllon, A. R. (2014). Criminal behavior and victimization
among homeless individuals with severe mental illness: a
systematic review. Psychiatric services.
This article’s objectives were to estimate the prevalence and
correlate criminal behavior, victimization and contact with the
criminal justice system among adults without homes and having
severe mental disorders. Of the 21 studies systematically
reviewed, incarceration rates went higher for the mentally ill,

9. and they were easily victimized for criminal behavior based on
the state of their mental health. The authors further explained
that the whole world have approximately 10 million prisoners,
with the United States leading the pack, with approximately 2.3
million prisoners. The article reports that prisoners have high
rates of psychiatric problems compared to the general
population, including substance misuse, personality disorder,
depression and psychosis. The study concluded that high
psychiatric morbidity levels are reported consistently in jails
and prisons from several countries over the last forty years.
Torrey, E. F., Kennard, A. D., Eslinger, D., Lamb, R., & Pavle,
J. (2010). More mentally ill persons are in jails and prisons than
hospitals: A survey of the states. Arlington, VA: Treatment
Advocacy Center.
The authors set out by explaining that more mentally ill people
are in prisons and jails than in mental hospitals, which means
the incarceration rates for the mentally ill are very high(Torrey,
Kennard, Eslinger, Lamb, & Pavle, 2010). The study also
mentions that there is significant correlation between criminal
behavior and contact with the criminal justice system for the
mentally ill, and that the correlation is largely drawn from
factors such as perceived need for medical services, substance
use, homelessness type ( street or sheltered ), criminal history
and age. The study concludes by explaining that homeless
mentally ill persons are easily victimized for criminal activity,
and this is why thousands of them find themselves in prisons
and jail systems.
Torrey, E. F., Zdanowicz, M. T., Kennard, A. D., Lamb, H. R.,
Eslinger, D. F., Biasotti, M. C., & Fuller, D. A. (2014). The
treatment of persons with mental illness in prisons and jails: A
state survey. Treatment Advocacy Center.
This article explores the figures relating incarceration and
mental problems. Most people always generalize and assume
that there exists a direct relationship between crime and mental
illness, and that the signs of mental disorders lead to the
involvement of criminal justice, and hence connecting people to

10. mental health interventions and treatment will prevent future
involvement by the justice system. The figures are alarming.
Ten times more people with mental problems are in prisons and
jails that they do in state psychiatric health facilities. In 2012,
an approximated figure of 356, 268 inmates suffering from
severe mental illnesses were in jails and prisons compared to
just 35, 000 seriously mentally ill patients in the state mental
health hospitals.Theory of application
Criminalization of mentally ill persons can be used as a theory
to explain their high rates of incarceration. The criminal justice
system has experienced the debacle of deinstitutionalization
more than any other sector in the society. While the intentions
are pure and understandable, the reform efforts meant to shield
the freedom and liberties of persons with mentally ill persons
led to several of them, most of whom are severely ill, escaping
without being treated properly (Torrey, Zdanowicz, Kennard,
Lamb, Eslinger, Biasotti, & Fuller, 2014). Because of the large
number of people suffering mental problems, a major problem
has come up: the criminalization of mentally ill Americans,
especially those having severe problems. To prove the theory,
America’s prisons and jails have become surrogate mental
illness hospitals for thousands of people suffering from related
problems.
A huge chunk of the prisoners and jail inmates with mental
problems having no charges against that have apprehended for
small charges or misdemeanours in the form of trespassing.
Further, research indicates that such inmates are four times
more likely to have been arrested and imprisoned or
incarcerated for crimes of less magnitudes and charges like
threats and disorderly conduct compared to the non-mentally ill
persons. Police have been using the disorderly conduct charge
more frequently to arrest and put behind bars people with
mental problems when they cannot find any other charge
(Torrey, Zdanowicz, Kennard, Lamb, Eslinger, Biasotti, &
Fuller, 2014). Drug and alcohol abuse related charges have also
become common since such consumption among the population

11. takes place frequently as a secondary challenge among those
with serious brain problems.
In detailing and examining records from the police, studies
have found that there is a direct relationship between people’s
mental disorders and the charge or behavior which contributed
to arrest. Dr. E. Fuller Torrey, the person behind this theory
explains that women suffering from serious conditions such as
schizophrenia was arrested in New Mexico for assault when she
got into a department store and started rearranging the shelves
as she developed a delusion that she had been working there
(Torrey, Zdanowicz, Kennard, Lamb, Eslinger, Biasotti, &
Fuller, 2014). When she was asked to vacate the premises, she
struck a police officer and the store manager.Data and Methods.
For this study, secondary data from government agencies both
in social services and justice department will be used. The
population to be sampled will be mentally ill people in mental
hospitals, those in incarceration, and the entire jail population.
The study will compare the total jail population in selected
states such as New York, California and Maryland. The
population is sampled from government data. From the evidence
for the decreased number of psychiatric beds for people with
mental problems and the existing evidence for a heightened
number of such persons being incarcerated in state prisons and
local jails, the study aims at examining the problem in each
state (Wallace, Fahmy, Cotton, Jimmons, McKay, Stoffer, &
Syed, 2016).
Data on inmates for the study is collected from Bureau of
Justice Statistics, Prison and Jail Inmates at 2016. For the
study, the percentage of prison and jail inmates assumed to
suffer from serious mental problems was estimated at 16
percent, and the assumption is based on a 2009 study conducted
by Steadman, which focused on jails in Maryland and New York
(Fields, & Phillips, 2013). Based on the available data, it is
believed that a 16 percent assumption is within limits, is
reasonable and rather conservative. However, the statistic is
limited in the sense that it has to be used for every state, where

12. the prevalence of mentally ill incarceration may not be exactly
the same figure.
Data on the number of inpatients in private and public
psychiatric hospitals, and the psychiatric units of generalized
hospitals is to be obtained from the 2016 Inventory of Mental
Health Organizations, as issued by the Substance Abuse
Inventory of Mental Health Services Administration under the
stewardship of the United States Department of Health and
Human Services. The data from the mental healthcare facilities
is set to be compared with data from the justice department, and
this will give an outlook of how many mentally ill persons are
in prisons and jails, as compared to those in state mental
hospitals. Expected Results
The study expects to find more mentally ill persons in state
prisons and the local jails than in mental hospitals. In every
correctional facility expected to be covered in the study, the
number of prisoners with mental problems are expected to
consume larger percentage compared to those without mental
problems. A survey by the Wall Street Journal conducted on 50
states on issues of mental health within the prison populations
provided exploding figures. The study established that in
Oregon in example 50 percent of the state’s estimated 14,000
prison inmates suffer from different forms of mental problems
(Fields, & Phillips, 2013).
The study expects to confirm that several states with huge
populations of inmates like Illinois and Michigan, report an
estimated 10 percent of their inmates suffering from serious
mental problems like schizophrenia. On the other hand, smaller
states in the example of Montana, reported that 15 percent of
their prisoners suffer from serious mental disorders. According
to a report released by the United States Department of Health
and Human Services four years ago, approximately 5 percent of
all adults in America suffer from serious mental problems
(Fields, & Phillips, 2013). Another important expected finding
to back an earlier hypothesis the length of sentences served by
people with mental problems.

13. For instance, in Florida Orange County Jail, mentally ill
inmates stay for 51 days, while the normal inmates stay for an
average of 26 days. This finding confirms there exists a
relationship between mental illness and the length of the
sentence. A mentally ill person is likely to stay behind bars for
longer days compared to normal inmates. Mentally ill inmates
present headache and serious management challenges to
correction officers, and hence their treatment behind bars
different from the normal people (Fields, & Phillips, 2013).
Therefore, being mentally ill in prison vs not mentally ill in
prison has a relationship with regards to their treatment. As
studied earlier, those with mental problems can be subjected to
harsh treatment such as isolation and confinement (Wallace,
Fahmy, Cotton, Jimmons, McKay, Stoffer, & Syed, 2016).
References.
Cloyes, K. G., Wong, B., Latimer, S., & Abarca, J. (2010). Time
to prison return for offenders with serious mental illness
released from prison a survival analysis. Criminal Justice and
Behavior, 37(2), 175-187.
Fazel, S., & Seewald, K. (2012). Severe mental illness in 33 588
prisoners worldwide: systematic review and meta-regression
analysis. The British Journal of Psychiatry, 200(5), 364-373.
Fields, G., & Phillips, E. E. (2013). The new asylums: jails
swell with mentally ill. Wall Street Journal, 25. Retrieved
From:
http://www.wsj.com/articles/SB10001424127887323455104579
012664245550546
Hawthorne, W. B., Folsom, D. P., Sommerfeld, D. H.,
Lanouette, N. M., Lewis, M., Aarons, G. A., ... & Jeste, D. V.
(2012). Incarceration among adults who are in the public mental
health system: Rates, risk factors, and short-term outcomes.
Psychiatric Services.

14. Johnston, E. L. (2013). Vulnerability and just desert: a theory of
sentencing and mental illness. Journal of Criminal Law and
Criminology, 103(1).
Lamb, H. R., & Weinberger, L. E. (2014). Decarceration of US
jails and prisons: where will persons with serious mental illness
go?. Journal of the American Academy of Psychiatry and the
Law Online, 42(4), 489-494.
Metzner, J. L., & Fellner, J. (2010). Solitary Confinement and
Mental Illness in US Prisons: A Challenge for Medical Ethics.
Journal of the American Academy of Psychiatry and the Law
Online, 38(1), 104-108.
Prins, S. J. (2014). Prevalence of mental illnesses in US state
prisons: A systematic review. Psychiatric Services, 65(7), 862-
872.
Raphael, S., & Stoll, M. A. (2013). Assessing the contribution
of the deinstitutionalization of the mentally ill to growth in the
US incarceration rate. The Journal of Legal Studies, 42(1), 187-
222.
Reingle Gonzalez, J. M., & Connell, N. M. (2014). Mental
health of prisoners: Identifying barriers to mental health
treatment and medication continuity. American journal of public
health, 104(12), 2328-2333.
Rossman, S. B., Willison, J. B., Mallik-Kane, K., Kim, K., &
Sherrill, P. (2012). Document Title: Criminal Justice
Interventions for Offenders with Mental Illness: Evaluation of
Mental Health Courts in Bronx and Brooklyn, New York.
Roy, L., Crocker, A. G., Nicholls, T. L., Latimer, E. A., &
Ayllon, A. R. (2014). Criminal behavior and victimization
among homeless individuals with severe mental illness: a
systematic review. Psychiatric services.
Torrey, E. F., Kennard, A. D., Eslinger, D., Lamb, R., & Pavle,
J. (2010). More mentally ill persons are in jails and prisons than
hospitals: A survey of the states. Arlington, VA: Treatment
Advocacy Center.
Torrey, E. F., Zdanowicz, M. T., Kennard, A. D., Lamb, H. R.,
Eslinger, D. F., Biasotti, M. C., & Fuller, D. A. (2014). The

15. treatment of persons with mental illness in prisons and jails: A
state survey. Treatment Advocacy Center.
Wallace, D., Fahmy, C., Cotton, L., Jimmons, C., McKay, R.,
Stoffer, S., & Syed, S. (2016). Examining the role of familial
support during prison and after release on post-incarceration
mental health. International journal of offender therapy and
comparative criminology, 60(1), 3-20.