The behavioral healthcare system in the U.S. fails to meet the needs of too many people who need it most. As states have emptied and closed down their psychiatric hospitals without creating community-based mental health services to support those in need, our jails and prisons have become dumping grounds for many of the most vulnerable members of society. 

For nearly a century, state asylums were the primary institutions where people with severe, chronic mental illness were sent to receive care, yet deplorable living conditions and pervasive abuse contributed to states releasing large numbers of patients and shutting down their psychiatric hospitals. Unfortunately, the robust network of community mental health centers that was promised to replace psychiatric hospitals was never built due to a lack of federal funding. Significant cuts to mental health spending and other social safety net programs have fueled increases in homelessness and made people with untreated mental illness more visible on our streets.

The shortcomings of deinstitutionalization coincided with the largest expansion of U.S. jail and prison populations in history, what’s commonly called mass incarceration. As a result, correctional facilities are treating more people with mental illness than public hospitals. Nearly 14.5 percent of men and 31 percent of women in jails have a serious mental illness such as schizophrenia, bipolar disorder, or major depression. Compare that to rates of 3.2 and 4.9 percent respectively in the general population. In addition, the millions of people who churn through the nation’s courts, jails, and prisons experience chronic health conditions, infectious diseases, and substance use at significantly higher rates than the rest of the population. And the conditions of confinement in many correctional facilities often involve overcrowding, violence, solitary confinement, and poor quality of medical care, all of which can be traumatizing.  

Furthermore, the negative effects of incarceration on health are not restricted to the individuals who have been behind bars. Generations of mass incarceration have also created stress and trauma in the communities where people who are incarcerated come from or return to by diminishing educational opportunities, dividing families, crippling economic mobility, and limiting housing options and access to social entitlements. Excessive policing and incarceration have wasted public money that could have been better invested in things like early childhood education, community-based psychiatric and addiction services, and public housing—the best weapons to help prevent and combat problems related to poverty, mental illness, homelessness, and addiction. 

At Vera, we launched an initiative called Justice Reform for Healthy Communities to address these issues. We believe the time is right to pursue bold reforms. The retributive politics that flamed the fury of decades of prison growth have lost much of their appeal. While there is a long way to go, we are seeing bipartisan cooperation at the federal, state, and local level to reduce correctional populations, repeal harsh sentencing laws, and invest in programming that aims to rehabilitate rather than punish.

These efforts require leadership and commitment from disciplines beyond the criminal justice system. Champions from education, child services, public health, and the private sector—some of whom you will hear from in this blog series—are working to educate diverse audiences on the toll of mass incarceration and advancing reforms that prioritize the outcomes that let communities thrive: better education, stronger family ties, economic mobility, and trust between citizens and their government.  

Vera is pleased to complement the WNYC broadcast, Breaking Point: New York’s Mental Health Crisis, with a blog series that features the voices of experts from a range of fields as they examine how the nexus of poverty, mental health, and the criminal justice system affects nearly every aspect of New York City life.