Mental Health
Systemic Issues Transform State Mental Hospitals into Criminal Facilities
Increasing Intersection of Mental Health and Criminal Justice Systems
The prevalence of severe mental illness in state hospitals is on the rise, yet the care provided before patients reach a crisis point has significantly diminished. This has resulted in a growing trend where the mental health system appears to criminalize rather than assist individuals in need. An example of this is Quincy Jackson III, a 28-year-old who has been navigating a cycle between shelters, jails, and hospitals due to his mental health struggles. Jackson has been diagnosed with severe psychosis and has faced arrest or citation 17 times since 2023, been jailed at least five times, and treated over 10 times at various hospitals.
State and Nationwide Trends in Mental Health Care
In Ohio, 90% of state hospital patients have criminal charges against them, even as the total number of psychiatric patients in the state has decreased by 50%. Nationwide, the number of patients served has dropped by 17% over the past decade. This decline is partly attributed to the closure of psychiatric units in local hospitals, which has further disrupted the flow of patients through state mental health systems. Ohio's hospitals are experiencing significant backlogs, with more than 1,000 patients currently in care, and a median wait time for a state hospital bed reaching 37 days. These prolonged waits have prompted lawsuits in several states and have been an issue in Ohio since 2018.
Challenges in Providing Adequate Mental Health Care
The shift towards treating patients with criminal charges within psychiatric facilities has resulted in inconsistent care that exacerbates mental health symptoms. Psychiatric medications can take up to six weeks to be effective, yet many facilities are turning away patients in urgent need of care without facing significant consequences. Discharging at-risk patients is illegal, but dozens of hospitals are reportedly not adhering to this law, and there is minimal governmental follow-up on illegal discharges. For instance, West Springs Hospital violated the Emergency Medical Treatment and Labor Act (EMTALA) by discharging suicidal patients and lacked trained staff for patient monitoring.
Over 90 psychiatric hospitals have violated EMTALA in the past 15 years, with only three penalties issued since 2019.
Efforts and Shortcomings in Addressing the Crisis
To address the ongoing crisis, Ohio has expanded crisis intervention training and launched a statewide emergency hotline. Despite these efforts, the backlog at hospitals continues to grow, as evidenced by Quincy Jackson III's 100-day wait for a hospital bed. The overcrowded conditions in facilities like Montgomery County Jail highlight the systemic challenges in providing adequate mental health care. The situation is compounded by the fact that psychiatric hospitals frequently turn away patients deemed 'gravely disabled' or actively suicidal, often due to a lack of insurance coverage or because they are considered 'frequent flyers' of the system.
In Michigan, the mental health system has faced criticism from experts, with severely ill individuals lacking continuous care. Families, such as that of Gille, who was diagnosed with paranoid schizophrenia, struggle to secure necessary assistance due to systemic failures that ignore patients unwilling to seek help.
Conclusion
The intersection of mental health and criminal justice systems highlights a critical need for reform in how mental health services are delivered and managed. With suicide rates nearing record levels and a growing number of high-profile incidents linked to untreated mental illness, the urgency for systemic change has never been greater. The Task Force on Criminal Justice and Mental Illness remains active in addressing these issues, yet more comprehensive enforcement of existing laws, like EMTALA, and increased accountability for psychiatric facilities are necessary to ensure that individuals receive the care they need rather than being funneled into the criminal justice system.