EDITORIAL: Jail no substitute for treatment of mentally ill

Aug. 07--Public officials and mental health advocates acted with the best of motives decades ago in releasing mental health patients from psychiatric hospitals. They thought it was for the patients' own good. Trouble is, many such types are now locked up again -- not in mental health facilities, but in jails and prisons.

Mental and physical abuse was occurring in some of those hospitals. The theory was that "mainstreaming" these individuals in the larger society would be better than keeping them behind closed doors, in what amounted to human warehouses.

But there were never enough halfway houses or personal care homes, never enough case workers, never effective enough drugs or drug management, to address the sheer number of mentally ill people who could not safely live on their own without help.

The problem is a big one. Nationally, the resident population in state hospitals dropped 90 percent from 1955, from about 558,000 to 43,000 today. Pennsylvania's rate was even steeper, 96 percent. Only 1,500 Pennsylvanians live in mental institutions today.

And behind bars? The statewide news service Pennlive estimates that nearly a third of Pennsylvania's 87,756 inmates had a mental illness on an average day during 2014. And about a third of those inmates had a serious mental illness, a chronic and debilitating disorder like schizophrenia or bipolar disorder. Other states also imprison disproportionately high rates of mentally ill people.

What can be done? Certainly no more psychiatric hospital beds should be closed. In fact, probably some should be added. Health officials should take another look at the current prohibition on using Medicaid in state hospitals, which results in placement decisions driven by funding, not by clinical assessment.

Outside hospitals, public officials and mental health professionals should work together to improve inadequate systems for treating individuals. Better, more available community programs and outpatient treatment must be available. Under the current system, appointments are terribly hard to get. If we're saving money by moving people out of hospitals, they at least ought to be able to receive timely treatment by appointment.

Jails and prisons are designed to house criminals, not to treat the mentally ill. If officials persist in moving, and keeping, the mentally ill out of hospitals, then society must provide adequate treatment in the community for this most vulnerable population.

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