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The increase could reflect the growing number of inmates with mental illness, though it also might stem from better identification of people in need of treatment, say researchers from California Health Policy Strategies(CHPS), a Sacramento-based consulting firm.

Amid a severe shortage of psychiatric bedsand community-based treatment throughout the state and nation, jails have become repositories for people in the throes of acute mental health crises.

The number of people with mental illness in jails and prisons around the nation is “astronomical,” said Michael Romano, director of Three Strikes & Justice Advocacy Project at Stanford Law School, who was not involved in the research. “In many ways, the whole justice system is overwhelmed with mental illness.”

Contributing to the problem in California is that county jails received a large influx of inmates from state prisons to jails as a result of a federal court order to ease prison crowding. In 2011, the U.S. Supreme Court ordered California to reducethe prison population because of overcrowding linked to poor medical and mental health care that it said constituted cruel and unusual punishment.

Three years later, a state propositionreclassified some felony crimes as misdemeanors, meaning offenders went to county jails instead of state prisons.

The new analysis, based on survey data from 45 of California’s 58 counties, opens a window into how the state is coping with the influx. “We think this is the first part of a more systematic discussion about what is going on in the jails and in the broader community with respect to mental health,” said David Panush, a co-author of the report by CHPS, funded in part by the California Health Care Foundation. (California Healthline is an editorially independent publication of the California Health Care Foundation.)

Across California and the U.S., far more people with mental illness are housed in jails and prisons than in psychiatric hospitals. That poses well-documented challenges: Insufficient staff training and patient treatment have contributed to inmate suicides, self-mutilation, violence and other problems.

One complaint among advocates for the mentally ill has been poor access to psychiatric prescriptions to treat such conditions as schizophrenia and bipolar disorder. The medicationsinclude antipsychotics, antidepressants, anti-anxiety drugs and others.

Jail officials in California say they are trying to better identify inmates who can benefit from such drugs. The numbers suggest that may be working. According to the analysis, an average of 13,776 inmates in the 45 California counties were on psychotropic medications in 2016-2017, up from 10,999 five years ago. But the portion of inmates on psychotropic medications varies widely by county, from 8 percent in Glenn to 32 percent in Sonoma and Napa, according to the analysis. The report is based on data from the Board of State and Community Corrections, an independent state agency.

– Naked Capitalism

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