By Vanguard Staff
It should alarm us all: more than half of people incarcerated in state prisons have a history of mental health problems, yet only one in four has received professional help while inside. This is not just a gap in care—it’s a devastating indictment of a system that criminalizes illness and fails at basic human decency.
According to data from the Bureau of Justice Statistics, 56% of people in state prisons report a current or past mental health problem. Nearly half have been diagnosed with a mental disorder, and 14% have experienced serious psychological distress within the past 30 days. Despite these staggering numbers, only 26% have received any professional help for mental health since their admission. Just 6% are currently receiving therapy or counseling from a professional.
This is what it looks like when a country fails to build a mental health care system and instead relies on cages and corrections officers to do the work of doctors and therapists.
Jails and prisons were never designed to be psychiatric hospitals. But in the absence of adequate community-based care, law enforcement and courts continue to respond to mental health crises with punishment. The result is a system that locks people away not because they are a threat to society, but because they are sick—and too often, poor, Black, brown, or disabled.
In California and across the country, we see this dynamic play out daily. Police are dispatched to respond to people in crisis, often escalating situations that could have been handled with trained mental health responders. Judges sentence people to years behind bars for behavior that stems from untreated trauma, psychosis, or substance use disorders. And inside prison walls, the very conditions—solitary confinement, overcrowding, lack of access to medication—only exacerbate the suffering.
It’s easy to pretend this is about individual failure or bad choices. But the reality is far more structural. The U.S. has slashed funding for psychiatric beds and community mental health clinics over the past several decades. In their place, we have built one of the largest prison systems in the world—a system that warehouses people with mental illness and then denies them the care they need.
This is not just morally indefensible. It is dangerous. When people are released from prison without having received adequate mental health care, they are far more likely to end up homeless, in crisis, or reincarcerated. We set them up to fail—and then we blame them for falling.
What would a real solution look like?
First, we must stop using incarceration as a substitute for care. That means fully funding crisis response teams, community clinics, and supportive housing. It means training police to step back when mental health professionals should step in. It means creating alternatives to jail—like diversion programs, mental health courts, and peer-led services—that prioritize healing over punishment.
Second, we need real accountability for the state-sanctioned neglect happening behind prison walls. No one should be locked in a cell without access to therapy, medication, or meaningful support. Prison officials should be required to meet standards of care—and face consequences when they don’t.
Finally, we need a moral shift. We must recognize that people living with mental illness deserve dignity, compassion, and the same rights as anyone else. We must reject a system that treats them as disposable.
Comprehensive data from the Prison Policy Initiative makes the injustice plain. The question is whether we have the courage to act on it.
All true and important recommendations. However, this article fails to recognize a critical reality and that is that approximately half of people with severe mental illnesses, like schizophrenia and bipolar disorders, have no awareness they are sick and, therefore, logically refuse treatment.
Jails will not treat Psychiatric patients over objection so they remain symptomatic behind bars. We all know the tragedies that can result.
Only a psychiatric hospital can medicate over objection, and only if the person meets legal criteria for commitment. Failure to treat first, makes all that follows irrelevant.
In other words, putting post stabilization resources and support before treatment is always doomed to fail.
We can help people maintain baseline stability but we can’t stabilize people who suffer from lack of awareness in outpatient settings.
Resources are critically important, but until we tackle equally critical systems of Psychiatry to assist people to regain sanity, the genocide will persist.