Read this with an eye toward below-guideline variance. Remember, outside studies, empirical data, and even anecdotal evidence can be persuasive in seeking a just sentence for your client.
The erosion of mental health care in the United States coincides with our efforts to de-stigmatize mental illness. We want to make it more socially acceptable, we just don't want to have to pay for it. The result: we jail the sick. We don't have anywhere else to treat them, to care for them, to let them heal. So we lock 'em up.
Psychiatric disorders are the only kind of sickness that we as a society regularly respond to not with sympathy but with handcuffs and incarceration. And as more humane and cost-effective ways of treating mental illness have been cut back, we increasingly resort to the law-enforcement toolbox: jails and prisons.
Nicholus Kristof wrote this in the Sunday Times today. He visited the Cook County Jail in Chicago, which houses over 11,000 inmates. Over half have been diagnosed with some form of mental illness. The Sheriff of Cook County seems to have the most spot-on, sympathetic assessment, “It really is one of those things so rich with irony: The same society that abhorred the idea that we lock people up in mental hospitals, now we lock people up in jails.”
In 1955, there was one bed in a psychiatric ward for every 300 Americans; now there is one for every 3,000 Americans. More effective drugs are available, but still out of reach for those living on the edge of society. Self-medication is often what lands them back behind bars. And it costs far more to incarcerate and medicate someone than it does to care for them while they are on their own. Yet, per HuffPo, "In the past three years, $4.35 billion in funding for mental health services has been cut from state budgets across the nation, according to a recent report."
More numbers can be found here, at the Bureau of Justice Statistics report, and the GAO issued a report last year, "BOP: Timelier Reviews, Plan for Evaluations, and Updated Policies Could Improve Inmate Mental Health." And fd.org offers a "Guide to Mental Health Mitigation," by David Freedman.
Back to Cook County: "As Sheriff Dart puts it: “We’ve systematically shut down all the mental health facilities, so the mentally ill have nowhere else to go. We’ve become the de facto mental health hospital.”