Cook County Jail, America's Largest Mental Hospital

Cook County Jail, America’s Largest Mental Hospital

At Cook County Jail, an estimated one in three inmates has some form of mental illness. At least 400,000 inmates currently behind bars in the United States suffer from some type of mental illness—a population larger than the cities of Cleveland, New Orleans, or St. Louis—according to the National Alliance on Mental Illness. NAMI estimates that between 25 and 40 percent of all mentally ill Americans will be jailed or incarcerated at some point in their lives.

The overwhelming majority had been arrested for “crimes of survival” such as retail theft (to find food or supplies) or breaking and entering (to find a place to sleep).

Chicagoans with mental illness end up in jail through a chain of small decisions by different local officials. Police officers can choose to take a mentally ill person home, to the hospital, to a shelter—or to jail. Prosecutors can choose whether or not to not bring charges. Judges can choose to set higher or lower bail amounts, thereby determining whether poorer defendants can avoid pre-trial detention and keep their jobs and housing. But once a person reaches the jail, the local sheriff can’t simply decline to take them into custody.

Cook County Jail does house its share of serious violent offenders. Some of them are mentally ill. Many aren’t. But the overwhelming majority of Cook County Jail’s mentally ill population is booked for minor offenses, Dart told me. “When people do not receive the care they need, they become symptomatic,” Jones Tapia explained. “When people become symptomatic with acute mental illness, a lot of times those behaviors look criminal. And we have done an excellent job of criminalizing people with mental illness in our state.”

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