The Mentally Ill in the Criminal Justice System: An Overview of Historical Causes and Suggested Remedies

This article examines the historical and contextual factors that are related to the growing numbers of persons with mental illness who are processed through the criminal justice system. The paper discuss five major mental health and criminal justice policies that frame the challenges associated with the mentally ill in the criminal justice system: deinstitutionalization (a shift in the locus of care from the state hospital to community-based treatment agencies); mental health law reform (notably more stringent criteria for involuntary admission to a psychiatric facility); fragmented care (little coordination between mental health and other treatment providers); drug enforcement (the war on drugs that resulted in the arrests of the mentally ill who use illicit substances); and public-order policing (the enforcement of arrest policies that target nuisance crimes). The article also presents recommendations for responding more effectively to the problems of the mentally ill in the criminal justice system. During the past three decades, fundamental changes in mental health and law enforcement policies have brought criminal justice professionals into increasing contact with people with serious mental illness (PSMIs). This contact occurs at every stage of the criminal justice process. The police, who are the gatekeepers of the criminal justice system, interact frequently with PSMIs. For example, in New York City