In the 1800s, reform movements began to advocate for progressive causes such as the better treatment of the mentally ill, abolitionism, temperance, and voter reforms. There were few resources at the time to treat the indigent mentally ill and they were often incarcerated under horrific conditions.
A Treatment Advocacy Center study reports that people with mental illness were routinely confined in prisons and jails from 1770 to 1820. People with mental health challenges were effectively physically put in boxes or cages and through discrimination put in the boxes of prejudice.
This dramatic rendition 'Out of the Box' reenacts a moment in the life of Dorothea Dix who heroically and successfully advocated for change.
Ironically, many of these same issues are paralleled today. Policies, such as “zero tolerance” policing, nuisance laws and mandatory sentences for drug offenses have contributed to the criminalization of mental illness.
Those struggling with mental illness often encounter the criminal justice system not for major offenses but for minor incidences. Since 1970, the United States has returned to the earlier practice of routinely confining mentally ill individuals in prisons and jails, which is once again regarded as inhumane and problematic.
In 1963, President John F. Kennedy signed the Community Mental Health Act to provide federal funding for the construction of community-based preventive care and treatment facilities.
The Medicaid program however excluded coverage for people in “institutions for mental diseases.” The deinstitutionalization movement had begun to take center stage.
As a direct result, state mental hospital populations went from 560,000 psychiatric patients in 1955 to 61,700 in 1996, a 90% decline.
These patients were often released to the community without adequate support services, which led to many becoming entangled in the web of the criminal justice system.
About 2 in 5 people who are incarcerated have a history of mental illness, resulting in jails and prisons becoming de-facto mental health facilities.