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In March, Dallas police were called to the house of a black family where a man, a member of the family, had a screwdriver. Police were told that the man was mentally ill, yet the police did not act in accordance with the established protocol of talking and calming. Instead they shot him dead.

While the family and community have decried the actions of the officers that day, there is another disturbing picture that emerges. Even if the officers had subdued him, even if they had ushered him away, would he have ever received help? Police are often not trained in the treatment of mentally ill suspects and inmates, after all. It’s more likely that he would have simply wound up in a system not meant to treat the mentally ill but, rather, one meant to treat all arrestees as criminals, regardless of how they end up in an officer’s hands.

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Of the more than 2 million people currently incarcerated in the U.S., nearly 500,000 are estimated to have serious mental illnesses—including bipolar disease, schizophrenia and deep depression. Approximately three-fourths of the incarcerated mentally ill also have drug- or alcohol-use problems. Once incarcerated, they spend more time in jail and are more likely to return than other inmates. Inmate treatment, when it is available, is rarely informed by the best psychological methods. All of these trends disproportionately affect African Americans, who are overrepresented in jails and prisons.

When people with mental illnesses are sent to prisons, they enter a system that is tragically ill equipped to address their needs. Those who enter the penal system don’t find enough treatment there. Jails and prisons are often understaffed and overcrowded. But even if the penal system were magically gifted with more beds and staff, that might not solve the problem because many prisons are philosophically in opposition to treatment models.

Once you are in prison, the point is to punish. There was a relatively brief trend toward rehabilitation in the 20th century, but with what has been called the “punitive turn,” prisons have turned away from modern attempts at rehabilitation and gone back to simply punishment. Incarceration is meant to be awful. The methods of punishment—of stripping away self-control, social isolation, even solitary confinement—worsen, rather than help, the problem.

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And the trend is deepening. In 2007 fewer than 400,000 people with mental illness were incarcerated—less than a quarter of the number today. The jump coincides with the growth of privately owned prisons, raising the question of whether the higher number is a result of for-profit jails and the need to fill them.

We have effectively returned the mentally ill to the asylums.

For centuries, before the advent of modern psychology, the mentally ill were shut away, out of sight, and often treated as less than human. Society did not know any better. The human brain was poorly understood, and treatments were often misguided and brutal.

Now we know better, or at least we should. The field of psychology has developed an elaborate and medicalized view of the human psyche, and we know that many illnesses are caused by biochemical imbalances, like many other illnesses of the body.

Yet the reality for many people with mental illness looks less like medical science and more like the very bad old days of the insane asylums.

The reasons may have more to do with the public imagination than with what is best for people with mental illness. Historically, there are two populations that receive institutionalization: those convicted of crimes and those deemed to be mentally ill. The mentally ill and the criminal were thought to be more alike than different. Both were perceived as deviant—people we would now consider to be mentally ill were once perceived as possessed by evil, or evil themselves. (And African Americans have a history of being demonized and dehumanized as inherently bad or prone to violence.) The treatments also have been the same—to isolate them from the general population—rather than to help them. 

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The long historical connection made between evil and mental illness lives on in the popular imagination, with a long history of movie villains who are mentally ill, from Norman Bates in Psycho to Batman’s Joker. It passes along to everything from the way we view mass killings like in Newtown, Conn., and Aurora, Colo.—diagnosing the killers in the press as if their disease is always associated with such crimes, when the vast majority of mentally ill people are nonviolent—to even the National Rifle Association’s efforts to shift the debate away from gun control by using the mentally ill as a useful scapegoat, creating an image of “lunatics” and “monsters” and grossly exaggerating the amount of violent crime they commit.

Despite the developing conceptualization of mental illness as illness, the cultural stereotype has prevailed, and mental illness is seen in the press as less a medical designation and more a sign of violent threat.

But even if one proceeds with the ill-founded logic of the “ill as evil,” it should also logically lead to more treatment instead of less—unless we are more interested in punishment and isolation than in treatment.

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Most mental illness can be treated on an outpatient basis, and there was a gradual move away from mass involuntary institutionalization of mentally ill patients in the 1960s and 1970s, placing many of them back into the communities. Now, though, the pendulum may have swung too far. There are not enough beds to fit the need. In 2013 there were 43,000 psychiatric beds in the United States, or about 14 beds per 100,000 people—the same ratio as in 1850.

But change may again be on the horizon. Recently the National Association of Counties, the Council of State Governments Justice Center and the American Psychiatric Foundation collaborated to form Stepping Up, “a national initiative to reduce the number of people with mental illnesses in jails.” The initiative appeals to the cost-saving incentives of the governments that pay the for-profit prisons. Its message—that treatment is less expensive and better than incarceration—is an effort to stop this tragedy by appealing to the lowest common denominator: not our humanity, but our wallets. If governments can’t see that the penal system is structured incorrectly in regards to mental health, they can at least see that it’s a waste of money.

They can see that the most humane strategy is also, by far, the cheapest. 

Sheri L. Parks, Ph.D., is associate professor of American studies and associate dean of the College of Arts and Humanities at the University of Maryland, College Park, where she directs the Arts and Humanities Center for Synergy. She is also the author of Fierce Angels: Living With a Legacy From the Sacred Dark Feminine to the Strong Black Woman. Follow her on Twitter.