Byline: RICHARD SHERMAN For The Register-Guard
REPORTS OF LARGE numbers of people with mental illness showing up in American jails and prisons began appearing in the professional literature in the 1970s. This phenomenon had not been reported since the 19th century.
In 1939 a British researcher named Lionel Penrose advanced the theory that a relatively stable number of persons are confined in any industrialized society. Using prison and mental hospital census data from 18 European countries, he demonstrated an inverse relationship between prison and mental hospital populations. Coining the term "transinstitutionalization," he postulated that if one of these forms of confinement is reduced, the other would increase.
So if there is a shortage of beds at the hospital, many mentally ill persons who come to the attention of law enforcement might well be directed to the criminal justice system. A corollary to this theory is that if civil commitment is reduced, involvement with criminal courts will increase.
Here in Oregon, and elsewhere in the country, we have again proved Penrose's theory to be accurate.
In the mid 1950s there were about 560,000 people in the state mental hospitals nationwide. Today there are about 62,000 people in state hospital beds. Oregon has followed this national trend. Around 1958 the state hospital census peaked at over 5,000. The current state hospital census is somewhere around 792, including Oregon State Hospital and the Eastern Oregon Psychiatric Institute. In addition, there are about 200 publicly funded acute care beds in various hospitals around the state. The state also reports that there are about 500 beds in community-based programs that were created as alternatives to state hospital beds.
While there is some variation in the professional literature regarding the prevalence of people with mental disorders in jail settings, most recent clinical studies report a range between 6 percent and 15 percent of the population. This figure represents people with severe and persistent types of mental disorders such as schizophrenia and bipolar disorder. In contrast, the statewide estimate for adults with serious and persistent mental illness is 2.84 percent.
Clearly, there is a concentration of people with these disorders in the criminal justice system.
Most who work in the criminal justice system will tell you that the number of people with mental illness in jails has been steadily climbing for over a decade. In surveys conducted by the State Mental Health Division, Oregon jail managers reported in 1994, in 1997 and again last year that the population of people with serious mental illnesses continues to increase. The problem is so acute that the Oregon State Sheriffs Association recently sent a letter to the governor describing the situation as being at "a critical level" and as needing to be addressed immediately. The letter has received no response.
Factors identified as contributing to the continued growth of this population in the criminal justice system, in addition to the phenomenon of transinstitutionalization, include the growth of the criminal justice system as a whole. The average daily population of jails has been increasing at an annual rate of 9.2 percent since 1983. We have seen a 76.8 percent increase since 1990.
Other contributing factors include a lack of police training in this area, lack of community-based services that would serve as alternatives to incarceration, and increased drug law violators. Research has shown that 72 percent of people with mental illness in a jail setting have a co-occurring alcohol or drug use disorder.
The most recent research shows that when substance abuse is absent, there is no significant difference between the prevalence of violence among mental patients and their nondisordered neighbors. …