Lawyers at the Bazelon Center for Mental Health Law in Washington, D.C., are closely following the case Brad H., et al. v. The City of New York, et al., which is challenging the city’s practice of not providing discharge planning for mentally ill inmates. In fact, the York State Psychiatric Association is now reviewing the case, and the Bazelon Center, along with the National Alliance on Mental Illness, the American Orthopsychiatric Association, and 11 New York organizations and coalitions have filed an amicus brief to support the plaintiffs.

The case brings to light important and disturbing societal trends concerning those with mental illness: Overall, the cost of caring for psychiatric patients has largely shifted from the mental health system to the correctional system, said Tammy Seltzer, a staff attorney with the Bazelon Center. Seltzer cited troubling statistics on this trend. For example, 600,000 to 1 million of those with mental illness are sent to jails or prisons every year, and at a given moment, 40 percent of Americans with a serious mental illness are estimated to be in jail or prison, accounting for 10 percent to 30 percent of the incarcerated population.

This shift of mentally ill people to the criminal justice system "is happening within a larger societal trend of ‘zero-tolerance policies’ and a crackdown on ‘quality-of-life’ offenses," Seltzer said. "These policies have a greater impact on the homeless mentally ill, who are often found guilty of nothing more than loitering or failure to obey an order to ‘move along.’ These individuals are being cited for violations that are really more a function of their mental illness and homelessness than actual crimes."

Coupled with this trend is the fact that since deinstitutionalization, states have not invested the money they saved by closing hospitals in community mental health services. In fact, in real dollars, states are spending one-third less on mental health services than they did during the height of the deinstitutionalization movement. Consequently, community mental health centers are overburdened, explained Seltzer.

When asked why government funding goes to the correctional system rather than toward the expansion of community mental health care, Seltzer replied, "The public is justifiably frustrated over the failure of the public mental health system to care for those most in need. Unfortunately, their concerns have led to misguided ‘quick-fix’ policies rather than a long-term investment in proven community-based programs."