By Rita Rubin, USA TODAY

On average, a seriously mentally ill person in the USA is three times more likely to be incarcerated than hospitalized, a report concludes today.

In no state was a seriously mentally ill person — someone with schizophrenia or bipolar disorder, for example — less likely to be incarcerated than hospitalized, the report by the National Sheriffs’ Association and the Treatment Advocacy Center found.

But there were wide variations among states. In North Dakota, a seriously mentally ill person was equally likely to be hospitalized as incarcerated. But in Nevada and Arizona, such a person was nearly 10 times more likely to be jailed than hospitalized.

“We’re not trying to say this is a criminal population,” says co-author James Pavle, executive director of the Treatment Advocacy Center, a non-profit based in Arlington, Va. “All they have to do is step over a line — public urination, a misdemeanor. Then they get in jail, and the whole thing can spin out of control.”

The report was based on previously unpublished 2004-2005 data from the Department of Health and Human Services and the Bureau of Justice.

“These people should be getting treatment, not jail time,” Pavle says.

As a result of the deinstitutionalization movement that began in the 1960s, though, “it is now extremely difficult to find a bed for a seriously mentally ill person who needs to be hospitalized,” Pavle and his co-authors write. In 1955, they write, there was one psychiatric bed for every 300 Americans. In 2005, there was one for every 3,000 Americans. “There are forms of treatment that don’t necessitate hospitalization,” Pavle adds.

The Akron (Ohio) Beacon Journal reported Friday that Summit County Sheriff Drew Alexander had threatened to stop accepting violent mentally ill people at the county jail. “We don’t want to be a dumping ground,” Alexander told the paper. “Everybody knows we need someplace other than a jail for these people.”

Two forces, one from the right and one from the left, drove the movement to release seriously mentally ill patients from hospitals, says report co-author E. Fuller Torrey, a psychiatrist who founded the Treatment Advocacy Center.

“Let’s empty out the hospitals so we can save money” went one line of thinking, says Torrey, executive director of the Stanley Medical Research Institute, a non-profit based in Chevy Chase, Md. The other: “If we’re really humane, we’ll release those people, and they’ll live happily ever after.”

The first people to be released were the least sick, Torrey says, “and many of them did very well.” But then, he says, came the sicker patients, who didn’t understand the need to keep taking their medications.

Torrey says the Akron sheriff is the first he has heard rebel, “but I think it’s a harbinger of what’s coming.”

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