In 1999, the US Bureau of Justice Statistics estimated that 283,000 jail and prison inmates suffered from a serious mental illness. One in four female inmates is reported to have a mental illness. Nearly half of the mentally ill inmates had been imprisoned for a non-violent crime. Twenty per cent of those with mental illness (male and female) had been homeless during the year before their incarceration, according to a study by the Center for Mental Health Services. In 2003, Human Rights Watch reported: ‘all-too-often seriously ill prisoners receive little or no meaningful treatment. They are neglected, accused of malingering, treated as disciplinary problems’.

Two other statistics further underscore the challenges for the mentally ill in the US. First, only 60% of the mentally ill in state and federal prisons reported receiving mental health treatment since incarceration. Second, the US remains one of the few countries in the world that executes the mentally ill if they commit a capital crime.

One explanation often given for such shocking statistics is that: in 1955, 560,000 men and women were in US State Psychiatric Hospitals; in 2004, there were fewer than 40,000. While the doors of institutions have been thrown open, public mental health services have been grossly inadequate to address the needs of the mentally ill.