A Handbook for the Study of Mental Health Social Contexts, Theories, and Systems

Hiday and Ray examine two prevailing beliefs about mental illness and the criminal justice system: that deinstitutionalization has led to the criminalization of mental illness and that persons with mental illness are dangerous and likely to commit crimes. The chapter reviews the available empirical evidence for these beliefs. Although arrest rates and incarceration rates are indeed higher for people with mental illness than for the general population, criminalization may be an inaccurate characterization. Furthermore, most people with mental illnesses are not violent, and only a small proportion becomes violent. The chapter goes on to examine how people with mental illness are handled by the criminal justice system. The authors suggest that there are five subgroups of people with severe mental illness who come into contact with the criminal justice system: (1) those committing only misdemeanor nuisance offenses; (2) those committing offenses involving survival behaviors; (3) those who abuse alcohol and drugs, which lead to high rates of criminal offenses from the use of illegal substances, from attempts to support their habits, and from violence arising out of their use; (4) those with a character disorder who have high rates of felonious criminal offending, especially for violence against others; and (5) a much smaller subgroup whose members fit the stereotypical image of a severely disordered person driven to criminally violent actions by delusions. All five groups tend to live in impoverished, disorganized communities where it is difficult to survive with a major mental illness. The authors conclude that the criminal justice system is left to pick up the pieces after the failure of other social institutions. What types of social stressors contribute to the criminalization of the mentally ill? What failures of social institutions have led to the incarceration of those with mental illnesses?