This piece was published in partnership with The Human Toll of Jail, a storytelling project from the Vera Institute of Justice and Narratively that was supported by the John D. and Catherine T. MacArthur Foundation's Safety and Justice Challenge.
A man bound hand and foot struggles to sit upright and hollers, "This is inhumane!"
Another pulls his knees to his chin and, wide-eyed, whispers about telekinesis and the CIA."Someone cut off all my toes," a third man with scars streaking his face says quietly. "I'm so glad I'm finally in the hospital."
But this isn't a hospital.
The Cook County Department of Corrections in Chicago is one of the largest single-site pre-detention facilities in the world, with an average daily population hovering around 9,000 inmates. It is estimated that 35 percent of this population is mentally ill.
According to a May 2015 report by the National Alliance on Mental Illness, Illinois cut $113.7 million in funding for mental health services between 2009 and 2012. Two state-operated inpatient facilities and six City of Chicago mental health clinics have shut down since 2009. The report goes on to detail that Governor Bruce Rauner's 2016 budget proposal to slash $87 million of funding for mental health services could cause an estimated 16,533 adults to lose access to care.
Watch the VICE News documentary on Cook County Jail and mental health behind bars:
Emergency room visits for patients having a psychiatric crisis increased by 19 percent from 2009 to 2012. A 2013 report by Illinois mental health care provider Thresholds found that the increase in ER visits and hospitalizations resulting from the $113 million budget cuts cost Illinois $131 million—almost $18 million more than the original "savings."
Now more patients than ever are being treated in jail rather than at a mental health facility. Cook County Jail has become one of the largest, if not the largest, mental health care provider in the United States. The Cook County Sheriff's Office estimates that it costs $143 per day to house a general population inmate. But when taking into account the treatment, medication, and security required to incarcerate a mentally ill person, the daily cost doubles or even triples.
When people are arrested—even before they visit bond court—within hours they are interviewed by social worker Elli Petacque-Montgomery and her team to screen for mental illness, a procedure unique to Cook County. Among the 60 people screened for mental illness on November 10 of last year after their arrest, 63 percent of women and 37 percent of men were considered mentally ill. Five had previously been involved with the Department of Children and Family Services, often indicating childhood abuse or neglect.
Petacque-Montgomery's team quickly assesses crisis situations and immediately places acutely psychotic, violent, or suicidal arrestees in single cells away from other inmates. People who are psychotic are then sent to CERMAK, the jail's division for physically ill and acutely mentally ill patients. Those with minor mental illness are sent to Division Two, Dorm Two, where they live in dormitory-style bunk beds instead of cells and receive therapy and medication.
After being diagnosed with mental illnesses when they were arrested, the four men interviewed below—Milton, Daniel, Tommy, and Andrew—were all serving time and receiving treatment in Dorm Two.
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