Care, Not Cages: Why Mental Health Is a Community Responsibility

We talk a lot about crime in America. We talk about homelessness. We talk about public safety. But what we don't talk about enough is how many of these conversations are actually conversations about mental health.

The truth is uncomfortable: some of the largest mental health "facilities" in the United States are not hospitals, treatment centers, or healing spaces. They are jails.

Rikers Island Jail in New York City, Twin Towers Correctional Facility in Los Angeles, and Cook County Jail in Chicago are now considered the three largest mental health care facilities in the country. Think about that for a moment.

Every year, nearly two million people living with serious mental illness are incarcerated instead of receiving the care, treatment, housing, and support they need. Nearly two in five incarcerated people have a history of mental illness, and many are locked up for nonviolent offenses directly connected to untreated symptoms.

People with mental illness deserve care, not cages.

The Crisis We Pretend Not to See

Many Americans like to believe this is a problem that exists somewhere else. We point to other countries and talk about institutionalization. We shake our heads at stories from abroad. Yet while traveling and speaking with people from different communities, I've often heard conversations about people being hidden away because their mental health symptoms make others uncomfortable.

The hard truth is that we do the same thing here.

We may not always call it institutionalization, but too often we respond to people struggling with mental health challenges by removing them from public view rather than addressing the root causes of their suffering.

I think about the Bay Area during major events. During the most recent Super Bowl, many people noticed something strange. Suddenly, there seemed to be far fewer unhoused individuals and fewer people visibly experiencing psychosis in public spaces.

Where did they go?

Seriously.

Where did they go?

There certainly weren't enough shelter beds available for everyone. There wasn't a sudden wave of affordable housing. There wasn't a miracle expansion of mental health services.

Yet somehow, the people many of us had grown accustomed to seeing every day were no longer visible.

As a society, we have become incredibly skilled at making vulnerable people disappear from sight without actually solving the problems they face.

How Mental Illness Becomes Criminalized

The criminalization of mental illness doesn't happen overnight.

It happens when someone can't access treatment because the waitlist is months long.

It happens when a person experiencing psychosis has nowhere safe to go.

It happens when someone loses housing because their symptoms make it difficult to maintain employment.

It happens when communities invest more in punishment than prevention.

Many people with moderate to severe mental illness are repeatedly arrested for survival-based behaviors such as trespassing, loitering, disorderly conduct, or petty theft. These are often symptoms of larger systemic failures rather than indicators of criminal intent.

The closure of psychiatric hospitals over the past several decades, combined with inadequate investments in community-based care, has left countless individuals without meaningful support systems.

As a result, jails have become the default response to mental health crises.

And they are failing.

Approximately two-thirds of incarcerated individuals with mental health challenges receive no mental health treatment while in custody. The jail environment itself can worsen symptoms through isolation, trauma, instability, and the use of solitary confinement.

For individuals experiencing depression, schizophrenia, bipolar disorder, PTSD, or other serious mental health conditions, incarceration often deepens the crisis instead of resolving it.

The Cost of Looking Away

The human cost is heartbreaking.

People lose years of their lives cycling through jails, emergency rooms, shelters, and temporary housing.

Families are separated.

Children lose parents.

Communities lose neighbors.

And taxpayers spend billions of dollars funding a system that is far more expensive than community-based treatment, supportive housing, and preventative care.

The financial burden alone should concern us.

But beyond the dollars and cents, we have to ask ourselves a more important question:

What kind of community do we want to be?

Do we want to be a society that responds to suffering with punishment?

Or one that responds with care?

What We Can Do Differently

The good news is that solutions exist.

Communities across the country are proving every day that treatment works better than incarceration.

Mental Health Courts are helping divert people into treatment programs instead of jail cells.

Mobile Crisis Teams provide trained mental health professionals who can respond to emergencies without escalating situations through arrest.

Crisis Intervention Team (CIT) programs equip officers with specialized training to recognize and respond to psychiatric emergencies.

Organizations like The Bail Project are helping people return home before trial by paying bail for individuals who cannot afford it. For people struggling with mental illness, avoiding unnecessary pretrial detention can prevent additional trauma and keep symptoms from worsening.

These programs save lives. But they only work when communities support them.

Taking Care of Each Other

Mental health is not solely an individual responsibility. It's a family responsibility. A neighborhood responsibility. A community responsibility.

We all have a role to play.

Check in on your loved ones. Pay attention when someone seems withdrawn, overwhelmed, paranoid, or in distress. Learn about mental illness before a crisis occurs. Advocate for better services in your community. Vote for policies that prioritize treatment and housing over incarceration. And most importantly, stop viewing people experiencing mental health challenges as problems to be removed.

They are our family members.

They are our friends.

They are our neighbors.

They are us.

If Someone You Love Is in Crisis

If someone is experiencing a mental health emergency, consider alternatives before calling law enforcement whenever it is safe to do so.

Call or text 988 to reach trained mental health crisis professionals.

Request a Mobile Crisis Team if one is available in your area.

If legal charges are involved, ask about Mental Health Court or diversion programs that prioritize treatment instead of incarceration.

Work with attorneys, healthcare providers, and family members to document psychiatric history and treatment needs so courts have a fuller picture of what is happening.

These steps can make the difference between someone entering treatment or entering the justice system.

A Future Worth Fighting For

Despite everything, I remain hopeful.

I see hope in families who refuse to give up on their loved ones.

I see hope in advocates pushing for reform.

I see hope in clinicians, peer support specialists, outreach workers, and community members showing up every day for people who are struggling.

I see hope in every conversation that challenges the idea that jail is an acceptable substitute for mental health care.

The reality is that any one of us could find ourselves or someone we love face a mental health crisis. The question is whether we will continue building systems that punish people for suffering or create communities that help them heal.

We don't need bigger jails.

We need stronger communities.

We need more compassion.

We need more treatment.

We need more housing.

We need more understanding. And above all, we need to remember that people experiencing mental illness are not disposable. They are worthy of dignity, support, and the opportunity to recover. Care, not cages, should always be the goal.