Criminalizing Serious Mental Illness: What Linked Urban Data Reveal and the Case for Community Care

The United States has responded to multiple societal ills, from substance use to homelessness to mental health, with criminalization. A new analysis using City and County of San Francisco data shows jails disproportionately harm people with serious mental illness (SMI). In addition to longer periods of incarceration and higher rates of repeat jail bookings, people with SMI also experience higher rates of homelessness, co-occurring substance use disorder, and urgent and emergent health services utilization before and after incarceration compared to their peers without SMI. The study provides a much-needed spotlight on jail research, as well as demonstrating the power of data when not siloed in multiple, disparate departments. Investing in community-based mental health resources, housing, and substance use disorder services can address the upstream determinants of incarceration and may benefit people with SMI.