PRISONS CALLED NATION'S NEW MENTAL HOSPITALS.

Byline: Fox Butterfield The New York Times

The first comprehensive study of the rapidly growing number of emotionally disturbed people in the nation's jails and prisons has found that there are 283,800 inmates with severe mental illness, about 16 percent of the total jail population. The report confirms the belief of many state, local and federal experts that jails and prisons have become the nation's new mental hospitals.

The study, released by the Justice Department on Sunday, paints a grim statistical portrait, detailing how emotionally disturbed inmates tend to follow a revolving door from homelessness to incarceration and then back to the streets with little treatment, many of them arrested for crimes that grow out of their illnesses.

According to the report, mentally ill inmates in state prisons were more than twice as likely to have been homeless before their arrest than other inmates, twice as likely to have been physically and sexually abused in childhood and far more likely to have been on drugs or alcohol.

In another reflection of their chaotic lives, the study found that emotionally disturbed inmates had many more previous incarcerations than other prisoners. More than three-fourths of them had been sentenced to jail or prison before, and half had served three or more prior sentences.

Many of them were arrested for bizarre public behavior or petty crimes like loitering or public intoxication. But the report, by the Justice Department's Bureau of Justice Statistics, also found that mentally ill inmates in state prisons were more likely than other prisoners to have been convicted of a violent crime.

Moreover, once incarcerated, emotionally disturbed inmates in state prisons spend an average of 15 months longer behind bars than other prisoners, often because their delusions, hallucinations or paranoia make them more likely to get in fights or receive disciplinary reports.

``This study provides data to show that the incarceration of the mentally ill is a disastrous, horrible social issue,'' said Kay Redfield Jamison, a professor of psychiatry at the Johns Hopkins School of Medicine. ``There is something fundamentally broken in the system that covers both hospitals and jails,'' said Jamison, the author of ``Night Falls Fast: Understanding Suicide,'' to be published later this year by Knopf.

With the wholesale closings of public mental hospitals in the 1960s, and the prison boom of the past two decades, jails and prisons are often the only institutions open 24 hours a day and required to take in the emotionally disturbed.

The hospitals were closed at a time when new antipsychotic drugs made medicating patients in the community seem a humane alternative to long-term hospitalization. From a high of 559,000 in 1955, the number of patients in state hospitals dropped to 69,000 in 1995.

But drugs work only when taken, and many states failed to build a promised network of clinics to monitor patients. To compound the problem, for-profit hospitals began turning away the psychotic.

At the same time, the number of jail and prison beds has quadrupled in the last 25 years, with 1.8 million Americans now behind bars.

``Jails have become the poor person's mental hospitals,'' said Linda A. Teplin, a professor of psychiatry and director of the psycho-legal studies program at Northwestern University.

All previous estimates of the number of emotionally disturbed inmates have been based on research by Teplin in the Cook County Jail in Chicago. She found that 9.5 percent of male inmates there had experienced a severe mental disorder like schizophrenia, manic depression or major depression, four times the rate in the general population.

Teplin said that while she welcomed the Justice Department count, it was open to question because the study relied on reports by the inmates themselves, who were asked whether they had a mental condition or had ever received treatment for a mental problem. People with emotional disorders often are not aware of them, or do not want to report them, she said, so the Justice Department estimate of more than a quarter-million inmates with mental illness may actually be too low, Teplin said.

In addition, Teplin said, the study was not conducted by mental health professionals using diagnostic tests, so it was impossible to tell what mental disorders the inmates suffered from, and whether they were severe illnesses, like schizophrenia, or generally less severe problems, like anxiety disorders.