State psychiatric hospitals nationwide have largely lost the ability to treat patients before their mental health deteriorates and they are charged with crimes. Driving the problem is a meteoric rise in the share of patients with criminal cases who stay significantly longer, generally by court order. In Ohio, the share of state hospital patients with criminal charges jumped from about half in 2002 to around 90% today, while the total number of state psychiatric hospital patients served declined 50% in the past decade, from 6,809 to 3,421.
Systemic Capacity Crisis
Psychiatric hospitals across the nation are short-staffed and consistently turn away patients or leave them waiting with few or no treatment options. The decline in capacity at state facilities has unfolded as local hospitals across the country shuttered their psychiatric units, which disproportionately serve patients with Medicaid or who are uninsured. In Ohio, the median wait time to get a state bed was 37 days in May, what one researcher called “a long time to be waiting in jail for a bed without meaningful access to mental health treatment.” One patient waited 100 days in jail for a bed at a state hospital according to jail records. Long waits, often leaving people needing care lingering in jails, have drawn lawsuits in several states, including Kansas, Pennsylvania, and Washington.
Operational Impact and Safety Concerns
The shift from mostly civil patients to criminally charged patients has changed the hospitals, with escapes becoming more frequent. In the first 10 months of 2024, at least nine patients escaped from Ohio’s regional psychiatric hospitals, compared with three total in the previous four years. After a patient at one Ohio hospital jogged away during a trip to the dentist, state officials stopped allowing patients to leave any of the six regional hospitals—a lockdown that affected treatment and recovery for stable patients. Federal records reveal that at Ohio’s larger state-run psychiatric hospitals, patients and staff have faced imminent danger. In 2019 and 2020, federal investigators responded to patient deaths, including two suicides in six months at one facility. One hospital employee told federal inspectors, “The facility has been understaffed for a while and it’s getting worse,” according to the federal report. Disability Rights Ohio filed a lawsuit alleging abuse and neglect at one facility, citing staff’s response to a patient who suffocated from a plastic bag over their head.
Cases Illustrating System Failure
One man with schizophrenia was hospitalized for about 10 days after requesting his father kill him, but staff released him despite his father begging them to keep him. The patient remembered “not being ready to leave” and being “still sick and still delusional.” Within weeks, he killed a 71-year-old man while delusional, believing the victim had abused him in another life. Another patient bounced between family homes, homeless shelters, jails, clinics, emergency rooms, and psychiatric hospitals over the past year, making the mental health system, in the words of his mother, “easier to criminalize somebody than to get them help.”
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.npr.org/sections/shots-health-news/2025/12/22/nx-s1-5644745/serious-mental-illness-psychosis-psychiatric-hospital-schizophrenia-crime-prison-ohio