One Story, Big Impact: Mental Health Advocacy in Jail

This Mental Health Awareness Month, we’re sharing SB’s story—a man with both a mental illness and disability who was incarcerated without the supports he needed. With help from Disability Rights Tennessee (DRT), SB received the care he deserved, and the jail adopted new policies to better serve all inmates. As we mark the 39th anniversary of the PAIMI Act, we’re reminded of what’s possible when people are seen, supported, and protected.

May is Mental Health Awareness Month. In honor of that, we want to share a recent client success story showing how far we have come and how far we still need to go.

SB’s¹ story is sadly a common one. He was living with both a mental illness and an intellectual and/or developmental disability (IDD) in a county jail. While there is not a full count of people like SB in Tennessee jails, we do know this:

• 34% of people, or about 1 in 3 people, in Tennessee jails need special accommodations due to mental illness.²
• Around 40% of state inmates nationwide have some form of an IDD.³
• Tennessee incarcerates people at the ninth highest rate in the world.⁴

SB’s public defender reached out to Disability Rights Tennessee (DRT) and voiced their concerns about the way the jail was not accommodating their client’s needs and the jail staff’s use of force, including tasers. DRT’s Community & Facilities (C&F) Team talked with the public defender, SB, his family, and the jail administrator. The C&F Team also carefully reviewed his records to find the best path forward for our client and others like him.

As the Protection & Advocacy (P&A) agency in Tennessee, our top priority is to make sure that all people living with disabilities and/or mental illness receive safe, respectful, and quality care. By working with the community to address concerns early and trying to resolve issues at the lowest level possible, DRT made direct recommendations to the jail. These included:

We are happy to report that thanks to DRT’s involvement, corrections officers at the jail receive ongoing training on mental health, de-escalation techniques, nonviolent interventions, and crisis intervention. Additionally, shift supervisors are now required to check in daily with inmates who have special needs. As often happens when people with disabilities get the support they need, it helps everyone. SB was moved to a special unit so he could receive personalized care, and the jail raised its standards for all inmates.

What makes this care possible?

DRT is able to provide our services for people like SB because of two powerful legal tools: the Developmental Disabilities (DD) Act and the Protection and Advocacy for Individuals with Mental Illness (PAIMI) Act. Together, these acts give the nationwide Protection & Advocacy (P&A) system the authority to protect the rights of people living with disabilities and/or mental illness in the places where they live, work, learn, or receive other services.

The DD Act was first passed in 1963 after people learned about the horrible conditions in institutions for people with disabilities of all ages. One of the worst examples was Willowbrook, a state-run facility for children with intellectual disabilities in New York. President John F. Kennedy once said the conditions there were, “less comfortable and cheerful than the cages in which we put animals in a zoo.”

In 1972, nine years after the DD Act was passed, Geraldo Rivera exposed what life was really like at Willowbrook for his local ABC affiliate station. The footage was shocking. The building was intended to house 4,000 children but in reality, it housed over 6,000. Inside those overcrowded walls were unsanitary living conditions and a culture of abuse, between guards and patients and between the patients themselves. Due to public outcry, Congress revised the DD Act. These updates defined what a developmental disability was, laid out protections for people with disabilities, and established a national organization to make sure people with intellectual and developmental disabilities can live in integrated environments and be free from abuse and neglect. This national organization, the Protection and Advocacy (P&A) system, is charged with making sure people with disabilities are safe and properly cared for.

Later, on May 23, 1986, Congress passed the Protection & Advocacy for Individuals with Mental Illness (PAIMI) Act, which expanded our work to include children and adults with mental illness. It gave DRT, and the P&A network as a whole, unique access to investigate abuse and neglect in institutional settings and offer comprehensive legal advocacy. This so-called “access authority” means that DRT has the authority to enter and speak to residents in institutions, nursing homes, schools, supported living facilities, and any other space that serves people with disabilities.

In 2000, both the DD and PAIMI acts were updated again. This time, it expanded who we could protect and recognized that disabilities and mental illnesses are life-long conditions and not curable diseases that need to be “fixed.” These updates also allow advocates to work in the broader community, not just institutions, so we can support people wherever they live, work, learn, or receive services.

Because of these laws, DRT can step up for people like SB, to help them stay free from harm, free from discrimination, and free to participate in their community. And during Mental Health Awareness Month, as we mark the 39th anniversary of the PAIMI Act, we celebrate what’s possible when people are seen, supported, and protected.

1. This is a pseudonym to protect our client’s privacy. ↩︎
2. https://www.tn.gov/content/dam/tn/correction/documents/StatisticalAbstract2024.pdf ↩︎
3. https://bjs.ojp.gov/content/pub/pdf/drpspi16st.pdf ↩︎
4. https://www.prisonpolicy.org/global/2024.html ↩︎

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