In this chapter we consider how people with mental illness and disabilities (together, mental disorders) have been thought of and treated over time, leading up to the present day. People with mental disorders have, throughout history, been excluded from basic opportunities due solely to their illness or disability. Denied opportunities include receiving an education, accessing or getting paid for employment, participating in government, and even living freely in the community. Routine confinement of people with mental disorders was well-accepted American practice through the majority of the country’s history. Too often, mistreatment of people with mental disorders has gone beyond mere exclusion and included abuses meant to eliminate mental disorders. Barriers and stigma around mental disorders do not stop at the doors of the legal system; problems are heightened for people who in addition to their mental disorders are also involved in the criminal justice system. This group of people is the focus of this textbook.

A theme throughout this text, and a purpose for which it was written, is to highlight and combat the persistent mistreatment faced by people with disabilities generally, and mental disorders in particular, especially as they come into contact with the criminal justice system. The risk of people with mental disorders experiencing mistreatment or harm is exacerbated (inside and outside of criminal justice) when impacted people fall into the intersection of multiple vulnerable groups due to factors (such as racial or gender identity, or poverty) in addition to disability. The existence and impact of these intersections is often noted in this text. As you observe the history shared in this chapter, you will learn about the progress we have made in our treatment of people with mental disorders. You will also see how much work remains to be done as we move forward to a criminal justice system that better serves this population and thus our community as a whole.