Alabama severe mental illness information, laws, & helpful resources

The term severe mental illness (SMI) includes schizophrenia spectrum disorders, severe bipolar disorder, and major depression with psychotic features. These disorders put an individual at high risk for criminalization and preventable tragedies such as victimization and suicide. Every state has different laws and policies around accessing treatment for SMI and some states have more resources and treatment options than others. Here you will find state-specific resources for navigating the SMI treatment system, an evaluation of local laws, as well as state SMI data and research.

State of Alabama next to Treatment Advocacy Center text, symbolizing local severe mental illness data, laws, and resources

Family Resources in Resources in Alabama

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How many people in Alabama have SMI?

134875

individuals with severe mental illness.

55953

individuals with SMI who receive treatment in a given year.

3.42 %

of the adult population is estimated living with a SMI in the United States.

State psychiatric hospital beds in Alabama

2023 total beds: 408
  • Civil beds: 268
  • Forensic beds: 140
2023 beds per 100,000 people: 8

Click here for more information about state psychiatric hospital beds in Alabama.

A minimum of 50 beds per 100,000 people is considered necessary to provide minimally adequate treatment for individuals with severe mental illness. Alabama fails to meet this minimum standard.

For Additional Information

Data is a powerful tool to advocate for change. Curious about a specific data point in your state? Reach out to us at ORPA@treatmentadvocacycenter.org

Fast Facts on SMI in Alabama

Deinstitutionalization, outdated treatment laws, discriminatory Medicaid funding practices, and the prolonged failure by states to fund their mental health systems drive those in need of care into the criminal justice and corrections systems.

Prevalence of SMI in jails and prisons
19%
Estimated number of inmates with SMI in 2021
7,800
State psychiatric inpatient beds 2023
408
Likelihood of incarceration versus hospitalization
19 to 1

2021 Alabama State Mental Health Agency's expenditures

Every state receives block grant funding from the federal government to provide mental health services to their community. Below is some information about how these dollars are spent and compares to other state spending.

SMHA expenditures
$391,337,880
Percentage of expenditures for state hospitals
23%
Expenditures per person served by the public mental health system
$4,124
Percentage of SMHA expenditures of total state budget
1.2%

Alabama's Treatment Laws

ALA. CODE § 22-52-91(a) 1. When a law enforcement officer is confronted by circumstances that give the law enforcement officer reasonable cause for believing that an individual within the county has a mental illness and that the individual is likely to pose a real and present threat of substantial harm to self or others, the law enforcement officer shall contact a community mental health officer. The community mental health officer shall join the law enforcement officer at the scene and location of the individual to assess the condition of the individual and determine whether the individual needs the attention, specialized care, and services of a designated mental health facility. 2. If the community mental health officer determines from the conditions, symptoms, and behavior that the individual appears to have a mental illness and poses a real and present threat of substantial harm to self or others, the law enforcement officer shall take the individual into custody and, together with the community mental health officer, deliver the individual directly to the designated mental health facility. 3. At the designated mental health facility, a responsible employee of the facility who is on duty and in charge of admissions to the facility shall be informed by the community mental health officer that the individual in custody appears to have a mental illness and is in need of examination and observation. 4. In determining whether an individual poses a real and present threat of substantial harm to self or others, all available relevant information shall be considered, including any known relevant aspects of the individual’s psychosocial, medical, and psychiatric history, in addition to the individual’s current behavior.

ALA. CODE § 22-52-1.2(a) Any person may file a petition seeking the involuntary commitment of another person. ALA. CODE § 22-52-10.4 a) A respondent may be committed to inpatient treatment if the probate court finds, based upon clear and convincing evidence, that all of the following are true: 1. The respondent has a mental illness. 2. As a result of the mental illness, the respondent poses a real and present threat of substantial harm to self or others. 3. The respondent, if not treated, will continue to suffer mental distress and continue to experience deterioration of the ability to function independently. 4. The respondent is unable to make a rational and informed decision as to whether or not treatment for mental illness would be desirable. b) If the probate judge finds that no treatment is presently available for the respondent’s mental illness, but that confinement is necessary to prevent the respondent from causing substantial harm to himself or herself or to others, the order committing the respondent shall provide that, should treatment for the respondent’s mental illness become available at any time during the period of the respondent’s confinement, that treatment shall be made available to him or her immediately. c) In determining whether an individual poses a real and present threat of substantial harm to self or others, all available relevant information shall be considered, including any known relevant aspects of the individual’s psychosocial, medical, and psychiatric history, in addition to the individual’s current behavior.

ALA. CODE § 22-52-10.2 a) A respondent may be committed to outpatient treatment if the probate court finds, based upon clear and convincing evidence, all of the following: 1. The respondent has a mental illness. 2. As a result of the mental illness, the respondent, if not treated, will suffer mental distress and experience deterioration of the ability to function independently. 3. The respondent is unable to maintain consistent engagement with outpatient treatment on a voluntary basis, as demonstrated by either of the following: a. The respondent’s actions occurring within the two-year period immediately preceding the hearing. b. Specific aspects of the respondent’s clinical condition that significantly impair the respondent’s ability to consistently make rational and informed decisions as to whether to participate in treatment for mental illness.

Recommended updates to treatment laws

  1. 1

    Amend Ala. Code § 22-52-91(a) to authorize citizen right of petition for at least enumerated citizens, preferably any responsible adult, for emergency evaluation

  2. 2

    Adopt express procedures for the court to monitor uncontested AOT orders entered into voluntarily to give the benefit of the black robe effect to all enrollees