Jails and prisons are the largest “mental institutions” in California, holding far more people with severe psychiatric illnesses than state hospitals, according to a report released last Tuesday by the Treatment Advocacy Center and the National Sheriffs’ Association.

“For a state with 38 million people — 1 in every 8 Americans lives in California —there are almost no public psychiatric beds available for individuals with serious mental illness,” the report states.

There are a total of 4,652 beds at Metropolitan, Patton, Napa, and Atascadero state hospitals, but 88 percent of them are reserved for mentally ill individuals who have been charged with crimes, according to the report. Another state hospital at Coalinga, the report says, is used almost exclusively for sexually violent predators.

There are more than 33,000 mentally ill inmates in California’s major prisons, according to the Associated Press. That’s 28 percent of the 120,000 inmates in those prisons.

According to Tuesday’s report, 26 of California’s 58 counties have no psychiatric inpatient beds.

“For mentally ill individuals who need to be hospitalized briefly to become stabilized on medication, this leaves few options,” the report states.

The Affordable Care Act has expanded treatment coverage for those with certain mental illnesses, but some advocates say it doesn’t go far enough. It doesn’t require states to have a certain number of inpatient psychiatric beds, for example.

California jails and prisons are also unequipped to effectively treat patients with mental illness, the report says.

Last Thursday, a federal judge ruled that the state’s treatment of mentally ill inmates is unconstitutional because it involves cruel and unusual punishment through excessive use of pepper spray and isolation.

According to the Associated Press, the ruling came after the public release of videotapes made by prison guards. The footage shows the guards throwing chemical grenades and pumping large amounts of pepper spray into the cells of mentally ill inmates, some of whom are heard screaming.

“Most of the videos were horrific,” U.S. District Court Judge Lawrence Karlton wrote in his 74-page ruling.

Karlton ordered the state to update its polices on the use of pepper spray and isolation units, but did not ban the methods.