The walking wounded are all around us, on the streets of San Francisco, Berkeley, Santa Rosa and Santa Cruz. They talk to themselves, to their long-suffering pets they drag along with them, to the gods above who clearly aren’t listening. Who’s crazier — the mentally ill howling at the demons in their heads, or the rest of us, who simply walk on by and pretend not to see?

The torment that afflicts these men and women is generally contained within. Only when it bursts menacingly into the open do we seem to intervene, with security guards escorting the madly bellowing from restaurants and stores back to the streets. In the most alarming cases, the police are called — forced into the dual roles of public safety protectors and psychiatric social workers. The consequences are sometimes tragic. People with mental illness are 16 times more likely to be killed by police in the United States, according to a report prepared last year for San Francisco District Attorney George Gascón.

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According to a recent report by the Stanford Law School Justice Advocacy Project, the number of prisoners in California with mental illness is on the rise, including those with severe psychiatric symptoms, whose number has increased by more than 60 percent since 2012. This growing mental health crisis comes even as reforms relieve prison overcrowding and alleviate other conditions behind bars. But these benefits, according to the report, are not being shared by mentally ill prisoners, who receive longer sentences and are often denied eligibility for early release granted to other inmates.

“Research shows that community based psychiatric treatment is frequently more effective and significantly less expensive than in-prison treatment at preventing crime and reducing incarceration rates for people with mental illness,” the report concludes. And yet even liberal Bay Area counties are still emphasizing incarceration over treatment, according to the report: “Among California’s 10 largest counties, Alameda County sends the largest percentage of inmates with mental illness to state prison (42 percent) and Orange County sends the smallest (24 percent). … Even counties with robust behavioral health courts and diversion programs, like San Francisco, send a higher percentage of mentally ill defendants to prison compared to the state average.”