Hundreds of people with mental illness sweat out jail time in Richmond with no medication -- the most basic care of all.

Like troubled inmates elsewhere, they receive little treatment, and most spend their time mixed with the jail's general population, where fear, threats and violence are part of daily life.

Fewer than one out of four Richmond City Jail inmates with mental illness received any kind of medication, a Richmond Times-Dispatch review of state data shows. The jail routinely holds 1,400 to 1,600 inmates, and in a recent Virginia Compensation Board report, 18 percent were mentally ill.

About one out of five of the most ill -- inmates diagnosed with schizophrenia or other delusional syndromes, as well as those with bipolar disease or major depression -- received medications designated for their conditions.

"They should be treating 99.9 percent of the people with psychoses," said E. Fuller Torrey, a psychiatrist and president of the Treatment Advocacy Center, a nonprofit group that pushes for better care for people with severe mental illnesses.

"It probably means they're just treating the people who are giving them trouble -- the paranoid schizophrenic in the back who's not talking probably isn't being treated."

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In contrast, state figures show that Chesterfield and Henrico counties' jails, as well as the regional jails serving Hanover County and the Tri-Cities, disburse enough psychiatric medication to treat all their inmates with mental illness.

In fact, the numbers for Chesterfield, the Pamunkey Regional Jail and the Riverside Regional Jail show that inmates often were given more than one medication for their illness.

But even in these jails, many of the most severely mentally ill don't receive antipsychotics, data show.

Richmond Sheriff C.T. Woody says his aging, overcrowded facility has been a dumping ground for people with mental illness and that he doesn't have the resources to cope.

People with mental illness often end up in jail after an arrest rather than in a hospital because they don't meet the state standard for commitment, which experts say is the strictest in the nation.

In Virginia, a social worker, a magistrate and judge all must agree that people are about to kill themselves or harm others or are completely incapable of caring for themselves in order to send someone to a mental hospital. The General Assembly this year is considering legislation that would lower the threshold for involuntary commitment.

After a story in The Times-Dispatch last year, state and local officials started working on a plan to improve care at the jail.

The newspaper reported then, as data from the Compensation Board show, that hundreds of inmates with mental illness serve their sentences mixed with the general population. The board's figures come from a survey to count inmates with mental illness and mental-health services as of October. Not all jails completed the survey.

The Times-Dispatch found that the Richmond jail did not have a consulting psychiatrist, relying instead on a medical director whose specialty is geriatrics, while inmates complained they often did not receive medications they needed or counseling they craved.

The jail dispenses mainly Haldol to the schizophrenic and bipolar inmates, but the state data show that other jails rely more heavily on newer, costlier medications.

"Whether individuals are in jail or in the community, they should have access to treatment that is the standard of care to include access to newer antipsychotic medications," said Meghan McGuire, spokeswoman for the state Department of Mental Health, Mental Retardation and Substance Abuse Services.

The Richmond City Jail still does not have a consulting psychiatrist. Most other jails do, and Henrico has a staff psychiatrist.

The Richmond jail's longtime psychologist has left, and spokeswoman Tara Dunlop said staff members are scrambling to improve services, with the nurse in charge of the jail's clinic spending much of her day inside a special mental-health unit. That unit houses about one-fifth of the jail's inmates with mental illness.

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Compensation Board data show that Richmond spends far less on mental-health services and medication than most other jails. The board monitors the expenses of jails in the state because it pays for most of their operating costs. Richmond officials, however, have complained that rising medical expenses are driving up the city's contribution to the jail's budget.

The city jail spends the equivalent of $25 per week for each inmate with mental illness, compared with $59 in Chesterfield and $141 in Henrico.

But David Harmon, who runs the Middle Peninsula Regional Security Center in Saluda, argues that it is worth the $384,000 a year his regional jail spends on mental-health care and medication.

"I still say we save money over the long haul by turning out people who are in better shape than we received them," Harmon said.

More than 80 percent of the jail's schizophrenic and bipolar inmates receive antipsychotic medications. Harmon said many of them start or restart taking medicine while in jail, adding that his staff works closely with local agencies to make sure people keep taking medications once they are out of jail.

Many, he says, stay out.

"A lot of people function better in jail than they do on the street, and it's because they maintain their medications in jail," Henrico Sheriff Mike Wade said.

"I'm interested in things that keep them out of the jail, and the medication is what will keep them out of jail if they can stay on it." Contact David Ress at (804) 649-6051 or dress@timesdispatch.com.