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‘The New Asylums’



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A horrifying story in the Wall Street Journal:

The country’s three biggest jail systems — Cook County, in Illinois; Los Angeles County; and New York City — are on the front lines. With more than 11,000 prisoners under treatment on any given day, they represent by far the largest mental-health treatment facilities in the country. By comparison, the three largest state-run mental hospitals have a combined 4,000 beds.

Put another way, the number of mentally ill prisoners the three facilities handle daily is equal to 28% of all beds in the nation’s 213 state psychiatric hospitals, according to the National Association of State Mental Health Program Directors Research Institute Inc.

“In every city and state I have visited, the jails have become the de facto mental institutions,” says Esteban Gonzalez, president of the American Jail Association, an organization for jail employees.

The crux of the matter is whether we’re going to find a way to treat more of the mentally ill, or continue to let them rot in jail:

The picture echoes the past. Two centuries ago, reformers were disturbed to find large numbers of the mentally ill in jails, paving the way for the development of state-run institutions. In the 1950s and 1960s, complaints about abuses, advances in medication and a push to give the patients more independence led to another change, this time toward community settings. The weaknesses of that concept — a lack of facilities, barriers created by privacy laws and tightened local and state funding — has brought the picture full circle.

“Society was horrified to warehouse people in state hospitals, but we have no problem with warehousing them in jails and prisons,” says Thomas Dart, sheriff of Cook County.



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