Prison, America's 'new asylums'

Matthew T. Mangino
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Prisons, America’s ‘new asylums’

A new report by the Treatment Advocacy Center, a nonprofit dedicated to the treatment of the mentally ill, found that the number of individuals with serious mental illness in prisons and jails now exceeds the number in state psychiatric hospitals by a factor of ten.
In 2012, there were more than 356,000 inmates with severe mental illness in prisons and jails nationwide. There were only 35,000 mentally ill individuals in state psychiatric hospitals.

The report entitled The Treatment of Persons with Mental Illness in Prisons and Jails suggests that prisons and jails have become America’s “new asylums.”
In 44 of 50 states a prison or jail holds more individuals with serious mental illness than the largest remaining state psychiatric hospital in those states.

Mental health agencies are not the only entities sounding the alarm. Cook County, Illinois Sheriff Tom Dart contends that society has cast aside the mentally ill, and that is the primary reason why prisons are overcrowded.
The Cook County Jail is currently the largest mental health facility in the United States with 30-35 percent of its roughly 9,000 inmates living with a serious mental illness.

Bob Carolla, a spokesman for the National Alliance on Mental Illness, told the Chicago Defender, without access to “adequate and effective” mental health treatment people will simply end up in the prison system.

Untreated psychiatric illness often gets worse. The problems are not just inside the prison walls. Many inmates with mental health problems leave prison more unstable than when they entered. The treatment of inmates with mental illness can be very costly and is often a strain on corrections’ budgets.
Just as important, inmates who are transitioning back into the community need to have immediate and seamless mental health services. Without adequate treatment the results can be catastrophic.

Last weekend in Brooklyn, a man with a history of psychiatric commitments, was accused of stabbing two children in an elevator, fatally wounding one. Investigators said he may not have connected with mental health services after being released from prison a week earlier.
Last December, President Barack Obama told an audience at the National Conference on Mental Health, “[L]ess than 40 percent of people with mental illness receive treatment.”


It is extremely difficult to find a bed for a seriously mentally ill person who needs to be hospitalized. In 1955 there was one psychiatric bed for every 300 Americans. In 2005 there was one psychiatric bed for every 3,000 Americans.
The Treatment Advocacy Center found that one of the driving forces behind the closure of state mental hospitals is based on the premise that it saves money.
Those savings may be illusory.

The Center makes a cogent argument for an unbiased cost assessment that identifies the comprehensive expense of incarcerating mentally ill individuals and provide public officials with a more accurate basis for making mental illness treatment policy.

(Matthew T. Mangino is of counsel with Luxenberg, Garbett, Kelly & George P.C. His book The Executioner’s Toll, 2010 was recently released by McFarland Publishing. You can reach him at and follow him on Twitter @MatthewTMangino)