D.J. Jaffe warns that the ongoing closure of mental hospitals is turning prisons into de facto psychiatric wards:
New York City’s Rikers Island jail already has more mentally ill than all the state hospitals combined. Despite that, the New York State Office of Mental Health is pushing a plan to close more mental hospitals in the state. … New York claims state psychiatric hospitals are not needed and points to California and Texas as role models. They have only five and eight state psychiatric hospitals, respectively, compared with New York’s 24. But both states have more than twice as many mentally ill incarcerated as New York does. In California, the mentally ill are almost four times as likely to be incarcerated as hospitalized. In Texas, it is eight times.
Why choose mass incarceration of the mentally ill over treatment? It’s not a matter of cost savings:
[Psychiatry professor Linda] Teplin says that while it is certainly not a cheaper system, it is easier to get support for new correctional facilities than it is obtain funds to provide mental health care in the community. She also says stigma can play a role in what gets backing, since people with severe mental illnesses on the street are not representative of all people with mental health needs. “They may engage in bizarre behavior,” she says. “Many people are afraid of people with severe mental illnesses. They’re not a sympathetic group.” Teplin says it would likely take a major public figure – perhaps with an ill family member to take leadership in this area for any real policy change to move forward.