The New Asylums: Mental Illness and the U.S. Prison System

The United States is facing a growing crisis: prisons are now home to more people with mental illness than psychiatric hospitals. The shift from mental health facilities to correctional institutions as the default caretakers for those struggling with mental disorders has resulted in profound consequences. With nearly 500,000 individuals diagnosed with mental health issues incarcerated in jails and prisons, compared to just 50,000 residing in psychiatric hospitals, the prison system has become the de facto mental health care provider for America’s most vulnerable.

From Psychiatric Hospitals to Jails

Decades of deinstitutionalization, a policy that began in the 1950s and accelerated in the 1980s, led to the closure of many state-run psychiatric hospitals. The goal was to provide more humane treatment in community settings, but without proper community-based mental health services, many individuals were left without support. As a result, a significant portion of those with severe mental illness ended up in jails and prisons.

In the wake of this shift, police departments found themselves on the frontlines of mental health crises. Officers began encountering individuals exhibiting symptoms of schizophrenia, bipolar disorder, and other psychiatric conditions, often resulting in incarceration. With no other place to turn, mentally ill individuals were cycled through the criminal justice system rather than receiving the treatment they desperately needed.

The Strain on the Prison System

Prisons, by design, are meant to house individuals who have committed crimes—not to provide medical or mental health care. Yet, in reality, jails across the country have become the largest “mental health” institutions, with a significant number of inmates requiring psychiatric care. This includes individuals suffering from schizophrenia, paranoid delusions, severe depression, and other psychiatric disorders.

For those suffering from mental illnesses, prison is not only an unsuitable environment for rehabilitation but one that exacerbates their conditions. The stress and isolation of incarceration can lead to dangerous mental health deterioration, with many prisoners self-harming, engaging in suicidal behavior, or experiencing psychotic episodes.

Inmates with Mental Illness: A Growing Crisis

One striking example of the mental health crisis in prisons is the experience of inmates like Robert Bankston, who was incarcerated for a robbery in 1989. Bankston, diagnosed with paranoid schizophrenia, frequently experienced psychotic episodes and self-injurious behaviors during his time in maximum-security prison. Without proper care or medication, his condition worsened, leading to violent outbursts, including head-banging and episodes of delusional thinking.

As the narrative in the documentary highlights, mental health treatment in prison is minimal, and many inmates, like Bankston, resist taking their prescribed medications. This creates a vicious cycle: the lack of treatment leads to further decompensation, which in turn leads to more severe behaviors that worsen their mental health.

The Role of the Prison System in Mental Health Care

The fact remains that prisons are not equipped to treat severe mental illnesses effectively. Security and safety are the primary concerns in correctional facilities, leaving little room for mental health care. Inmates with psychiatric conditions often struggle to adhere to the basic rules of prison life, resulting in conflict with staff and fellow prisoners. In some cases, this leads to solitary confinement, which can further deteriorate their mental health.

For instance, in Ohio, reforms have been made to address the rising mental health needs within the prison system. Mentally ill inmates are separated from the general prison population and housed in mental health units where they can receive specialized care, including medication and psychiatric support. While these units are an improvement, the overall system still struggles to address the growing needs of mentally ill inmates.

A Call for Change

The situation in America’s prisons is clear: they are failing to meet the needs of the mentally ill. The U.S. criminal justice system was never designed to serve as a mental health provider, yet it has increasingly become one. The vast number of mentally ill individuals incarcerated in U.S. jails and prisons demonstrates a systemic failure that requires urgent attention.

Experts argue that more needs to be done to provide mental health care outside of prisons. This includes better community-based mental health services, more accessible psychiatric hospitals, and a shift away from incarceration for individuals suffering from serious mental disorders. Until then, the prison system will continue to house an alarming number of mentally ill inmates who are in dire need of the care and support that they simply cannot receive behind bars.

Conclusion

The story of mentally ill individuals being incarcerated in jails and prisons is not a new one, but it remains an ongoing tragedy. While some reforms have been implemented, the mental health crisis within America’s prisons is far from solved. To truly address the needs of the mentally ill, we must look beyond the prison walls and focus on creating a more robust and accessible mental health care system that prevents individuals from entering the criminal justice system in the first place. Until this shift occurs, the disturbing trend of prisons becoming the new asylums will likely continue.