Jail Care for Mentally Ill: Local Failure, National Issue

Last month, the U.S. Department of Justice declared it would sue Los Angeles County unless it dramatically improved the “constitutionally inadequate” care of mentally ill inmates in the county jail system.

The threat was based on a Justice Department probe that found prisoners languishing for weeks without the medication they needed to stabilize their mental conditions. Other inmates were given powerful drugs for mental aberrations they may not have had. Descriptions of their living conditions in cramped, dingy cells read like something out of medieval times.

Since that order, Merrick Bobb, a special counsel to the county Board of Supervisors who is assigned to investigate problems in the Sheriff’s Department, says that there has been progress but not nearly enough. Bobb chided the Sheriff’s Department and the county’s Department of Mental Health for being at loggerheads over how much care to provide. He was also unimpressed by a Mental Health Department memorandum claiming major improvements.

Bobb’s analysis is important, but this situation demands a larger context. Many of the mentally ill inmates in jails here and around the nation are behind bars because of the failure of deinstitutionalization. That was the wholesale closure of mental hospitals (400,000 beds nationwide, by one estimate) that began in the late 1950s and early ‘60s. Meanwhile, the system of community-based outpatient care facilities that the former mental patients were supposed to rely on was never developed properly.

The result has been an accumulation of mentally ill people in homeless shelters around the country, and in jails like those in Los Angeles County.

To be sure, more improvements must be made here. But the bigger problem is that jails have become the new warehouses for the mentally ill, and they are not equipped to handle that task. The shame of it is that some of the current inmates could have led productive lives if they had had access to the mental health facilities that were promised but not delivered.