Jails in America: The New 21st Century Psychiatric Hospitals

men together inside a prison cell

Before the 20th century, most individuals who suffered from mental illness were kept in psychiatric hospitals and sanitariums. These institutions were overcrowded, unsanitary, and dehumanizing. In the mid-19th century, Dorothea Dix began an effort to improve mental health treatment by creating the first mental hygiene programs in the United States, eventually resulting in various state laws that forced communities to build new psychiatric hospitals and reform existing ones.

man in a jail wearing orange shirt looking at a picture
Photo by RODNAE Productions on Pexels.com


The United States has the highest rate of incarceration in the world. Currently, there are over 1.8 million people incarcerated, with about 1.2 million of them being held in state and federal prisons and an additional 573,000 under local or county jurisdiction. This is a population that exceeds that of any country other than China and Russia combined. With numbers this high, jail becomes a form of psychiatric hospital for many inmates who have mental health issues but can’t get treatment because they’re behind bars.

Mentally Ill People are Being Punished for their Illness

The mentally ill are the most vulnerable population in our society. They are often the victims of a society that has no patience for their conditions and punishes them for their illnesses. They are over-represented in the prison system, often paying a high price for crimes they would never have committed if not for their illness. With mental health services so difficult to access and prisons overcrowded, jails have become the new psychiatric hospitals.

A Brief History of American Prisons

As of 2021, the United States has the largest prison population in the world, with an estimated 1.8 million people incarcerated at any given time. In addition to being the largest, it is also the most racially disproportionate prison population, with a majority of inmates being African American or Latino. The U.S. locks up 639 people per 100,000 citizens for non-violent crimes. With all these prisons overpopulated and spending skyrocketing year after year on corrections systems, it still begs the question – have we turned our jails into new psychiatric hospitals?

The Incarceration Problem

“The United States has an incredibly high number of incarcerated individuals. Therefore, the incarceration problem has become a widely contested issue because it impacts disadvantaged people and marginalized groups the most. Additionally, the prison system has become capitalized by outside corporations which fund prisons, but there is still a high cost to tax-payers. Furthermore, there has been an increase in the number of private prisons that have been created. For-profit prison companies have come under scrutiny because of their lack of satisfactory staff and widespread lobbying. Violent offenses are the most common type of offense among prisoners in the U.S.” – https://www.statista.com/statistics/262961/countries-with-the-most-prisoners/

What Can be Done to Make Prisons Safer for Everyone Involved?

The question of what can be done to make prisons safer for everyone involved is a tough one. One way that correctional institutions have tried to accomplish this is using solitary confinement cells, which are often used as a form of punishment or deterrence. Inmates are placed in these cells with little human contact and with no outside stimuli, which studies show has detrimental effects on mental health. Without any stimulation to occupy their time, inmates are left with nothing but their thoughts, which usually leads to anxiety, hallucinations, and depression. There needs to be some sort of reform for inmates who enter prison suffering from mental illness so that they can receive treatment before their condition worsens; this will lead to better outcomes not only for them but also for other inmates who share space with them.

How do we change from Punishing Mentally Ill People to helping them?

In order to change the current system, we must first understand why this is happening and what can be done. We have seen a dramatic shift in how people are treated for mental illness. In the past, when an individual was suffering from a mental illness, he or she would be admitted to a psychiatric hospital for treatment and care. Today, that person is more likely to go to jail or prison. Why? Part of it stems from stigma- many believe that individuals who commit crimes are also mentally ill. So instead of providing them with treatment, they’re locked up. Partly it has to do with limited resources; jails and now hospitals often don’t have enough psychiatrists on staff, and they need the beds for other inmates and patients. And partly its due to high recidivism rates- jails provide fewer opportunities for rehabilitation than hospitals did before society turned its back on them. We need to reverse this treatment of those with mental illnesses.–MM






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