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Manhattan Institute

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The Case to Bring Back the Asylum


The Case to Bring Back the Asylum

The Wall Street Journal May 19, 2018
Health PolicyMental Illness

A new generation of flexible, varied institutions would help reduce the vast numbers of mentally ill adults in jails and prisons

When Richard Quintero broke into a Pizza Hut in High Point, N.C., early one morning in late March, he called 911 himself to let the police know. “Yes, this is Jesus Christ and I just broke into the Pizza Hut,” he said, according to a recording of the call. He then told the dispatcher that he was schizophrenic and kept getting kicked out of homes. When the police arrived, Mr. Quintero was cooperative but was still arrested on charges of felony breaking and entering and felony larceny. He spent time at a state prison before being found incompetent to stand trial and sent for a short-term stay at a state mental hospital.

It is difficult to imagine how ethically sound treatment of mentally ill prisoners can be delivered.

Many in his situation, unfortunately, tend to stay behind bars: In the U.S. today, jails and prisons have become our mental asylums. The Bureau of Justice Statistics estimates that some 365,000 American adults with serious mental illness are behind bars and an additional 770,000 are on probation or parole. A 2017 Justice Department study estimates that some 37% of all prison inmates suffer some mental illness and that 26.4% of jail inmates suffer from a psychosis.

They are behind bars because, too often, they have nowhere to go. Two generations of policy have led to the mass closing of state mental hospitals. The extent of the resulting problems—for the seriously mentally ill in general, not just those in jails or prisons—is so widespread that a case is building to bring back the asylum, especially for those who pose a risk to others or themselves. But proponents aren’t advocating for a return of the inhumane places of the past. What’s needed is a new generation of flexible and varied institutions.

To understand the problem, it helps to look back at the history of asylums. In 1840, Dorothea Dix, the former headmistress of a Boston school for girls, had completed a trip to England meant to help recover her health. Influenced by Quaker reformers there, she was exposed to the cause then known as “lunacy reform”—the idea that government had an obligation to care for the mentally ill.

Continue reading the entire piece here at The Wall Street Journal


Howard Husock is Vice President for research and publications at the Manhattan Institute. 

Carolyn Gorman is the project manager for education policy and mental-illness policy at the Manhattan Institute.

Photo: Gould Farm in Massachusetts