“We are literally drowning in patients, running around trying to put our fingers in the bursting dikes, while hundreds of men continue to deteriorate psychiatrically before our eyes into serious psychoses. . . . The crisis stems from recent changes in the mental health laws allowing more mentally sick patients to be shifted away from the mental health department into the department of corrections.”
―California prison psychiatrist

Nowhere in our society is the debacle of deinstitutionalization felt more than in our criminal justice system. While well intentioned, reform efforts meant to protect the liberties of people with mental illnesses result in many of the most severely ill going without needed treatment. That, along with major cost-shifting by the states to the federal government following the advent of Medicare and Medicaid, has led to the largest component of today’s health crisis: the criminalization of Americans with severe psychiatric illnesses. In fact, America’s jails and prisons are now surrogate psychiatric hospitals for thousands of individuals with the severest brain diseases.


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