But that's just nuts, right? He should be placed in a state mental hospital where he can get the right treatment for his brain disorder. Earley, a former reporter for The Washington Post, discovers that jails and prisons have become our de facto mental institutions in the wake of the deinstitutionalization movement, which was trying to solve another problem -- the abuse of the mentally ill in those state-run institutions. (Think Frances and One Flew Over the Cuckoo's Nest.)
Observing inmates on the psych floor of the Miami-Dade County jail over the course of a year, Earley attacks the shortsightedness of trying to deal with mental illness on the cheap. In fact, prisoners housed in psych wards are far more costly than others because they spend six times longer in jail, even when charged with identical crimes. Put it down to the still pervasive stigma of mental illness, says Earley, which makes judges and prosecutors afraid to release such prisoners. Because so many of them get caught in the revolving door of arrest, jail and just enough "treatment" to stabilize them for trial, the cost to taxpayers is enormous. At one point, the jail's psychiatrist encounters a prisoner whom he had first met as a medical school resident more than two decades earlier. Since then, the prisoner had been arrested 50 times.
But change is possible. One reform-minded Miami judge developed an innovative misdemeanor diversion program for mentally ill offenders. After one year of emphasizing treatment over jail, the judge tallied the results and found that the recidivism rate had plunged from 70 percent to an astonishing 7 percent.
In the 19th century, Dorothea Dix fought for the humane treatment of the mentally ill, who were routinely confined in jails, poorhouses, and prisons. Today, says the psychiatrist from Miami-Dade's ninth floor, we've actually gone backwards.
Earley's conclusion: The mentally ill need compassionate, long-term treatment for the chemical imbalances in their brains, and they shouldn't have to go to jail to get it. Now how crazy is that?