Out of the asylum, into the prison?

Not perzackly.

Kevin Drum and Matt Yglesias point to this graph as suggesting that the astounding prison-building spree the country has been on since about 1980 reflected the process of de-institutionalization for mental-health patients: in effect, a substitute of the prison for the asylum.


That idea is widely shared (see, for example, Bruce Harcourt’s paper, from which the graph is drawn), but it doesn’t really work. The timing isn’t right, with the prison (and jail) boom coming long after the bulk of the mental-hospital releases. And the demographics aren’t right, either. As Steven Raphael and Michael Stoll point out in Do Prisons Make Us Safer? (just published), mental-hospital patients tended to be white, female, and elderly, while prisoners are disproportionately black, male, and young.

Certainly, the jails have borne some of the brunt of de-institutionalization; the Los Angeles County jail has been described as the largest mental hospital in the nation. But Raphael and Stoll compute that fewer than 130,000 of the nation’s 2.3 million prison and jail inmates are the products of de-institutionalization; that’s about 10% of the growth in the system.

Yes, it’s important to provide better mental-health services to criminal-justice clients, and doing so will tend to reduce prison and jail headcounts. But de-institutionalization is not among the major sources of mass incarceration. That policy had costs, some of them due to the failure to replace asylum care with good community-based care. Those costs fell on the criminal justice system, on the neighborhoods disturbed by disturbing behavior, and on those released, many of whom wound up on the streets or in homeless shelters.

But surely the civil libertarians got the bigger question right: locking people up for acting crazy is a pretty rotten thing to do, and I’m glad we mostly don’t do it anymore. There’s a revisionist tendency to add de-institutionalization to high-rise public housing on the liberal-good-intentions-gone-awry list. It should be resisted. And the notion that the current level of incarceration is somehow historically normal needs to have stake driven through its heart.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

One thought on “Out of the asylum, into the prison?”

  1. Thank you for involving common sense, ethics, and facts in a debate that has, all too often, been lacking in all three. We certainly still have a lot of work to do in providing community-based services and helping those who are still incarcerated by the mental health system to find appropriate, voluntary alternatives that do not deprive them of their liberty. Even after "de-institutionalization," this still happens: http://thesystemisbrokenblog.wordpress.com/2014/0….

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