Who provides more effective treatment for mentally ill people, jails or hospitals?

The Virginia Pilot takes a look at mental illness among jail inmates.

...The process of deinstitutionalization sped up rapidly in 1965, when Congress created Medicaid. The new health program excluded payments to large “institutions for mental diseases.” That forced the shutdown of mental hospitals across the country and was designed to create smaller facilities within communities.

In 1955, state mental institutions had about 558,000 beds. There were 337 mental hospital beds per 100,000 people in the United States, according to a 2016 study by the Treatment Advocacy Center.

Far too few smaller community facilities opened to make up the difference. Today, there are roughly 12 beds per 100,000 people.

...More than a quarter of the jail population – roughly 186,000 people – are believed to be in serious psychological distress.

Deinstitutionalization never really happened, said Hall, the Nashville sheriff; the burden of care simply shifted.

“I tell everybody we just reinstitutionalize these people in a different building,” he said. Jails are dealing with a population that has needs beyond what the criminal justice system is able to address.

Read more here.