The reporters quote Esteban Gonzalez, president of the American Jail Association, a lobby for jail employees: "In every city and state I have visited, the jails have become the de facto mental institutions." Of the 22 states that responded in detail to the reporters' survey, which as a whole have most of the nation's prisoners, "their mental-health patient ratios ranged from one in 10 inmates to one in two," the ratio reported in Oregon and Iowa.
"Some facilities have attempted to cope by hiring psychiatric staff and retraining prison officers," the Journal reports. "Few, however, claim to be adequately equipped to handle some of the nation's most mentally frail. A seeming revolving door compounds the problem: Upon their release, the mentally ill tend to find scant resources and often quickly fall back into the system, says Mr. Gonzalez." And that phenomenon is probably more prevalent in rural areas, which typically are short of mental-health resources.
The situation is a return to the times of a century or more ago, when knowledge of mental illness was rudimentary at best and the mentally ill often would up behind bars. State-run mental institutions were developed, but gave way to community-based treatment. "The weaknesses of that concept—a lack of facilities, barriers created by privacy laws and tightened local and state funding—has brought the picture full circle," the Journal reports.