Arnold Kling  

Mental Health Institutions and Prisons

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Bernard Harcourt writes,

we should not be surprised that there are so many persons with mental illness behind bars today. We deal with perceived deviance differently than we did in the past: instead of getting treatment, persons who are viewed as deviant or dangerous are going to jail rather than mental hospitals.

...we should not be surprised that our mental health systems are in crisis today. The infrastructure is simply not there. This is evident in states across the country where persons with mental illness are being housed in jails rather than treatment facilities.

What is also clear is that Seung-Hui Cho probably would have been institutionalized in the 1940s or 50s and, as a result, the Virginia Tech tragedy may not have happened. According to the New York Times, the director of the campus counseling services at Virginia Tech said of Cho: “The mental health professionals were there to assess his safety, not particularly the safety of others.” It’s unlikely we would have taken that attitude fifty years ago.

But the problem is, we would also be institutionalizing another huge swath of humanity — and it’s simply not clear how many of those other lives we would be irreparably harming in the process.

The grim theory is that mental health institutions and prisons substitute for one another. The mental health institution is a form of preventive detention, which is problematic from the standpoint of our tradition of liberties.

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CATEGORIES: Economics of Crime

COMMENTS (7 to date)
Regina writes:

If someone is a danger to society, then who cares where there put! First of all you can't force someone to stay at a mental hospital. If someone is going to cause harm to society, then they will find away. People who are in jails or prisons obviously did something wrong and I don't care their excuse. I'm not down to treat crazy people who have already committed crimes, let them serve their time and then help them if it's even possible. Why take a murderer and try to help him or her? By all means, help them but don't think it's okay to place them back in society. Don't use the excuse, they have a mental problem, we know thats why their in prison and away from everyone else!!!

David Rothman's The Discovery of the Asylum, is probably the most exhaustive history of incarceration institutions in America. He explicitly parallels the birth and growth of asylums with prisons in the US.

By the way, the functions of both institutions appear to have been achieved effectively by private means long before state, regional, or national provision.

John S Bolton writes:

In terms of this case, regarding older alternatives,
a monastery in Korea would have received someone like that.
Due to lack of loyalty to the citizenry and the net taxpayers thereof, the mass-murderer was brought here, under no qualifications whatever, other than being someone's relative.
His parents were pressers in a dry-cleaning business, who didn't even have health insurance until one of them began working in a public school cafeteria.
It was already obvious years prior, that they were increasing the level of aggression on the net taxpayer; when foreigners do this, it comes from, and breeds further, hostility against those from whom their net public subsidy must come.
There was treason and the condition of being accessory to treason, in the process which resulted in that chain of immigration;
this is what is different about immmigrants, among other things.

Thebastidge writes:

I'm not sure that this view of the 'golden age' of mental health care has much fact behind it. Until the 1960's at least, mental health care basically consisted of isolating individuals from society- in sanitariums which had worse track records of abuse and inmate conditions than many prisons.

There's a reason for people to resist being categorized as mentally ill. Part of this comes from superstitious hold-overs which stigmatize craziness as a moral failing, particularly in Asian societies, or as evil such as Western European views of possession by demons.

But a large part of resistance to being categorized as mentally ill is an entirely rational resistance to loss of freedom and the possibility of barbaric treament and incarceration.

Matt writes:

The mentally ill are generally harmless (from personal experience!).

Unfortunately, we live in a literally high energy society, large fast trucks, huge oils storage, masses of cars at 70 MPH, large community schools.

This scale of economies makes us vulnerable to even small errors, as recent stories of crashes and shootings are teaching us.

I have no immediate answer.

Floccina writes:

'The mental health institution is a form of preventive detention, which is problematic from the standpoint of our tradition of liberties.'

Well said.

Jason Malloy writes:

I saw this suggestion on Marginal Revolution not long ago.

But the truth is that the etiology behind mental health problems and crime look very different.

For instance Cho was a well-behaved child and an adult with no criminal history. This isn't the kind of guy that you usually find in prison. Criminals are naughty children, delinquent teens, and adults with an already impressive criminal record.

Men are more criminal than women, young are more criminal than old, low IQ are more criminal than high IQ. This has nothing to do with 'mental illness'. Criminal behavior is mostly a male problem based on genetic predisposition, status opportunity, and community standards, not mental illness.

I'm also having a hard time interpreting Cho as anything but an angry and harmless weirdo before his rampage. Only in retrospect is he a 'predictable' threat - there are millions of similar people and they are harmless.

Any society that locks away people before they commit crimes, sure wouldn't look like a just place to live to me.

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