A psychologist is leading the largest jail in America—and helping rethink incarceration and mental health

CHICAGO—Home to about 10,000 inmates, Cook County Jail takes up a huge swath of land on Chicago’s southwest side. It’s the largest single jail in America, and because about a third of its inmates are mentally ill, it also doubles as the largest mental health institution in the country.

So it makes sense that the jail’s new warden, Nneka Jones Tapia, is a clinical psychologist. Since she was promoted to her job five months ago, Jones Tapia has helped to reimagine how the jail operates. She’s trying to create a jail that doesn’t just keep people locked up but gives them treatment and supports them even after they go free.

“For the longest time we, being correctional institutions, have thought that our work ends when the person is released,” Jones Tapia told me in an interview Sunday at Chicago Ideas Week, where she spoke on a panel. “We know that that’s not the case because those same individuals are coming back to us in worse predicaments than the way they left.”

In the 1950s, states started shutting down asylums and opening local mental health clinics. But those clinics have been decimated by budget cuts in Illinois and across the country, making it harder for people with mental illness to get the medication or therapy they need. One inmate at Cook County Jail told NPR last year that he committed a crime just so he could get back behind bars and get his medicine.

“We have a misperception of what public safety is, and the media unfortunately hasn’t helped when we portray the mentally ill as violent,” Jones Tapia said. “Of course, the automatic reaction is ‘lock them away.’ That’s what we’ve done for centuries, and it’s not working.”

So at Cook County Jail, she and her boss, Sheriff Thomas Dart, are pioneering new practices. It starts before inmates are even admitted into the jail’s custody: Every new inmate is screened by a mental health professional and diagnosed for mental illnesses. The jail then gives that information to judges during sentencing, hoping to encourage them to send people to treatment instead of a long-term jail sentence.

Every individual who is admitted to jail is automatically signed up for Medicaid, which makes them eligible for medication and treatment. “We’ve got individual therapy, group therapy, art therapy, you name it, it’s there,” Jones Tapia said. Some inmates who are expected to be released soon get counseling and job training.

The inmates with the worst illnesses are housed in a psych ward and given the kind of attention they’d receive in a mental institution. Since 2009, all officers have received mental health training, teaching them how to handle outbursts peacefully and communicate with people facing disorders. There’s also a staff of psychiatrists and nurses.

The jail also has no solitary confinement cells, which many psychologists say is a form of torture.

The jail’s most innovative practices take place outside it. Administrators mapped which neighborhoods released mentally ill inmates go back to, and noticed that many aren’t served by mental health clinics. So they sent some psychologists on staff to open pop-up clinics in these areas and help recently-released inmates continue their treatment.

“We can set someone up with the greatest plan, but when they leave, they can run into a number of obstacles we hadn’t even thought about,” Jones Tapia said. “We wanted to keep our tentacles out there [in the community] so we could help them to navigate.”

Cook County Jail may be the first major U.S. correctional institution to be run by a psychologist. Jones Tapia worked in the jail’s psych ward since 2006, so she said her new job hasn’t been a difficult transition.

She also grew up with her father, brothers, and other family members spending time in jail.

“Having loved ones incarcerated and knowing what that’s like, and being identified as an ‘at-risk child,’ I can better understand the population that I’m working with,” she said. “Fifteen, twenty years ago, I never thought I would be doing this.”

Jones Tapia said she thinks correctional institutions around the country are moving toward more humane and progressive practices of treating mental health.

“We know what’s needed, we know what the right thing to do is,” she said. “I see all of us getting onboard to do it.”

Univision, one of Fusion’s parent companies, is a sponsor of Chicago Ideas Week.

Casey Tolan is a National News Reporter for Fusion based in New York City.