Why a clinical psychologist is running America’s second-largest jail

The nation’s second-largest jail has named a clinical psychologist to be its new director—a public admission that America’s prisons have essentially become mental-health facilities.

Dr. Nneka Jones Tapia, a 37-year-old psychologist, is set to become executive director of Chicago’s Cook County Jail, where about 1,900 of the 8,000 estimated daily inmates have a serious mental illness, Jones Tapia told the Chicago Tribune.

The Cook County Jail has been called the nation’s largest mental health care provider. Period.

“Incarceration and mental health treatment have been infused, they are one and the same,” Cook County Sheriff Thomas Dart said in a statement about Jones Tapia’s appointment.

The jail has become “de-facto mental health hospital” over the last few years due to six area mental health facilities shutting down due to lack of funding in 2012, Dart told the New York Times last year. Another is set to close at the end of this month. The mentally ill end up in prison due to low-level crimes they commit, often as a result of their mental illness. In many cases there are limited alternatives for treating the illnesses in the community.

Chicago is not alone. County jails are the biggest mental-health facilities in California, New York, and Florida, among other states, according to the Wall Street Journal.

Here’s a reason why: since the 1950s, funding for mental health hospitals and treatment has dwindled across the board. “In 1955 there was one psychiatric bed for every 300 Americans. In 2005 there was one psychiatric bed for every 3,000 Americans,” reads an often-cited 2010 study by the National Sheriff’s Association and the Treatment Advocacy Center, a mental health advocacy group.

Starting in the 1960s (some credit the popularity of Ken Kesey’s bestseller One Flew Over the Cuckoo’s Nest for this), America began the process of what has come to be known as “deinstitutionalization“—the removal of patients from state run mental health facilities.

Local, community-oriented mental health care was considered to be a better option to state facilities. President John F. Kennedy passed the Community Mental Health Act in 1963, which was meant to expedite the switch to localized care. “Most [patients] are confined and compressed within an antiquated, vastly overcrowded, chain of custodial State institutions… This situation has been tolerated far too long,” Kennedy said at the time, promising funding for more localized treatment.

But the funding never came. States, compounding the problem, cut funding as well. The following graphs from a 2014 study by Stanford University track the result of these policy failures in the state of California:

Within a decade, the criminal justice system was transformed into a mental health system. Today, two million people with mental illnesses are booked into jails each year, according to the National Alliance on Mental Illness.

What’s worse: people with serious mental health issues stay in jail for longer periods of time, are regularly denied treatment and medication for their conditions, and cost taxpayer more money to house than if there was adequate mental health funding in the first place, various studies have found.

Jones Tapia had been working for the Cook County Sheriff’s office since 2013, overseeing mental-health strategy for the jail. She told the Chicago Sun Times that she “grew up in the jail,” having spent an internship there in 2006 before moving to North Carolina to work as a psychologist in a private prison.

A key part of her strategy as executive director will be building relationships with judges, in order to exert her expert opinion on what kind of people should actually be sent to jail, she told the Chicago Tribune. “This job is 99.9 percent about the relationships you build,” she said.

In an interview with NPR, she said that her appointment “sends a powerful message” about the state of the criminal justice system, and the need for better mental health funding.

“Law enforcement was never meant to handle mental illness – severe mental illness,” she said. “It’s a travesty.”

Daniel Rivero is a producer/reporter for Fusion who focuses on police and justice issues. He also skateboards, does a bunch of arts related things on his off time, and likes Cuban coffee.