The sheriff’s response has been to try making his jail “the best mental-health hospital” possible. He has done away with solitary confinement, a practice which has long been known to cause and worsen mental woes. (Doing so has also cut staff assaults, he says). He appointed psychologists as jail directors and hired medically trained staff in place of some guards. Inmates can take courses in yoga, chess and other activities intended to rehabilitate.
Spend a day in his jail and much appears unusual for a place of detention. In a damp and gloomy basement, prison workers hand out questionnaires to men arrested the night before. They scramble to see inmates before they go before a bail judge (who will release most the same day), to get a chance to diagnose the mentally ill, see who gets treatment and offer care.
For those kept inside—the jail holds some 6,000 detainees at a time, many for three-to-six months—further diagnosis and treatment follows. Staff in a beige hospital building distinguish between 1,600 inmates, currently, who are “higher-functioning” for example with depression, 382 of “marginal stability”, perhaps with schizophrenia, and 80 who suffer the most acute psychosis. The last are the hardest to manage, let alone release safely.