Some jail wardens complain that their facilities have become little more than makeshift mental asylums, and that they lack the money and expertise needed to handle problems, says the New York Times. “It's a national disgrace how we deal with this,” says Cook County, Il. Sheriff Thomas Dart, who appointed psychologist Dr. Nneka Jones Tapia to run the Cook County Jail and who refers to the facility notorious for its history of violence and overcrowding, as the nation’s largest mental institution in the country. He said that as many as one-third of the jail's 8,600 inmates were mentally ill. Three large jails — Rikers Island in New York City, the county jail in Los Angeles and Cook County in Chicago — are operating under federal oversight, in part because of mistreating the mentally ill.
Cook County has become a model of sorts for other troubled institutions in how to deal with the mentally ill, and it recently hosted delegations from Rikers Island and Los Angeles County. Before becoming warden, Dr. Jones Tapia oversaw health care at the jail, and under her guidance, Cook County began offering services that would have been unthinkable a few years ago. All new inmates now see a clinician who collects a mental health history to ensure that anyone who is mentally ill is properly diagnosed and receives medication. The jail forwards that information to judges in time for arraignments in the hope of convincing them that in certain cases, mental health care may be more appropriate than jail. “We've started to focus on the entirety of the system, from the point of arrest through discharge, and really forcing the whole system to take a look at the people that we're incarcerating,” Dr. Jones Tapia said.