Cook County Jail's newest warden is a clinical psychologist. Last week, the New York Times profiled Nneka Jones Tapia, the psychologist-turned-executive director of the Chicago-area jail, where roughly one in every three inmates is mentally ill. Jones Tapia took over the position in May of this year. While not an entirely new occurrence, it is rare for a mental-health specialist to inhabit a role usually reserved for someone with security expertise, and Jones Tapia's appointment could signal the start of a new trend for psychologists in jails and prisons.
With anywhere between 8,000 and 11,000 people locked up at any given time, Cook County Jail is often called the "largest mental-health facility" in the country. But it's not the only corrections institute that finds itself caring for patients alongside prisoners. Psychologists have played a role in the corrections system for decades, and for good reason: A 2006 report from the Bureau of Justice estimated that 56 percent of state prisoners, 45 percent of federal prisoners, and 64 percent of jail inmates, had some form of mental-health issue.
The United States has a long history of housing the mentally ill in jails. Even in colonial America, many were opposed to incarcerating the mentally ill, which is testament to how little progress we've made over the last 300 and some years.
Shuttering the clinics to save money may do little to ease Chicago's budget woes.
Massachusetts became one of the first colonies to pass a law that funneled any individual "lunatic and so furiously mad as to render it dangerous to the peace or the safety of the good people, for such lunatic person to go at large" into the corrections system. Several other states, like New York and Rhode Island, followed suit. These early inmates were treated much the same as everyone else; a philosophy that lasted until the 1920s, when prisons began to employ psychologists and psychiatrists.
But if the late 18th and early 19th centuries brought the rise of mental institutions and hospitals—the first facilities to both confine and treat the mentally ill—then the 20th century saw those facilities fall, with the 1963 enactment of the Community Mental Health Act, which aimed to move patients from overcrowded asylums into community-based treatment centers. That legislation kicked off a trend of divestment in mental-health facilities, which continues to this day, and has had direct impacts on Cook County Jail. As Matt Ford reported earlier this year for the Atlantic:
The Great Recession accelerated the nation's downward trend in mental-health spending. Between 2009 and 2012, America's 50 state legislatures cut a total of nearly $4.5 billion in services for the mentally ill, even as patient intakes increased by nearly 10 percent during the height of the economic crisis. Until a few years ago, Chicago had 12 mental health clinics. In 2011, Mayor Rahm Emanuel's first budget proposed closing six of them. The closures—city officials referred to them as "consolidations"—would save the city an estimated $3 million as it struggled to balance its budget.... The Chicago City Council passed Emanuel's budget that November without dissent, 50 to 0.
When the clinics shut down, incarceration rates increased, according to Alexa James, executive director of NAMI Greater Chicago. In the end, shuttering the clinics to save money may do little to ease the city's budget woes. A 2013 report found that mentally ill inmates can cost the city three times as much as other inmates, so if many of those patients end up in the corrections system, Chicago probably won't come out ahead after all.
Cook Country Jail has implemented some practical interventions to deal with the soaring number of mentally ill inmates. Cook County Health and Hospitals System officials interview inmates upon intake and sign eligible inmates up for a low-income health insurance policy, which helps fund necessary medications and treatment. The jail also has a Mental Health Transition Center, to teach participants how to function with their mental illness outside prison grounds. But as Melanie Newport reported for the Marshall Project in May, Cook County Jail has hired a psychologist as warden at least once before:
Jones Tapia is not the first mental health professional to run a major jail; in fact, a psychologist ran Cook County Jail as warden from 1968 to 1970 and then as head of the Cook County Department of Corrections until 1977. When he was hired as warden, Winston Moore had worked for the state as a juvenile gang psychologist. Given that the jail's population was 80 percent black and that Moore, himself an African-American, claimed to know the gang leaders in Chicago, he was seen as the ideal candidate for the job.
Moore's tenure as warden was plagued by budget crises, lawsuits, and numerous escapes, Newport reported, ensuring that any reforms he may have enacted were never achieved. Since then, officials in cities and states across the U.S., including Michigan and New York City, have tried to institute policies to provide treatment—rather than punishment—for mentally ill offenders, but in many states, prisons and jails still hold more mentally ill individuals than hospitals. Jones Tapia has at least one advantage over Moore, however: her previous experience in correctional facilities. And given the current momentum for criminal justice reforms, she may have a more lasting impact than her psychologist-turned-warden forebears. Giving psychology specialists more oversight and the ability to create an environment that has the best chance of producing reformed and productive citizens may be a way to reduce the record number of incarcerated Americans, mentally ill or otherwise.