Why Are Correctional Facilities the Nation’s Largest Mental Health Care Providers?

Credit: Prins, Jacob and Laura Draper & McQuaid, Russ. Courtesy of: New York: Council of State Governments Justice Center, 2009.http://cbs4indy.com/2015/09/03

The women’s ward at Central State Hospital, 1926. Courtesy of: Indiana Historical Society, Indianapolis

The Old Pathology Building on the former Central State Hospital grounds, Indianapolis, Indiana. Courtesy of: IndyStar Newspaper

Credit: Segal, Steven P. Deinstitutionalization, in Terry Mizrahi and Larry E. Davis, editors Encyclopedia of Social Work 20th edn. Courtesy of: New York: Oxford University Press, 2008

Credit: Beeler, Donald B. Deinstitutionalization of Indiana State Mental Hospitals: A Staff Report. Courtesy of: Indiana Department of Mental Health, 1977

This former Veterans Administration Medical Center has been the home of Larue D. Carter Memorial Hospital since 1996. Credit: Scott, Kate and Tabitha Hubbard.

Obituary of reformer Albert Thayer, Indianapolis News, October 1, 1920.

This image shows the brutal architecture of modern prisons. Image of New Castle Correctional Facility. 2015. Credit: Scott, Kate and Tabitha Hubbard.

Image from Richard Ross’s Juvenile in Justice Series. Ross hopes these images will reveal the true conditions of the justice system and lead to change. Credit: Ross, Richard. Juvenile in Justice. Courtesy of: http://richardross.net/juvenile-in-justice

Credit: Photo by Richard Ross Courtesy of: http://richardross.net/juvenile-in-justice

Courtesy of: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5920a3.htm

Central State Hospital, Indianapolis, Indiana
On November 21, 1848, Indiana Hospital for the Insane opened in Indianapolis.

It was later renamed Central State Hospital. In its first decade of operation, the Indiana Hospital for the Insane housed and treated nearly 1,800 people.

In the 19th century, patients at Central State included those who had severe mental illness, epilepsy, and alcoholism. “Religious excitement” and “disappointment in love” were listed among the many causes of “insanity.”

The Old Pathology Building on the former Central State Hospital grounds, Indianapolis, Indiana
In 1992, with a dwindling patient population and scandals resulting from poor management, Governor Evan Bayh ordered Central State Hospital to close. In June 1994, the facility closed after 146 years of operation. Indiana was part of the national trend of deinstitutionalization, the gradual, systematic closing of state mental hospitals.

Today, most of Central State’s buildings have been demolished, although a few have been repurposed. Since 1969, the Old Pathology Building (pictured on the left) has been the home of the Indiana Medical History Museum.

Larue D. Carter Memorial Hospital Indianapolis, Indiana
When state mental hospitals closed, some patients returned to their home communities. Others moved to new treatment facilities, such as nursing homes or other psychiatric hospitals. When Central State Hospital closed, some patients and staff transferred to Larue D. Carter Memorial Hospital.

Larue D. Carter Memorial Hospital has been in operation since 1948. There are 136 beds in the hospital, and it serves adults with mental illness, as well as children and adolescents who have emotional disturbances.

In 2015, the state of Indiana announced that it would close Larue Carter and replace it with a new psychiatric hosptial in Indianapolis.

Former patients such as Albert Thayer published exposés and testimonials, like The Indiana Crazy House, published in the 1880s, in hopes of drawing attention to the terrible conditions of state mental hospitals. Thayer also wrote pamphlets revealing the substandard conditions of Indiana’s jails, prisons, and county homes.

Connections between Correctional Facilities and Mental Hospitals

“Ill-suited as the ordinary poorhouse is to care for the insane, the jail is still worse. Sometimes the poor wretches would be passed back and forth from asylum to jail to jail to asylum, each officer trying to be rid of a troublesome inmate.”
Alexander Johnson, Superintendent of the Indiana School for Feeble-Minded Youth in Fort Wayne, Indiana, 1923

New Castle State Correctional Facility New Castle, Indiana
Incarceration of people with mental illness is not a new trend. However, experts report an increase of people with serious mental illness in correctional facilities as a result of factors including the rising incarceration rate and decrease in mental health care treatment.

Indiana has operated state facilities in New Castle since 1907, when it opened the Indiana Village for Epileptics. The New Castle Correctional Facility opened in 2002. This privately operated facility is now the largest prison in Indiana, with the ability to house about 3,200 inmates.

The maximum security psychiatric unit in this prison is designated for male prisoners with serious mental illness. After a federal judge determined in 2012 that prisoners with mental illness in Indiana had experienced “cruel and unusual punishment,” the state has expanded its psychiatric services in prisons.

“Nearly a quarter of both state prisoners and jail inmates who had a mental health problem, compared to a fifth without, had served three or more prior incarcerations.”

Three Ways to Improve the Criminal Justice System for People with Mental Illness
Keep people with mental illness out of the penal system and get them health care.

  • Train first responders to handle crises involving people with mental illness.
  • One of the country’s first mental health courts began in Indianapolis in the 1990s.

Improve conditions in correctional facilities.

  • Train correctional officers to care for people with mental illness.
  • Stop punishments, such as solitary confinement, that aggravate mental conditions.

Help those released from prison or jail.

  • Plan for re-entry into the community, including mental health care, before inmates are released.
  • Ensure access to facilities where former inmates can receive treatment for mental health conditions.