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Description

This report is about how to humanely and ethically get the chronically mentally ill people off the streets and out of the jails and prisons. It is primarily addressed to psychiatrists, mental health providers, public health officials, law enforcement personnel and others generally interest in and concerned about the neglect of our psychologically impaired and disabled citizens. This population numbers in the hundreds of thousands and they are too impaired to be effectively treated in an outpatient setting. The old asylums gave them a safe and structured environment where their basic needs were met and someone was there to help them if they were becoming agitated or overwhelmed by their illnesses. There are severe consequences and hidden costs in the lack of care for these individuals, who are mostly either homeless or incarcerated. Both of these outcomes subject them to neglect, violence or other damaging experiences which further exacerbate their illness states. I also address some of the economic issues that will have to be faced in order to make a transition back to the asylum model of care. It is likely, however, that making that transition will minimize the currently hidden costs of their care, relieving some of the problems in the prison system and in the emergency services where most of the homeless access care at times of crisis.