It's a collision of realities that adds up to worsening trouble for American jails: More inmates than ever have addictions or mental illnesses, while county sheriffs don't have the expertise or the resources to cope. Steve Coll of the New Yorker takes a deep dive into what his story calls the "jail health-care crisis." The issue also affects larger prisons, where inmates are incarcerated for longer stretches, but Coll says the problem is "particularly acute" in smaller jails, such as those run by rural counties. That's because "large numbers of people booked into custody are in a state of distress or ... will suffer withdrawal, which can require close monitoring and specialized treatment that jail wardens are not equipped to provide."
To get a sense of the scope of the problem, consider that a 2017 study by the Bureau of Justice Statistics found that about half of those in jails had a mental illness of some kind. What's more, about two-thirds had a drug addiction or dependency. The latter figure drew from decade-old stats, meaning it doesn't reflect the more recent opioid crisis. As a result of all this, many jails are turning to for-profit companies to provide health services, and Coll's story examines the deluge of lawsuits from inmates that have resulted. Lots of factors are at play, but "a significant amount of the serious neglect documented in lawsuits arises from the fact that jails have become a primary provider of medical care for the severely mentally ill." Click to read the full story, which sees faint signs of hope toward reform, including changes in Texas made after the suicide of Sandra Bland. (Read more Longform stories.)