This month's issue of Psychiatric Annals, guest edited by Howard M. Kravitz, DO, MPH, and Joel M. Silberberg, MD, is entitled "Correctional Psychiatry: Effective and Safe Linkage of Mentally Ill Offenders." This series points out the frequency with which the county jail system is becoming this nation's leading default resource for acute psychiatric care for a growing proportion of the public. This has led to the necessity for jails to develop acute psychiatric assessment and care capabilities and for the criminal justice system to shift its philosophical orientation "from one of traditional adjudication to one of therapeutic jurisprudence" and "to ensure effective interactions between the criminal justice and the mental health systems."
The articles in this issue also make clear the desperate need for follow-up services to prevent jails from being "revolving doors" for rearrested mentally ill offenders. Available psychiatric care is a large part of the solution to this problem, and increasing numbers of psychiatrists will be needed to man the systems required to respond to this situation.
One has to wonder what it says about modern society that the criminal justice system is being called on to solve the problem of responding to the mental health needs of our most vulnerable citizens. Can modern technology and economics reweave our social fabric? It seems a bit frayed.