During the 60's it became fashionable to argue that we should discharge long term patients from mental hospitals and give them the freedom to integrate into society.  Since then the numbers in mental hospitals have fallen dramatically with rates decreasing by 400%.  But critics argue that this has been a fundamental mistake and that over the same time prison rates have increased 425% with the result that we have replaced asylum with prison and traded one form of incarceration for another.

Should we reverse the policy of discharging mental patients and build new hospitals to address the problem?  Or is this a naive conclusion that would condemn thousands to permanent institutionalisation and recreate this misery of asylums of old?  Or do we need an entirely new approach to prison and psychiatric treatment and an end to categorising the socially disruptive as either mad or bad? 

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