Yes, this is 21st-century America. Where we have better means to treat mental illness than ever before, but choose to let the insane people decide to get it or not. Where we supposedly deinstitutionalized the mentally ill by closing down psychiatric hospitals, and then reinstitutionalized them behind bars. The number of psychiatric beds on a per capita basis is back at 1850 levels, and there are three times as many seriously mentally ill people in jail or prison than in hospitals, according to the Treatment Advocacy Center. Where we let sick people sleep on the streets. About a third of homeless men and two-thirds of homeless women are seriously mentally ill. Imagine the national outrage if people with Alzheimer’s were permitted to wander around the streets uncared for. But, by some perverse logic, it’s considered okay for schizophrenics.

The federal government can act on this travesty only at the margins. It is largely up to the states. They can make a real difference by stopping the further closure of public-hospital psychiatric beds and making it easier to compel treatment. Civil-commitment laws that require imminent danger to self or others are too strict. As D. J. Jaffe of Mental Illness Policy Org puts it, that standard doesn’t prevent violence, it requires violence in order to get care to someone too irrational to realize that he needs it.