The past horrors of some shuttered institutions are undeniable, but we must also recognize the disturbing realities of the present. There are over one million individuals who have serious mental illness warehoused in our nation’s jails and prisons—many committed nonviolent crimes. A quarter-million more are homeless. Some of these individuals—and others—cannot care for themselves, they deny or are unaware of the severity of their illness, or they present a danger to themselves and others. In theJournal of the American Medical Association, we argued that for some of these seriously ill patients psychiatric asylum is warranted.