The fact that the incarceration rate in the United States is one of the highest in the world, certainly in the industrialized world, draws a great deal of attention from criminal justice reformers. What lurks beneath this data point is something far more troubling. The three largest psychiatric facilities in the country are not mental health treatment facilities, halfway houses, community mental health centers, or outpatient hospitals. No, they are the county jail systems of Los Angeles County and Cook County, as well as that found on Rikers Island in New York City. This last facility, which provides treatment to tens of thousands of individuals with psychiatric disabilities every year, has been at the center of litigation that has now spanned over fifteen years. That lawsuit, Brad H. v. The City of New York, claims that Rikers Island, because of the extensive treatment it provides to those incarcerated there (under the City’s constitutional obligations), is, for all intents and purposes, a mental health facility. As such, it has obligations under state law to provide what is known as discharge planning services: the provision of assistance to individuals leaving an inpatient facility to ensure that those individuals can continue their treatment upon release.