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Does A.A. carry the message into prisons and hospitals?

In short:

  • Yes, and it started in hospitals. The 1939 text tells a sober member to find newcomers "by asking a few doctors, ministers, priests or hospitals" (p. 89), and warns that the work may mean "innumerable trips to police courts, sanitariums, hospitals, jails and asylums" (p. 97). That's written as each member's own Twelfth Step work, not as a program run by an organization.
  • Bill W.'s history (1957) dates A.A.'s first meeting inside a mental hospital to Rockland State Hospital in New York and its first prison group to San Quentin in 1942. By the 1955 convention, he reports, there were A.A. groups in 265 hospitals and 335 prisons (A.A. Comes of Age, 1957).
  • A.A. goes into hospitals but doesn't run them. The Long Form says hospitals "ought to be well outside A.A.—and medically supervised" (p. 564), and Bill wrote in 1946 that none of the hospitals A.A. works with "are known as 'A.A. hospitals'" (P-17, "Money," 1946).
  • Today the work is organized through corrections committees and treatment committees (called "hospitals and institutions," or H&I, in some areas). They take meetings into prisons and jails where the facility allows it, carry the message into treatment settings, and act as contacts when people are released (P-16, 2018; A.A. Service Manual, 2024–2026 edition).

What the Big Book says (1939)

Chapter 7 opens with the Twelfth Step's instruction to carry the message, and then tells the reader where to find alcoholics who want help: "You can easily find some by asking a few doctors, ministers, priests or hospitals." (p. 89). It adds: "cooperate; never criticize." (p. 89). A few pages on, it advises that "Approach through a doctor or an institution is a better bet." (p. 91) than going through the family.

The chapter is plain about where the work leads. Helping others may mean sharing your money and your home and "innumerable trips to police courts, sanitariums, hospitals, jails and asylums." (p. 97). That sentence is addressed to the individual member doing Twelfth Step work. It's the member who makes the trips. Nothing in the 1939 text describes a committee or a scheduled meeting inside an institution.

Hospitals run through the book's own story of how A.A. started:

  • Bill says that when he was close to drinking again, "Many times I have gone to my old hospital in despair." (p. 15). Talking with a patient there lifted him up.
  • The Foreword to the Second Edition (1955) tells how Bill and Dr. Bob went to work "upon alcoholics arriving in the ward of the Akron City Hospital." (p. xvii). Their first case became A.A. number three.
  • Chapter 11 tells the same story from 1939: the two friends phoned the head nurse of a local hospital and asked for a prospect (p. 156). The early members were willing "to place a new man in the hospital and visit him afterward." (p. 159).
  • The chapter's closing example (dated "(1939)" in the text) is a member's work in a new city, where arrangements were made with the chief psychiatrist of a large public hospital to select alcoholics from "the stream of misery which flows through that institution." (p. 163).

Chapter 8, "To Wives," says of men committed to institutions: "For years we have been working with alcoholics committed to institutions." (p. 114). The next sentence, "Since this book was first published, A.A. has released thousands of alcoholics from asylums and hospitals of every kind." (p. 114), can't be from the first printing, since it looks back on the book's publication. Our sources don't say when it was added.

Apart from the "jails" among the places a member's trips may lead (p. 97), the 1939 text says nothing about prisons as places to carry the message. Its other uses of "jail" are about a drinker's own risks and past: amends that might land a member in jail (pp. 78–79) and the "final stage" of drinking (p. 107).

How it grew: Bill W.'s account (1957)

A.A. Comes of Age (1957) gives the history:

  • The first hospital meeting. Dr. Russell Blaisdell, head of Rockland State Hospital, a New York mental institution, let A.A. members into the alcoholic ward, let them start a meeting inside, and a few months later let busloads of committed alcoholics go to outside meetings (A.A. Comes of Age, 1957). Bill calls it "A.A.'s first working relation with a mental hospital, since duplicated more than 200 times" (A.A. Comes of Age, 1957). He also notes that a few alcoholics had already been released into A.A. from two New Jersey asylums, but "Dr. Blaisdell's Rockland State Hospital was the first to enter into full scale co-operation with A.A." (A.A. Comes of Age, 1957).
  • The first prison group. Clinton T. Duffy, warden of San Quentin, looked to A.A. "as a tool to help us rebuild lives" (A.A. Comes of Age, 1957). With help from members in the San Francisco area, "thus began the pioneering of A.A.'s first prison group in 1942" (A.A. Comes of Age, 1957). Duffy credited both the members who came in from outside and the first inmates who stuck with it (A.A. Comes of Age, 1957).
  • By 1955. At the St. Louis convention a panel on "A.A. in Institutions" reported groups "in 265 hospitals and 335 prisons" around the world (A.A. Comes of Age, 1957). The panel also gave a parole figure: about 20 per cent of alcoholic parolees made it before A.A., 80 per cent since (A.A. Comes of Age, 1957). Those are the panel's figures as Bill reports them. Our sources have nothing to check them against.
  • The office. The New York office came to have a department for "special service to prison and hospital groups" (A.A. Comes of Age, 1957).

Pass It On (1984) adds that on his western trip in late 1943 Bill spoke inside San Quentin to an audience of about 420 inmates (Pass It On, 1984).

In, but not owning: hospitals and the Traditions

Early groups were tempted to run hospitals of their own. Bill's 1947 Grapevine article on hospitalization, excerpted in P-17, says that groups which set up their own drying-out places "almost always backfired" (P-17, "Hospitals and A.A.," 1947), because it put the group into a business few members knew anything about. In 1946 he summed up where A.A. had landed: "Years ago we used to think A.A. should have its own hospitals, rest homes and farms." (P-17, "Money," 1946). Hospitalization "is not a function of A.A. in the sense of management or ownership." (P-17, "Money," 1946). Then: "Everywhere we cooperate with hospitals." (P-17, "Money," 1946).

The Long Form of Tradition Six puts it into the Tradition: hospitals and similar facilities should be incorporated apart, shouldn't use the A.A. name, and "ought to be well outside A.A.—and medically supervised." (p. 564). An A.A. group "may cooperate with anyone" but not to the point of "affiliation or endorsement, actual or implied" (p. 564).

So the answer has two halves, and both come from the same sources: A.A. members carry the message into hospitals, and A.A. doesn't own, run or endorse hospitals. See: Does the Big Book endorse treatment centres? · Is A.A. a treatment program? Does it provide detox, housing or counselling? · Tradition Six: can an A.A. group partner with a treatment centre?

How it's done today (2018; 2024–2026)

These are present-day service descriptions, not the 1939 text.

P-16, The A.A. Group (2018). A group may have a corrections representative and a treatment representative who work with the local corrections or treatment committee (P-16, 2018). Corrections representatives, "known in some areas as hospitals and institutions (H&I) representatives," take A.A. meetings into prisons and jails "where allowed by the correctional facility" (P-16, 2018). Through the temporary contact program, called Bridging the Gap in some areas, they may write to people inside and act as A.A. contacts when they're released (P-16, 2018). Treatment committee members "work to help hospital and treatment center staffs better understand A.A." and carry the message to alcoholics in treatment, and may act as contacts when patients are discharged (P-16, 2018).

P-16 also applies Tradition Six to meetings held inside institutions: a group that meets in a correctional or treatment facility shouldn't use the institution's name, which makes clear that the group isn't affiliated with it and "simply rents space there for meetings" (P-16, 2018).

The A.A. Service Manual (2024–2026 edition). Areas list corrections and treatment facilities among examples of Twelfth Step work "that may not be practical for groups, districts or intergroups to take on by themselves" (A.A. Service Manual, 2024–2026 edition). An area committee asks itself: "Is the A.A. message getting into hospitals, prisons, jails and rehabilitation centers?" (A.A. Service Manual, 2024–2026 edition). The General Service Conference has a Corrections committee and a Treatment and Accessibilities committee. Among the Corrections committee's jobs is to "Clarify what A.A. can and cannot do, within the Traditions, to help alcoholics both while in custody and upon release" (A.A. Service Manual, 2024–2026 edition). At the General Service Office, the corrections desk runs the Corrections Correspondence Service, which pairs incarcerated alcoholics with members outside, and "Responds to about 5,000 letters from inmates every year" (A.A. Service Manual, 2024–2026 edition). Intergroup and central offices may also keep in touch with groups inside facilities and arrange pre-release contacts and speakers (A.A. Service Manual, 2024–2026 edition).

"H&I" isn't a Big Book term. In our sources it appears only in P-16, as a local name for these committees.

Taking the message into a prison or a hospital is a different thing from signing papers for a court. See: Does A.A. sign court slips or write letters for courts and probation?

Read it yourself

Sources

Source Pages Date
Alcoholics Anonymous, Chapters 1, 7, 8, 11 15, 78–79, 89, 91, 97, 107, 114, 156, 159, 163 1939 (p. 114's "Since this book was first published" sentence is later; date not given)
Alcoholics Anonymous, Foreword to the Second Edition xvii 1955
Alcoholics Anonymous, Appendix I, Long Form Six 564 1946
P-17, "Money" (Bill W.) — 1946
P-17, "Hospitals and A.A." (excerpts from Bill W.'s "Adequate Hospitalization") — 1947
A.A. Comes of Age (Bill W.) — 1957
Pass It On — 1984
P-16, The A.A. Group — 2018 (revised 2022)
The A.A. Service Manual — 2024–2026 edition

Comes of Age and Pass It On are cited by the file-page markers in our copies (f.), not printed pages.

Recovery Starts is independent and not affiliated with Alcoholics Anonymous. Quotations are brief and cited; the Big Book, P-16, the Service Manual, A.A. Comes of Age and Pass It On are © A.A. World Services, Inc. P-17's articles are © AA Grapevine, Inc.

These pages answer questions about A.A. from A.A.'s own published literature, read in full, with every quote checked word for word against the page it cites. Recovery Starts is independent and not affiliated with Alcoholics Anonymous. What we read, and when each source was written.