Here is a truly astonishing 2006 documentary from PBS’s “Frontline” that you can watch in its entirety online: The New Asylums. It shows how one of Ohio’s prisons struggles to cope with the large proportion of its inmates who are mentally ill. The most disturbing statistic in the documentary is that, in the US, 500,000 mentally ill people are now in prisons, TEN TIMES as many as are in mental hospitals. As you watch it, also keep in mind that Ohio has one of the best systems in the US for providing mental health care to prison inmates. The vast majority of mentally ill American prisoners get nothing like this level of care. The documentary was the winner of the grand prize of the 2006 Robert F. Kennedy Award for Journalism.

Although not explicitly discussed in the documentary, the historical irony portrayed here is pronounced and grim. The giant state mental “asylums” of the 19th century were built, in no small part (all heroic mythologies aside), because prison warden’s complained that the “mad” made life in the prisons unbearable for themselves and the other prisoners. But by the 1930s, it was clear that state mental “hospitals” (as they had been renamed) were a disaster. Still, it took another 30 years to figure out a politically palatable way to dismantle them — the community mental health system. Of course, community mental health was never properly funded and has virtually collapsed in many places, so the “mentally ill” (as they had been renamed) became homeless, with few supports. Many commit petty (and a few, not so petty) crimes and end up in the very prison system that rejected the mentally ill a century-and-a-half ago.