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Introduction | A Visit to Jail | Locked Up and Psychotic
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In the early 1840's, crusading prison reformer Dorothea Dix wrote a scathing report to the Massachusetts legislature:

Trouble in Mind
Photo essay by Steve Schapiro

I proceed, Gentlemen, briefly to call your attention to the state of Insane Persons confined within this Commonwealth, in cages, closets, cellars, stalls, pens: Chained, naked, beaten with rods, and lashed into obedience!

Dix argued that the many insane people in Massachussetts jails and almshouses did not belong there; they should be placed in more humane institutions designed just for them. Massachusetts and other states responded. Dix's campaign led to the construction of some 30 new mental institutions. Forty years after she started her campaign, the 1880 United States Census said 99% of the nation's 'insane persons' lived at home or in asylums. Only a few hundred were in jail. That was the practice in the US for the next century: mentally ill people who couldn't cope on their own were confined in mental hospitals. Most never had the chance to live freely in society—or to get in trouble there.

That has changed. Last year the U.S. Justice Department said 280,000 people with serious mental illnesses were in jail or prison—more than four times the number in state mental hospitals. American RadioWorks Correspondent John Biewen explores why.

Next: A Visit to Jail