In the 1840s, Dorothea Dix traveled the country confronting state legislatures about the unconscionable treatment of prisoners and urging, in particular, the building of hospitals for those with psychiatric illness. By the 1880s, there were 75 psychiatric hospitals in the United States, and a survey estimated that less than 1% of prisoners had mental illness.

Then it all came undone. In 1955, approximately 560,000 patients occupied state hospital beds; today the number is approximately 35,000. It is no mystery where the patients went: In 1880, 0.7% of U.S. prisoners had serious mental illness; in the 1970s, the rate was approximately 5%, and today it is likely more than 20% (an estimated total of almost 360,000 inmates).,/p>

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