Joe Cardo was known as a "bugout"—prisonspeak for a person battling mental illness. Sentenced to two years at Attica Correctional Facility in upstate New York for attempted robbery, he was clearly unwell in 2015, searching the yard for half-smoked cigarettes and claiming to shoot orbs of light. His diagnosis: "schizoaffective disorder," a kind of schizophrenia. And Cardo wasn't alone in the US prison system, which houses about 90% of psychiatric patients under government care. As prison journalist John J. Lennon writes in Esquire, it's a strange plan: Treating mental illness in prison is twice as expensive as using community care (state prisons spend $5 billion annually to house nonviolent offenders with disorders), and mentally ill parolees often fall back into legal trouble.
Back in the 1800s, America largely moved the mentally ill from penitentiaries to asylums for similar reasons, but by the mid-1900s asylums had become corrupt and the strategy was abandoned. Now, in the era of mass incarceration, almost 400,000 of America's 2.2 million prisoners are mentally ill. Some receive mental-health care behind bars, but critics see a contradiction between mental healing and prison life. "We're not psychiatrists," a corrections officer says in Insane, a book reviewed by the New York Times. "We don't know how to take care of people with mental illness." Or as Cardo put it after a fight erupted in the notorious A-block yard at Attica, "Oh, man. This place is crazy." He was released into public housing in 2016, but still says he can shoot orbs of light. Click to see Lennon's full piece. (Read more prison stories.)