A generation ago, the state closed its mental hospitals on the west side of Columbus.
Many former patients wound up on the street and sometimes in jail.
Now, there are so many people with mental illness filling the Franklin County Jail, that deputies get special training in how to handle the population.
More than 80 times a day, a new inmate is locked in a cell at the Franklin County Jail.
Most go into group cells with others awaiting trial or transportation to prison.
But up to one quarter of them need special attention because of a mental illness.
Staff members, like mental health liaison Douglas Hahn, have to make the call.
He said that questionable cases go to observation. But it's often obvious.
"They're talking to people that you and I can't see. Or they're telling me they're a special agent. Or they have magical powers. Or that they've been visited by aliens," Hahn said.
In a corner of the busy intake area, the Chief Deputy for Corrections Mark Barrett talked quietly with Deputy Peter Wickham about a recent arrival.
"The nurse put him in a gown, and then Mental Health came in," Wickham explained.
These inmates move on to the sixth floor, with individual cells, so they won't be bothered by other inmates. They get out once daily to a larger area for exercise and showers.
Barrett said that many of the inmates needed medication before they were brought in, but they did not get it or they would not take it.
"Often times, they end up coming to jail simply because there's a lack of other facilities in which to take those persons," Barrett said.
When they take their medicine, they can function well, Barrett said. When they don't, they often get in trouble.
William Brigham was convicted of domestic violence after he attacked his mother. At the time, he said that he was off his psychiatric medicine.
"I have periods of mania and depression and I hear voices," Brigham said. "I have like two conversations at once. I have like a conversation that I'm trying to have with you normally, and then the other voices in my head are going another thing. And it's really stressful. It's a really stressful thing to go through."
There are so many mentally ill inmates that deputies get special training in how to handle them.
When one grows agitated and cannot be calmed, the response team steps in.
"We try to do it by safety with numbers, getting the right resources at the right place at the right time to deal with it, and try to de-escalate the situations," Barrett said.
If necessary, a violent or dangerous inmate is strapped into what's called the Pro-straint Chair for up to three hours. A nurse checks him every 10 minutes.
Staff said that it can be frustrating work.
"A challenge at times. And the true mental health inmates that we have in here, it's almost like dealing with your kids," Wickham said.
Barrett said that staff was there to run a jail, not a hospital.
On the third floor, the cells aren't barred, but solid metal.
Wickham brings inmates there if they are dangers to themselves or others or if they were throwing bodily waste.
It's an area with half a dozen cells that smelled foul. Deputies can't force the men to take either medicine or showers. But they have a special compassion for inmates whose minds create a prison worse than steel walls.
Wickham leaned forward to look through a small window set in the heavy door.
"You were crying? You were banging your head?" he asked. "Oh you wanted to hurt yourself? Is that why they put you in a gown? How you doing now? You're not banging your head?"
Another inmate broke into a spontaneous rap. As he sang he bounced. He had plastered a two-inch-long worm of wet tissue to the tip of his nose, so it bounced along with him.
Wickham smiled as he approached the window. "Oh, you're going to sing a song?"
He leaned closer and looked. "What's on your face here? Oh, you don't have pants on. Oh, dear," Wickham said as he moved away.
Some inmates are sent on to a psychiatric hospital.
Hahn tried to get others on medicine, and linked to resources in the community when they leave.
Occasionally, he has gotten thank you notes from people he has helped.
Like the chief and deputies, Hahn said that he knows that there's nowhere for the homeless mentally ill to live and be treated.
In a tough economy, politicians rarely talk of spending more money to care for this population. For some of these people, jail means a bed, a roof over their heads and regular meals.
"Some of them know what kind of crimes to commit to come back her," Hahn said. "There needs to be some other options out there in the community, so people don't have to come here to get care."
Watch 10TV News and refresh 10TV.com for more information.