By Gage’s estimate, between 20 and 30 percent of Washington’s 16,700 inmates are mentally ill. When I asked why, Gage, who spent two decades at Western State Hospital before switching to the DOC, went broad. “It used to be called deinstitutionalization,” said Gage. “Now it’s called trans-institutionalization. We took everyone out of the state hospitals, and they pretty much, the same population, ended up in prisons and jails.” The jailing of the mentally ill cannot honestly be called an accidental byproduct of the nation’s fractured mental-health system. The disinvestment in mental health care has gone on too long — generations now — to be considered anything but deliberate neglect. In 1955, before deinstitutionalization, there was one psychiatric bed for every 300 U.S. residents. A half-century later, that ratio is now 1 in 3,000. That has led to another telling ratio: For every one person in a public or private psychiatric bed in Washington, there are 3.1 people with serious mental illness in the state’s jails and prisons, according to the Treatment Advocacy Center. Nationally, the ratio is 3.2 to 1.