To many, asylums are a relic of a bygone era. State governments took steps between 1950 and 1990 to minimize the involuntary confinement of people in psychiatric hospitals, and many mental health facilities closed down. Yet, as Anne Parsons reveals, the asylum did not die during deinstitutionalization. Instead, it returned in the modern prison industrial complex as the government shifted to a more punitive, institutional approach to social deviance. Focusing on Pennsylvania, the state that ran one of the largest mental health systems in the country, Parsons tracks how the lack of community-based services, a fear-based politics around mental illness, and the economics of institutions meant that closing mental hospitals fed a cycle of incarceration that became an epidemic.