This dissertation examines the role and function of mental health care in the ever shape-shifting US carceral state. Drawing on three years of ethnography inside LA’s jails and amidst political processes occurring outside of them, I consider how and why jail mental health care appears to only sustain and further individual and collective suffering. Situating this crisis in the longer histories of neoliberalism, the U.S. carceral state, the political economy of mental health care and the history of psychiatry, I show how this crisis is, fundamentally, about the carceral regime’s ability to reproduce itself, inter-personally, institutionally and extra-institutionally. I argue that the LA jail system has recruited psychiatry to enact a discursive-techno-spatial fix to the problem that madness, and psychic decompensation generally, introduces into its institutional order. This psychiatric fix displaces the problem of madness from the carceral institution and neoliberal social order into the person’s individual pathology and/or brain, on to its mental health housing units, or out to mental health diversion programs and/or state hospitals. This act of displacement seeks to preserve the legitimacy and functioning of the carceral institution itself. Enacting this fix, however, requires a particular form of psychiatry, one explicit in its biological orientation and implicit in its anti-humanist therapeutic pessimism, wherein patients’ lives are doomed to recurrent incarcerations and early death, and care is alienated and mortified. This form of psychiatric practice launders the jail’s everyday practices of domination and alienation.Contraposed with the psychiatric fix, this dissertation examines two counter-hegemonic projects that have sought to interrupt this carceral regime’s functioning and plan a future different from perpetual crisis. Inside the jail, a group of incarcerated men, working as “Mental Health Assistants” (MHA) observed their peers psychiatrically deteriorate as they churned in and out of the jails. Against this isolation and abandonment, the MHAs developed an innovative project borne in mutuality and possibility, by which the jail began to be undone. Outside the jail, a coalition of health providers and community organizers challenged the jail’s legitimacy as a solution to housing and community and long-term mental health care — organizing to defeat LA County’s plan to build a new, 2-billion dollar ‘treatment jail’ in 2019. Bringing together a conjunctural analysis of the LA jail mental health crisis and the pre-figurative possibilities of psychiatric utopianism demonstrated by the organizing inside and outside the jail, this dissertation views jail mental health care as a terrain of psycho-politics. On this terrain, particular relationships harden and become the glue holding the jail together and enabling its reproduction, while struggles are simultaneously waged at its points of contradiction. This multi-leveled approach demonstrates how the jail is an institutional and ideological regime, while offering a lens through which to understand efforts to interrupt carceral social reproduction.