Life in a maximum security psychiatric hospital is not the same as in prison, according to ABC 13, who went inside the only such facility in Texas. Jeff Bearden, director of the hospital's Forensic Psychiatric Program, told ABC13, "Once they're admitted, the handcuffs and shackles come off and they become patients of the public mental health system."

That means they are treated differently than prison inmates. In a way, they have more freedoms, including the fact that in most facilities, women and men are in the same buildings, according to what Brottman told A&E. She said patients can wear regular clothes and are not identified by numbers, as they are in the prison system. Because they are patients, they are given regular medications and therapy or treatment from doctors. Friends and family can visit and hugs are allowed. However, they are watched by guards and the buildings are surrounded by fencing. 

According to Brottman, some patients would rather be prison or jail, because "They're treated with more dignity." 

She elaborated that as a patient in a maximum security psychiatric hospital, everything you do is viewed as "a symptom instead of a rational choice that anyone might make. In prison, you can stay in your room, you can choose not to go to meals, you can choose not to go out into the yard, and it's not jotted down in your file as a symptom of an illness — it's just a choice."

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