From Ohio History Central
In 1837, the Ohio legislature established the Ohio Lunatic Asylum in Columbus, Ohio. Dr. William Awl served as the director of this institution until 1850. Before creation of this institution, most mentally-ill Ohioans received no formal treatment for their illnesses. Their loved ones commonly had the ill person confined in a local jail or in the Ohio Penitentiary, hoping that their family members would not be able to harm themselves while under confinement. Awl believed that mental health problems were illnesses that physicians could treat, and in 1843, he even proclaimed that he had cured one hundred percent of his patients at the Ohio Lunatic Asylum. Critics of the institute and of Awl began to refer to the physician as "Dr. Cure-Awl."
By 1851, the Ohio Lunatic Asylum could house just three hundred patients. The current director, Dr. S.A.T. Smith guessed that two thousand Ohioans needed treatment. Most of Ohio's mentally ill remained confined in county jails or at the Ohio Penitentiary. To provide greater access to mental health facilities, the Ohio legislature, in 1852, authorized the creation of two new asylums. These asylums were to be constructed in Cincinnati and Canton, but due to several reasons, they were eventually located in Cleveland and Dayton. Over the next several decades, Ohio constructed additional asylums to meet the needs of Ohio's mentally-ill residents.
At the start of the twenty-first century, Ohio no longer operated asylums. Long-term mental health facilities continued to exist in the state, but private health care companies, known as Behavioral Healthcare Organizations (BHOs), managed these institutions. The Ohio Department of Mental Health had oversight over these privately-owned facilities to ensure adequate care for Ohio's mentally-ill population. The BHOs also provided outpatient services.