Eyal Press contends there are entire areas of life we’ve delegated to “dirty workers”—functions we’ve declared necessary, but that we strive to keep hidden. In his new book, Dirty Work: Essential Jobs and the Hidden Toll of Inequality in America, Press points to the transformation of jails and prisons into the country’s largest mental health institutions. He calls the people struggling to offer treatment in those settings “dirty workers”—not because their work isn’t noble, but because collectively we’ve put them in a situation where it’s impossible to practice ethical care.

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Hear a related New Thinking episode with Homer Venters, the former chief medical officer for NYC Jails.