Prison gets a bad reputation across the board, and some of it is deserved. But the reality is more nuanced than either the horror stories or the official line suggest.
The best way to think about prison care is this: it is the minimum required by law, delivered consistently, without much warmth but without deliberate neglect either. The government funds it, which means it is adequate by a baseline standard and not much more. Nobody inside is going to confuse it with quality healthcare, but people are not being left to suffer without any attention, either.
Mental health care specifically has improved in federal and many state systems over the past two decades, largely because of litigation and court-mandated reforms. Most facilities have some version of a mental health unit, access to psychiatrists for medication management, and counselors available for ongoing needs. Whether those resources are sufficient for the population that needs them is a separate question, and the honest answer is usually no. There are not enough mental health staff relative to the number of inmates who need services, wait times can be long, and the environment of incarceration itself is counterproductive to mental wellness in ways that no amount of programming fully addresses.
The food analogy is actually a useful one for understanding the whole system. Prison food meets nutritional requirements. It keeps people alive and functioning. It is not enjoyable and it is not designed to be. Mental health care works the same way. It meets a floor, it addresses acute crises, it manages medications, but it does not heal anyone. The extras, the genuine therapeutic relationships, the individualized treatment, the kind of care that actually moves the needle, those are largely absent.
It is realistic and humane in the most literal sense of both words. Nothing more, and inmates learn quickly not to expect more.