Green’s Dictionary of Slang

screw n.²

a mad person.

1953

W. Brown Run, Chico, Run (1959) 31: Tomas is a screw. He don’t like boom.

In compounds

screw factory (n.)

a psychiatric hospital.

1975

J. Wambaugh Choirboys (1976) 207: Mrs. Bloomguard [...] did a naked tap dance in front of the Pomona courthouse and had to be taken to the screw factory to get rethreaded.

In phrases

loose screw (n.)

an eccentric.

1912		Van Loan ‘Ten-Thousand-Dollar Arm’ in Ten-Thousand-Dollar Arm 3: There have been enough peculiar left-handers to justify the belief that side-wheelers and loose screws go together.
1932		(con. 1910s) J.T. Farrell Young Lonigan in Studs Lonigan (1936) 6: Girls had loose screws in their beans.