|Correctional Mental Health Care: Part II|
|By Carl ToersBijns, former deputy warden, ASPC Eyman, Florence AZ|
As a follow up on another article written about the seriously mental ill (SMI) persons incarcerated in our prisons [Social Injustice for the SMI persons in Prisons], this editorial is written to illustrate the need for more mental health care inside our prisons and what the barriers are that prevents effective programs and treatment for the many persons suffering with this illness. Today the Department of Justice estimates that due to the deinstitutionalization of our state hospitals, many SMI persons have been imprisoned in our state and federal prisons with serious treatment needs but are actually suffering needlessly because of either receiving no treatment, partial treatment or inadequate placement in a place designed for treatment.
Although this is an anecdotal opinion of the current conditions inside our prisons based on both first hand experience and observation of 25 years inside Southwest prisons as a prison administrator, it has been established that more than a quarter of our prison population [many say it’s as high as 50 %] suffer from some type of mental health illness that requires either treatment, medication or both in order to cope with the stressors and daily events inside the penitentiaries. The reasons given for untreated or ineffective caretaking of these SMI can be based on several facts that are not disputable in all the research that has been conducted in the past several decades. The first and foremost factor why correctional facilities suffer in the area of providing treatment to the SMI is the fact that most, if not all, government budgets are strained and funding for mental health programs are limited causing a domino effect that includes the understaffing of qualified medical / mental health staff and the inability to provide proper housing facilities in which correctional therapy programs can exist and the offenders be housed. This limited access to treatment facilities hampers the ability to appropriately treat all those identified needing help with their illness or disabilities.
Secondary, there is an obvious lack of support within the prison administration and cultural setting that allows the existence and success of prison therapy programs to work and be effectively management without political interference. Associated costs and the need for special training discourages many administrators to implement and seek sound therapy programs within their own span of control due to finances and high costs of medication, staffing and other treatment associated expenses.
Lastly, since we have already acknowledged that there are limited funds, limited qualified staffing and limited space, there should be no surprise that those caseloads that do exist are unusually large and hard to manage. This unusual large number of patients has impacted the quality of the services provided and induced high levels of anxiety and frustration by dedicated professionals working extremely hard to meet their program goals. This ineffectiveness or inability to treat has indirectly caused a continuous cycle of SMI persons coming in and out of prisons creating a high recidivism that can only be reduced if the resources were committed to deal with their issues before they leave the prison setting. The dangers associated with these released SMI persons who have not received care while in prison effects our communities and increases their chances of committing crimes again almost assuring society that they will spend the rest of their lives inside a prison with lengthy and determinate sentences to keep them off the streets in the name of “public safety” and “tough on crime.”
The “tough on crime” mandate has overcrowded our prisons with many people who could in fact receive treatment before they are incarcerated and allowed to participate in outpatient treatment programs with the support of their families and other support groups. Since many treatment hospitals have been shut down or have limited bed space since the deinstitutionalization days, the prisons have become the only alternative for SMI persons to be committed and left behind. Since prisons were designed for those who possess and demonstrated “criminal behaviors” it is important to recognize that many SMI persons do not have “criminal intent” when they are experiencing a psychosomatic psychosis and the matter of treatment, medication and stabilization is important to their disability treatment. While many state and federal prisons are equipped with mental health services that serve those with mental health problems and disabilities in prisons there are serious flaws in their design and purpose as too much of the care giving responsibilities are placed on the correctional officers who have no special training in the supervision of such special needs offenders. Therefore, due to lack of the number of qualified staffing available and the expense of training staff for these tasks, the programs become fragmented and ineffective as the communication, education and behaviors are not effectively understood and sometimes ignored due to the excessive caseloads or overcrowding. Although is can be said that there are many devoted and professional correctional staff and mental health personnel with the right attitudes to do the job there is just not enough funding or space to give this matter the priority it deserves. Perhaps it is time for lawmakers who have run for office on the “tough on crime” motto to find funding and implement alternatives for the SMI persons instead of sending them to prisons. It seems only right since it was their approach on the matter that created this crisis inside our prisons today.
Editor’s note: Carl ToersBijns (retired), worked in corrections for over 25 yrs He held positions of a Correctional Officer I, II, III [Captain] Chief of Security Mental Health Treatment Center – Program Director – Associate Warden - Deputy Warden of Administration & Operations. Carl’s prison philosophy is all about the safety of the public, staff and inmates, "I believe my strongest quality is that I create strategies that are practical, functional and cost effective."
Other articles by ToersBijns:
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