The independent Commission on Safety and Abuse in America's Prisons is half way through its public hearings and has received information from a variety of voices in corrections - all with the idea of helping to improve operations in this country's prisons and jails.

According to Alexander Busansky, Executive Director for the Commission - staffed by the Vera Institute of Justice, the one thing he has been surprised about is the way the different expert witnesses have come together for one common goal.

"I have always believed that what goes on inside requires a serious examination and a  serious review and to do that you need people who are involved and engage in the issues. There's no one person who speaks for everyone," said Busansky.

Testimony in two public hearings, one in April in Florida and the second last week in New Jersey, have involved officers, former inmates, corrections executives, representatives form professional associations, physicians, advocates, statisticians and others.

They have been honest about the problems they face and the need for more attention and resources to be paid to the corrections field.

"Our goal has been to engage all of the different voices to establish the common ground and explore more rigorously the differences they have. We're doing that not just with the diversity of voices, but also with the diversity of stories [and] the things that have worked or not worked," said Busansky.

At the hearing on July 20, commissioners wanted to examine more closely the institutional causes of violence and abuse as well as medical and mental healthcare in prisons.

Busansky said that the testimony made clear that problems that arise in correctional facilities do not only impact the lives of inmates, but also the lives of those who work there and those whose loved ones are incarcerated.

"[We experience] the power of the idea that what happens in prison and jail does not stay in jail. Conditions of confinement, overcrowding, public health, mental health, all bears on the lives of those who leave facilities and it all comes back into the community. We see it in lots of different ways from aberrant behavior to the spread of disease," said Busansky..

And, communicating that message to those inside and outside the profession, he believes, will help improve the system.

"I think getting our message out to corrections folks and the concerned public is essential to our success. Prisons and jails are not going to improve themselves because people on the outside say they should be. Everyone must come together on common ground to address these issues," he said.

Below are some of the excerpts from written and spoken testimony provided to the commission during it's second hearing on July 20, 2005.

Institutional Issues

Daud Tulam: Former inmate Daud Tulam is a former inmate who spent over 18 of the 25 years of his incarceration in the Management Control Unit at the New Jersey state prison in Trenton. He is currently working for a corporation that makes component electronics parts for industry and the military. He lives in Salem with his family.

Excerpt: The MCU is an isolation facility where inmates are locked down in single cells, roughly 9 by 13, for 23 hours out of every day, 7 days a week. Inmates are let out of their cells for each meal to receive their trays, and also for some exercise (in a small fenced in area) every other day.
Although spending this much time in locked down isolation could be
detrimental to one's psyche, I found that I was able to survive my experience by having the ability to adapt.
I used my ability to read and write to help keep my mind occupied, I developed a very regimented routine that I would follow each day to pass the time and to keep myself busy. I would wake up at the same time every day. I would read and write for a period of time as well. In addition, I was able to maintain a strong family connection, which helped me a great deal. Inmates who did not have that kind of support tended to have difficulties.
During the time I spent in the control unit, I noticed that some other inmates struggled with the lock down conditions. I observed that some individuals, who were quite normal when they arrived on the unit, started to change over time. Some started talking to themselves, some developed poor hygiene habits. I even observed and heard about a number of attempted suicides.
An order placing an inmate in the control unit is supposed to be reviewed every 90 days. However, I found the reviews were just a sham with no real investigation of whether it continued to be an appropriate way to confine me.
I have just completed my first year of re-integration with the general community. Although I made it out and have been able to adjust pretty well, there have been some lasting effects from the time I spent in the control unit and in prison in general. I have noticed that my social skills deteriorated and, although I was on the quiet side to begin with, I am now much more reserved around others. I also have become desensitized to violence, having seen so much of it while incarcerated. To this day, I maintain a very disciplined structure to my daily life that I notice other people do not follow.

Gary Harkins: Sergeant Gary Harkins is in his 25th year at the maximum security Oregon State Penitentiary (OSP) in Salem, Oregon. During his career as a Corrections Officer, Correctional Corporal, and now Correctional Sergeant, he has worked every uniformed position at OSP. He has worked in the Oregon Department of Corrections Training Section revising staff curricula and currently sits as the only Correctional Line Staff representative on the 11-member Oregon Department of Public Safety Standards and Training's Corrections Policy Committee. Sgt. Harkins served three terms as President of the Association of Oregon Corrections Employees and for the past eight years, he has been the Recording Secretary for Corrections USA.

Excerpt: In Oregon, the two largest state agency budgets are the education and corrections budgets. It's very hard to say no to a bus load of school children when you have to chose who gets adequate funding and who doesn't...
In the 99-01 Biennium, the ODOC had over 400 uniformed staff vacancies so the
Department could use the funds for something besides staff. On 3/31/01, there were 340 vacant positions in the Department with most of these being held open due to the need to balance our budget and to pay for positions that the State legislature refused to fund in the Department's budget. As of today, the Penitentiary has over 30 uniform staff vacancies as reported by the ODOC. However, line staff believe that we could use an additional 30 staff to fill out areas where we are running thin. This would greatly increase the safety of staff and inmates in these areas. One result of this staff shortage is the Penitentiary's overtime budget being over $1 million dollars a month.
Another result of this shortage of staff is the inability to have our 15 minute rest breaks per the national and state labor rules. We do not receive compensation for these missed breaks. As a result of missed breaks, some staff sneak out for them when they can but it can have unfortunate consequences. One position I work each week, the main Control Floor, is a two man post. One day, about 8 months ago, I was relieved by another C/O for lunch. There is constant inmate traffic at this time of day moving in various directions across the floor. I was gone for about a minute when my relief asked my partner if he could leave for a quick smoke break. Two minutes after he left the floor, a lieutenant was walking across the floor when an inmate came out of the crowd and stabbed him three times in the back. My partner was stabbed and assaulted in the process of trying to restrain the inmate before other staff could arrive to help. If we were adequately staffed to allow a staff member to take a proper break, it is quite possible that the injuries suffered by these two staff would have been lessened....
The correctional staff have a vital role in society. Sometimes, when the public learns of our profession, they say "you must have an interesting job." Often, however, we are viewed with disdain, like we work with lepers or other societal outcasts (I do not wish to demean those who do work with them) but we and our families are treated like we are the inmates as well. We want safe and secure institutions where inmates can learn to be better, productive citizens and the Correctional Officers can come home to their loved ones each day. We are not knuckle dragging guards working in smelly dungeons and we do not deserve that reputation. Unfortunately, the media reinforces that image every time they use the phrase "guard." It is my hope that this commission will help dispel this negative image of correctional officers.

Richard L. Stalder: Richard L. Stalder was appointed Secretary of the Louisiana Department of Public Safety and Corrections in February 2004. He previously served as Secretary under the administration of former Governor Edwin W. Edwards (1992-1996) and former Governor M.J. "Mike" Foster, Jr. (1996-2004). Secretary Stalder is the current President of the national Association of State Correctional Administrators and was President of the American Correctional Association (ACA) from 1998 to 2000.

Excerpt: I want to very specifically urge your advocacy for certain things.  One is for pay and benefits for correctional officers, people who work in our prisons and our jails.  You cannot run the kind of safe and stable facilities that you want and that we advocate for without a well trained, career staff.  In Louisiana I regret to tell you that we start our correctional officer's at the state level at $18,000 a year, gross.  Now, if they're fortunate enough to be able to participate in our benefits and insurance program, that takes $3,600 off the top.
Most of our correctional officers are eligible, thank God, for their children to participate in the Children's Health Insurance Program, funded federally, so at least the kids can enjoy health benefits.  Our turnover is 30 percent a year.
If this commission can advocate for pay and benefits for correctional officers in our prisons and our jails, you will take a significant step forward in promoting safety in these environments.
I like to say public safety relative to corrections is not just about keeping dangerous people behind bars.  Public safety is about making sure they don't exit our system with contagious diseases.  So that if we know that someone has disease prevalence or that we have a higher disease prevalence in our institutions, we need the resources to deal with that and I would urge this commission to be sure that the scope of what you do and advocate for includes advocacy for the treatment of disease in our institutions.
Hepatitis C, because it's a disease of intravenous drug abuse and it's a disease of lower social economic status have Hepatitis C and, regrettably, the treatment is 18 months long and it  costs about $20,000 per inmate.  If I treated everybody in the State of Louisiana in my correctional system who had Hepatitis C, the cost would exceed the annual limit for bonded indebtedness for the entire state.  We need help. 
One of the most important things we can do relative to overcrowding, in my opinion, is to support programs for children and this commission I think, and I hope, can take a step forward and say, you know, in all of this that we deal with and we talk about safety and abuse in America's prisons, let's deal with some of these issues that can help make sure that people don't get the opportunity to come into prison.
The children of the people in our prisons are seven times more likely to go to prison than other kids in similar socioeconomic status, seven times more likely.  You know, I hope that this commission will look at that tragic statistic and say, you know, to deal with overcrowding we need to promote safety, let's pay attention to kids, particularly the children of people who are in our prisons. 

James H. Bruton:  James H. Bruton has over thirty-four years of professional experience in corrections. He was the Warden at the Minnesota Correctional Facility - Oak Park Heights, the state's maximum security prison, from 1996 until his retirement in 2001. Prior to that, Mr. Bruton was the Deputy Commissioner of the Institutions Division in the Minnesota Department of Corrections. Mr. Bruton has been an Adjunct faculty member for the University of St. Thomas' Criminal Justice Department since 1987, and is also an Adjunct faculty member at the University of Minnesota, Hamline University, Minneapolis Community and Technical College, and Century College. He has been a consultant with the National Institute of Corrections and an expert witness for the Ramsey County Attorney's Office. Mr. Bruton is the author of The Big House: Life Inside a Supermax Security Prison, published in 2004, and a contributor to Super Max Prisons: Beyond the Rock.

Excerpt: ...Unfortunately, some prisons do not operate on the principles of dignity and respect. In those systems, officers think that by threatening new inmates, they will set a tone of superiority. They think that by treating inmates with disdain, they will maintain control. They are wrong. Contempt breeds contempt. Mistreated inmates react with hostility and resistance. What's more, this resentment against constant mistreatment continues past the release date when offenders are returned to the community and are expected to associate appropriately with the general public.
I met inmate John Smith the day after his transfer to Oak Park Heights. What he told me reaffirmed the importance of treating inmates with dignity and respect.
First, Smith thanked me. He said that after being processed in, escorted to his cell, and locked in for the night, he was surprised to hear one of the officers say, "Good night. We'll see you in the morning." This simple pleasantry, Smith said, had been absent from his previous prison experience, and helped ease the anxiety that exists with an institution transfer.
Then Smith told me about a previous transfer experience. In that instance, he was greeted with the following question: "Where would you like your body sent if you're murdered here?" It set the tone for the rest of his stay.
Prisons do not run safely through intimidation. They don't run safely through fear of automatic rifles or corporal punishment. Prisons don't run safely by accident; they run safely by design. And it all starts with how you treat people.
This is the most critical of all management principles in prison operations. It forms the foundation upon which every thing else is built. Security and control - given necessities in a prison environment - only become a reality when dignity and respect are inherent in the process.

Medical/Mental Health Care

Thomas Farrow: Thomas Farrow served 14 years of a life sentence before the Governor of New Jersey commuted his sentence. He was paroled in 1984. Shortly before returning to prison in 1996 on a parole violation, Mr. Farrow was hospitalized for bi-polar disorder. From 1996 to 2005, he was incarcerated in four prison facilities in New Jersey. Upon his release, he spent a brief period in a halfway house until this past May.

Excerpt: ... much of the worst mistreatment and abuse of inmates with mental illness persists in our prisons despite efforts to improve conditions. And although it can be difficult to get treatment in the free world without money and resources, that fact does not justify the serious abuse and degradation of mentally ill prisoners that I witnessed during my time in prison.
Perhaps the single biggest problem that prisoners with mental illnesses face in prison is the insensitivity of correctional staff. In my experience, the majority of corrections officers responded to outbreaks by mentally ill inmates as a disciplinary problem, the response to which was to place the prisoner in lock-up where he would go without treatment and deteriorate. I witnessed a lot of resistance by corrections officers to the administration's efforts to empower mental health providers to intervene on behalf of mentally ill prisoners. This resistance took many forms. For example, at times when I would meet with a psychiatrist to discuss my medication the officer who escorted me there would purposefully and unnecessarily stand in the door and listen, which made it impossible for me to confide in the doctor and signaled to me that there was no respect for the doctor/patient relationship. Often corrections officers would refuse to bring us to our appointments with mental health providers and it seemed they simply had no respect for mental health treatment.
... In general, I think it is fair to say that the corrections officers in the mental health units did not evidence any special training or sensitivity toward the mentally ill, and in fact these units often seemed to be the place where officers who had been in trouble or had difficulty elsewhere got placed.
... you should understand that the lack of care and truly effective therapy on the inside means that those people will be sure to be released in no shape to fight for the help they need on the outside. Abuse and degradation of the mentally ill in prisons persists despite efforts to reform the system and it is my hope that this Commission will do something to address the attitudes toward prisoners that make it so difficult to change the way they are treated.

Joe Baumann: Joe Baumann began his career as a correctional officer in the California Department of Corrections (CDC) 19 years ago. He is currently assigned to the California Rehabilitation Center (CRC) and is the CRC Chapter President of the California Correctional Peace Officers Association (CCPOA). In addition to the CRC, he has worked in the California Institution for Men and the California Institution for Women and has had the opportunity to work in Medium Security General Population Housing, Administrative Segregation, Protective Custody Housing, Reception Centers, and several Mental Health Program housing units. The observations and opinions he expressed at the hearing are his own, and not those of CDC or CCPOA.

Excerpt: I've seen overcrowded prisons that lack sufficient space for proper medical and mental health facilities, prisons that cannot recruit and retain qualified health care professionals, and a cadre of custody and medical staff that are stretched to the limits with the day-to-day grind of doing a thankless job...
In January 1996, an inmate utilizing several combination locks in a mesh laundry bag assaulted a correctional officer at my institution. After a violent struggle with several other staff, the inmate was subdued and ultimately transferred to another institution. The victim of the assault medically retired because of the significance of the head injuries she'd received.
The follow-up investigation revealed that the inmate had a long history of schizophrenia and hadn't received his medication in the three weeks that he'd been housed at CRC. No one in health care services had been monitoring the inmate's medication regimen. The confrontation between the officer and the inmate was triggered by the inmate's distress over his mother's failing to arrive for an expected visit, a woman who'd passed away some 5 years previously.
Since that date, the number of inmates in CRC's Mental Health Delivery System has climbed from less than 300 to more than 800. While we've received an increase in psychiatrists and psychologists, we've never received the additional staff necessary to supervise and distribute medication within the allotted time frames, and the training received by C/Os is still lacking at best.
Many of the issues that plague the inmate population directly affect the working conditions and safety of the correctional officers of this country. I would hope that through processes like this one that the stereotype of the violent, knuckle dragging "prison guard" can be put to rest once and for all. For too long it's been used to simplify systemic problems that the vast majority of the public has no interest in: prisons.

Dr. Joe Goldenson: Dr. Joe Goldenson has been the Program Director and the Medical Director for the San Francisco Public Health Department's Jail Health Services (JHS) since 1993. Dr. Goldenson serves as a medical expert appointed by the federal court in three cases related to health care provided to prisoners. Dr. Goldenson has also been involved in evaluations of the health care services in the Wisconsin Supermax Correctional Facility, the Los Angeles County Jail, the Dallas County Jail, and the Jefferson County Jail (Port Townsend, Washington). Dr. Goldenson is a member of the California Medical Association's Corrections and Detentions Health Care Committee. He has served as a consultant to the Francis J. Curry National Tuberculosis Center and is currently a member of a committee revising the Center for Disease Control's guidelines for the management of tuberculosis in correctional facilities. Dr. Goldenson is a fellow of the Society of Correctional Physicians and has served as secretary and treasurer of the Society. He has been an Assistant Clinical Professor at the University of California, San Francisco since 1980.

Excerpt: Unfortunately, almost 30 years after Estelle, the state of health care in many correctional systems remains poor and inadequate and fails to meet the constitutional standard set by the Supreme Court. Lack of timely access to routine, specialty, and emergency care; lack of chronic care programs; incompetent and inadequate care; and deficient medical records systems are common problems. In many of the correctional institutions with a satisfactory health care delivery system, necessary changes have only come about as the result of court orders or settlement agreements. In many cases, this has involved the appointment of medical experts or special masters to oversee the health care programs and ensure compliance with court decrees....
Recently, U.S. District Judge Thelton Henderson decided to place California's state prison health care delivery system under receivership... Judge Henderson concluded that "horrifying details" presented in a series of hearings over the past month had filled him with a sense of urgency and persuaded him that the California Department of Corrections was unable to manage medical care without outside help... In most correctional systems, health care is under the auspices of the Sheriff or Department of Corrections. Security is their main concern. The provision of healthcare is often not seen as a core function and is not given much attention.... Custody staff often has managerial responsibility over medical decision making, a role, as noted above, for which they do not have the necessary medical education and training... In most systems, the health care budget is part of the overall corrections budget and is controlled by the Sheriff, warden, or other officials within the custody bureaucracy... It is difficult to attract qualified physicians and nurses to work in correctional facilities.
This is due to a number of factors, including the poor reputation of health care staff who work in corrections, the stigma of working in a correctional facility, inadequate facilities, and poor working conditions.... Many staff view prisoner requests for medical care as attempts at manipulation.
The lack of adequate medical care in correctional facilities leads to unsafe conditions and... can rise to the level of abuse...The pain and suffering resulting from poor medical care is not supposed to be part of that punishment. Provision of inadequate health care creates needless pain and suffering for the many prisoners who require such services. In its most appalling form, inadequate care transforms a prison sentence into a death sentence.

Arthur Wallenstein: Arthur Wallenstein currently serves as Director of the Montgomery County (Maryland) Department of Correction and Rehabilitation. All three of the county's correctional facilities are accredited by the American Correctional Association and the National Commission on Correctional Health Care.  Mr. Wallenstein previously served as Director of the King County (Washington) Department of Adult Detention and as Director/Warden of the Bucks County (Pennsylvania) Department of Corrections. In 2004, he was the first correctional administrator to win the coveted Bernard Harrison Lifetime Achievement Award from the National Commission on Correctional Health Care for his outstanding commitment to improving health care in corrections. Mr. Wallenstein has served as an Adjunct Faculty Member at Temple University, St. Joseph's University, the University of Washington, and currently Montgomery College (Maryland). He has a special interest in international relations and has co-authored a book on the United Nations and international organizations. 

Excerpt: Jails are the site of most correctional business, and health care is a critical element in the admission and booking of over 10 million prisoners annually. ...Providing specialized health care services for over 10 million human beings is an enormous undertaking and drives many public policy considerations that do impact the safety of our local correctional facilities, the staff who work in this environment, and the communities that are served by these institutions.
...there is likely no single area of correctional practice more accepted across liberal and conservative advocacy and evaluation than health care delivery. Standards now exist that provide guidance to any correctional system in this country regarding the proper nature of correctional health care.... It would be a grave error to assume or to portray this health care system as deficient, inappropriate, abusive, or beyond the pale of constitutional practice. Certainly there are deficient health care operations in selected jurisdictions, but the quality of correctional health has improved dramatically, and this is part of the testimony that must be presented and reviewed by this Commission. It is not singularly a story of abuse but rather a much broader story of change, constitutional growth and development, expanding service delivery as a function of vast changes in the nature of health care needs brought to the jail system, and increased opportunity to dramatically improve public health services for an enormous "at risk" population.

Jeffrey A. Beard: Jeffrey A. Beard, Ph.D., has served as Pennsylvania's Secretary of Corrections since 2001 and is responsible for the management and operations of the Corrections Department. A licensed psychologist, Dr. Beard has a broad background and over thirty years of experience in criminal justice and corrections.
Dr. Beard has been an acting superintendent at the State Correctional Institution (SCI) at Rockview, a superintendent at SCI-Cresson, and a superintendent at SCI-Camp Hill, where he had overseen reconstruction planning, improvements to the overall security of the facility, and management of 1,600 inmates after two major riots destroyed or seriously damaged much of the facility.

Excerpt: I believe that objective criteria are needed to measure the safety and the humaneness of our systems and facilities...
The Association of State Correctional Administrators (ASCA) has a committee known as the Performance Based Measures Committee, of which I am the Chair, that is actively working on developing performance measures... Key indicators for public safety, institution safety, substance abuse, and mental health have been developed. Key indicators for justice and health standards are in final development. A web site has been established to allow states to submit data, in accordance with specific data elements and counting rules (to ensure consistency of measurement), and to compare both across
a system and between systems. Specific contextual information is also collected so that like facilities and systems can be easily compared. A pilot, consisting of six states, of this system has been operating since last year, and ASCA is now prepared to roll this out to other states, as we also will expand the number of measures upon which data is being collected...
But we now know much more about the root causes of criminal behavior. We know that there are rehabilitative programs that do work, and we know where many of our offenders come from. I believe that this commission can help us have safer prisons by focusing on the causes and looking for alternatives that can not only reduce criminal behavior in the first place, but, when it does occur, to make sure that incarceration is, in fact, the best alternative. We failed as a society to do this 25 years ago, and we continue that failure to this day.
I believe that most medical issues, and there are many, arrive at our prisons and jails with the inmate when the inmates enter prison. Many of the serious contagious diseases were acquired due to IV drug use and unsafe sex practices in the community...It is also important to remember that in order to be successful in providing a quality health care program that meets the community standard of care and maximizes the positive impact on the public's health, one must have a comprehensive program. It must include assessment, education, prevention, and treatment protocols, and it must focus on both staff and inmates.
A good example of a comprehensive and aggressive approach to corrections health care is Pennsylvania's DOC's handling of hepatitis. We began a number of years ago by incorporating it into our staff training and we offered Hepatitis B vaccines to all staff. We then put together a more comprehensive program dealing with assessment, education, prevention, and treatment with a focus on both staff and inmates.
We continue to assess new inmates for Hepatitis C. We also provide education on
hepatitis for all inmates and staff. This is done through pamphlets, videos, group discussion, and training programs...Anyone who tests positive for Hepatitis C receives additional education about the disease and potential consequences. Initially, we also offered drug therapy to all those who were positive and not excluded from treatment for mental health or medical reasons. But our protocols are dynamic and, as we learned more and as current research supported recommendations by the National Institutes of Health (NIH) and the Centers for Disease Control (CDC), our protocol evolved to meet the community standard of care...

Robert B. Greifinger: Robert B. Greifinger, M.D., is a health care policy and quality management consultant. His work focuses on the design, management, quality improvement, and utilization management in correctional health care systems. He has extensive experience in the development and management of complex community and institutional health care programs and strengths in the bridging of clinical and public policy interests. His current clients include the courts, state and local correctional systems, and the Civil Rights Division of the United States Department of Justice. He has had a variety of assignments as a court appointed expert to investigate and design remedies for ailing correctional health care systems, and has worked on assignments for the Centers for Disease Control, the Urban Institute, the Council on State Governments, and John Jay College of Criminal Justice. Dr. Greifinger was the principal investigator for the recently published Report to Congress on Seizing Public Health Opportunities through Correctional Health Care.

Excerpt: The conditions in some correctional facilities are redolent of conditions in prisons in the United States a century ago. ...One hundred years later, despite the widespread availability of modern diagnostics, knowledge about containment, and multidrug regimens for communicable disease, some American prisons are currently incubators of this same scourge. Too little attention is being paid to inmates as public health sentinels. Too little attention is paid to preventing, diagnosing, and treating conditions that can poison life for families and members of the free-world society.
A view of the health status of inmates is a view through a window to our society at large. Because of whom we incarcerate, especially drug users and the mentally ill, inmate morbidity is highly concentrated with people who have mental illness, communicable disease, and the consequences of alcohol and substance abuse.... Not only are rates of diabetes, asthma, hypertension, and heart disease disproportionate to age-adjusted cohorts in the free world, rates of alcohol and drug use, communicable disease, and mental illness are even higher in comparison.
There are clear opportunities to improve the health status of inmates through focused attention to primary prevention, early detection, and evidence-based clinical interventions. Seizing these opportunities will not only accrue to the benefit of the inmates themselves, but also to the benefit of the public health. Of course, acting on these clear opportunities takes political will and resources.

Jamie Fellner: Jamie Fellner, Esq., is the director of the U.S. Program of Human Rights Watch (HRW). The program promotes increased respect for international human rights in the United States by documenting and advocating against human rights abuses by U.S. federal, state and local officials, particularly abuses in the criminal justice system. She is the author or co-author of numerous published Human Rights Watch reports and backgrounders on human rights violations in the United States. Prior to assuming the position of director in 2001, Ms. Fellner was associate counsel at HRW.

Excerpt: Corrections systems have not been able to keep up with the exploding prison population-much less the exploding population of offenders with mental illnesses. Many-if not most-prison mental health services are woefully deficient. They are crippled by understaffing, insufficient facilities, limited programs, and the restrictions imposed on them by prison rules and prison culture. All too often, seriously ill prisoners receive little or no meaningful treatment. They are neglected, accused of malingering, treated as disciplinary problems.
Without the necessary care, mentally ill prisoners suffer painful symptoms and their conditions can deteriorate. They are afflicted with delusions and hallucinations, debilitating fears, extreme and uncontrollable mood swings.... They refuse to obey orders or lash out without apparent provocation. They assault other prisoners or staff. They beat their heads against cell walls, smear themselves with feces, self-mutilate, and commit suicide.... By helping individual prisoners regain health and improve coping skills, [mental health services] promote safety and order within the prison community as well as offer the prospect of enhancing community safety when the offenders are ultimately released.
Corrections officials recognize the challenge posed to their work by the large and growing number of prisoners with mental illness. They recognize they are being asked to serve a function for which they are ill equipped. They need support in their efforts to ensure appropriate conditions of confinement and mental health services for the mentally ill men and women consigned to them. Political sentiments and public opinion must be marshaled to understand the need for enhanced mental health resources-for those in as well as outside of prison. The problems we have documented can be solved-but to do so requires drastically more public commitment, compassion, and common sense than have been shown to date.

Dr. Reginald A. Wilkinson: Dr. Reginald A. Wilkinson, Ed.D., has been the Director of the Ohio Department of Rehabilitation and Correction (DRC) since 1991. He has been employed with DRC since 1973 and has served in a variety of positions including Director of Training, Warden and Regional Director of Prisons. Dr. Wilkinson is a Past President of both the Association of State Correctional Administrators and the American Correctional Association. Currently, he is the Vice Chair for North America of the International Corrections and Prisons Association and Chair of the National Institute of Corrections Advisory Board. Dr. Wilkinson is also the President and Executive Director of the International Association of Reentry.

Excerpt: ...why is it important to have a good correctional mental health treatment program? Beyond all the legal and practical reasons one might express, above all, it's the right thing to do!
For both security and health reasons, we need to know whether offenders are demonstrating purposeful negative behavior as opposed to those who are "acting out" because of their mental illness. Mental health professionals working closely with security professionals assist in this task.
Whether the prisoner has an acute psychiatric illness or a personality disorder, correctional staff should be concerned with preventing further deterioration. Suicide and suicide attempts are stark examples of the consequences of unknown or unattended deterioration. Accordingly, prevention and amelioration of mental health related problems, from an administrative and clinical perspective, are a conscious, ongoing mission.
Unfortunately, prisoners with a "weakness," either physical or mental, are at a disadvantage and are sometimes preyed upon by "stronger" inmates. There is, of course, a constitutional duty to protect vulnerable inmates, and the mentally ill and developmentally disabled often fall into this category.
Knowing inmates' physical and mental limitations allows staff to appropriately house, classify, assign jobs, and treat prisoners. Good mental health, then, includes screening and evaluations, which provide this crucial information.
As is the case with 97 percent of all prisoners, transition to the community is inevitable. For community health and safety reasons, operating a holistic mental health service delivery program for offenders is paramount.
From my perspective, it is clear that comprehensive mental health care for offenders yields positive results: offenders are better able to cope with the prison environment; releasees stand a better chance of not recidivating; staff feel safer as they perform their duties in calmer environments; and, fewer citizens are victimized, thereby improving public safety.

Resources:

For more information about the Commission, contact  Jennifer Trone at (917) 535-4937

For full testimony given by these and other experts, visit www.prisoncommission.org