Prison Mental Health Care

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Diverting Mentally Ill to Treatment, Not Jail

Officers Ned Bandoske (left) and Ernest Stevens are part of San Antonio's mental health squad — a six-person unit that answers the frequent emergency calls where mental illness may play a role. (Jenny Gold/KHN)

Officers Ned Bandoske (left) and Ernest Stevens are part of San Antonio’s mental health squad — a six-person unit that answers the frequent emergency calls where mental illness may play a role. (Jenny Gold/KHN)

This week, Julie Small has reported on this blog about court-ordered overhauls in caring for mentally ill inmates in California prisons. About one-fourth of California’s inmates — 37,000 people — have mild to severe mental illness.

As Small reported, U.S. District Judge Lawrence Karlton ordered the California Department of Corrections and Rehabilitation (CDCR) in April to draft new policies for use of force and has signed off on CDCR’s plans. Now the department is working on plans to comply with Karlton’s orders to change how it handles segregation for inmates with mental illness.

So, I was riveted by a report this morning from NPR and Kaiser Health News about a different approach — a coordinated, comprehensive approach — to a county-run mental health system. The story was set in Texas’ Bexar County, (pronouced “bear”) home to San Antonio and the Alamo, and the program is now a model for the nation. Continue reading

State Seeks Return to Full Control over Prison System Mental Health Care

By Julie Small, KPCC

Pelican Bay State Prison, Crescent City, CA. (Michael Montgomery/KQED)

Pelican Bay State Prison, Crescent City, CA. (Michael Montgomery/KQED)

More than a decade ago, a federal judge appointed a special master to oversee mental health care in the California state prison system. Since then, California has spent billions of dollars to improve psychiatric care for inmates. On Wednesday, the state will formally ask to have that oversight ended. But a high suicide rate among inmates is complicating the state’s petition.

Experts hired by the state and by the court say there are  fundamental problems with how the Department of Corrections and Rehabilitation handles suicidal prisoners.

The experts say things go wrong as soon as an inmate is labeled suicidal. While waiting for a psychiatric assessment, the prisoner is placed in a holding cell the size of a telephone booth.

Despite the billions spent overall on mental health care, the suicide rate in California’s prisons has been going up.
Jane Kahn, a lawyer who represent inmates in lawsuits against the prison system, says male prisoners are often stripped “and left just in their boxers.”

“The biggest concern is that prisoners will not report that they’re feeling suicidal if they’re held in these kind of settings,” Kahn adds. “We think it’s one of the many factors that explains this high rate of suicide within our system.”

And despite the billions spent overall on mental health care, the suicide rate in California’s prisons has been going up. Over the past 14 years an average of 31 prisoners a year have killed themselves -– a rate higher than the national averages for federal and state prisons as a whole. Continue reading