Monday, December 5, 2011
Treatment of mentally ill prisoners needs to be addressed
Recently there was an audit from Robert C. Lewis, director, Division of Prisons, describing horrific and abusive conditions at Central Prison Inpatient Mental Health Facility in Raleigh. The report gives details about inadequate staffing for nurses and clinicians (Psychiatrists, Psychologists, Social Workers); poor quality of medical records about distribution of psychotropic medications; concerns about patient safety, health, welfare, and dignity; lack of proper infection control; and concerns about safety of staff and inmates.
Reading the audit leaves one with the conclusion that there is a lack of effective management concern, at all levels, about the care of prisoners with a mental illness at Central Prison. It also raises questions about the treatment of people with mental illness throughout the jails and prisons in North Carolina. This combined with the failure of mental health reform implies that North Carolina government does not care about people who suffer from a brain disorder.
Individuals with a mental illness are vastly overrepresented in the prison population — in the U.S. approximately 24 percent of the prison population lives with a serious mental illness, while in the juvenile system that is up to about 70 percent. The statistics tell us there is a problem — we are arresting people sometimes for exhibiting symptoms of their illness, then they go downhill while in prison since they cannot follow the rules, don’t get necessary medication, or treatments, and are generally incapable of conforming due to their illness. So no, we don’t agree with comments made by various public figures that these are all criminals. Rather, there is a problem with our system not recognizing early on that some of these people in fact have a medical problem.
Recently the Commission on Mental Health passed rules to improve conditions in the prisons for those living with mental illness things like minimally adequate treatment, proper screening and identification, medication protocols, limits on seclusion and restraint, and most importantly lots of tightening up of discharge planning that may reduce the very high recidivism rate we have for those with mental illness coming out of the prisons. Yet these very rules have been languishing for eight months, awaiting the required fiscal note.
Let’s get our General Assembly and governor to move these rules along. Let’s fix this problem, now.