Monday, October 25, 2010

Half of people in jails, prisons have serious mental illnesses

From The Oklahoman:

He's a quiet man with a sad secret.

He rarely tells others that he hates himself; but his self-mutilation screams out to prison staffers.

"Jimmy” sits alone in his cell with his thoughts. Maybe he tries not to think about the legacy of sexual deviancy, from childhood incest to years of sexual abuse that a string of men have inflicted on him.

Between his first and second stint in prison — in 2001 for possession of a controlled dangerous drug and last year for second-degree robbery — correctional officers saw him prostituting himself at a truck stop. Broken and homeless, Jimmy said he was hungry.

Now that he's back for a 10-year sentence, staff psychologists visit him twice a day during rounds and see that he takes his medications to help calm the voices and visions that haunt him.

"They're calling prisons the new asylums. That's true,” said Linda Evans, clinical coordinator for Joseph Harp Correctional Center and western Oklahoma. "It's tragic.”

Jimmy — the prison staffers didn't want his real name used — is not unusual. He's just one of the more than 600 inmates in the Lexington prison who are on psychotropic medications to treat mental disorders and diseases.

"Half of our yard is on psychotropic medications,” Evans said.

About half of the roughly 26,000 inmates across the Oklahoma incarceration system are seriously mentally ill or have a documented history of serious mental illness. More than 4,500 systemwide receive medication for mental illness. The Department of Corrections has about 28 psychologists and psychiatrists working in state prisons.

"We're putting people in prison who shouldn't be in prison,” said Robert Powitzky, chief mental health officer for the Corrections Department.

The problem is not unique to Oklahoma. Nationally, more than half of all prison and jail inmates report mental illness, says a recent Justice Policy Institute report. Treating the mentally ill before they enter the justice system can help improve public safety and the lives of the mentally ill and substance abusers, as well as save money, according to the report.

Some mentally ill offenders do need to be in prison, Powitzky said. For the others, it costs three times more to keep them incarcerated than in community treatment programs. It's about $25,000 yearly versus $8,000, Powitzky said.

The system struggles as more seriously mentally ill people are being locked up and the average inmate is much more seriously mentally ill.

"It's just not right. We're traumatizing people with serious mental illness by putting them in a criminal justice system and asking them to survive,” he said.

The mentally ill often barely survive in the real world but the tough prison culture is even worse, Powitzky said.

"Then we're throwing them back out into the community and asking them to readjust. It's just not fair.”

Before they go to prison, mentally ill offenders typically go to county jails, many of which also are overcrowded.

"We have been referred to as the largest mental health facility in the state,” said Maj. Jack Herron, Oklahoma County jail administrator.

Of the 2,112 prisoners Friday, 289 (14 percent) had a mental health diagnosis and 275 (13 percent) were on psychotropic medications.

The inmates are kept in two areas separately from the other prisoners and see a staff of a half-dozen psychologists or psychiatrists.

"A lot of these people in the past would have been treated somewhere else but because of those (mental health bed) closings we're treating them in the jail now,” Herron said.

Following the Nov. 2 election, the new governor will face a host of issues, including the question of what to do about Oklahomans' mental health.

"For people with an untreated mental illness and addiction, how do we make sure they get to see the inside of a medical facility as opposed to the inside of a prison cell?” said Terri White, commissioner for the state Department of Mental Health and Substance Abuse Services.

Under a $20 million to $25 million budget cut in 18 months, the state lost more than 100 beds for substance abusers across the state, along with many children's mental health beds, White said. At the time the beds were being shut down, 600 Oklahomans were waiting for residential substance abuse treatment.

She said funding for mental health is low in Oklahoma, number 46 in the nation.

"We know when Oklahomans don't get services, the consequences of untreated mental illness and addiction are devastating. People will get more and more ill without this care,” she said.

"And they will show up in the criminal justice system. They will show up in foster care. They'll show up in the emergency rooms in crisis.”