NEWSMENTAL HEALTH IN PRISON

In a matter of days, the Change.org campaign to have 12 year old Cristian Fernandez tried as a juvenile in Florida has grown from 10,000 to over 160,000. Supporters all over the world have been asking Angela Corey to try Cristian as a juvenile, and above all else, ensure that he is not sent to an adult prison facility. They have been hopeful and confident that Corey will do the right thing. And they might just be right.

Corey has recently stated that Fernandez will not serve life in prison and that he will serve his sentence in a juvenile facility. He will not stand trial, and a plea deal is expected to be worked out soon.

In early March, Cristian was left alone with his two year-old half-brother David, despite having broken David’s leg a year prior. While the two boys were alone, Cristian allegedly pushed his brother against a bookcase, and David sustained a head injury. After their mother returned home, she waited six hours before taking David to the hospital, where he eventually died.

Cell phones and prisoners keep popping up in the news these days. Corrections officials paint cell phones as a crisis, saying prisoners are using them to orchestrate crimes, to smuggle drugs and weapons into prison and -- gasp! -- to update Facebook profiles.

The real reason prisoners want cell phones, however, is to talk to their families. A former Florida prisoner recently told the Broward New Times that phones are being used far more often to keep in touch with loved ones than to commit crimes. "The vast majority were used by inmates desperate to stay in touch with, and hold on to, their wives and children," the long-serving prisoner, who didn't give his name, told a reporter.

What's driving prisoners to use cell phones rather than prison phones? The cost. As you may know, states and phone companies conspire to pull hefty profits from poor families and prisoners who just want to stay in touch. At last count, only six states pass up commissions from phone companies. As the ACLU pointed out in a blog post this summer, the phone companies and corrections departments win in these deals, while everyone else loses. "Prisoners and their families suffer financial hardship or fall out of touch, and when sentences expire, prisons release a more alienated and less rehabilitated group of prisoners into society."

Scott Henson recently suggested at Grits for Breakfast that prisons allow restricted, monitored access to smartphones, rather than trying -- and failing -- to restrict them. "One of the key indicators regarding successful reentry is whether the offender retained ties with friends and family while on the inside who can help them succeed
when they get out," Henson said an in intereview. "Facilitating communication with those people while inside reduces recidivism and therefore future crime."

Now in its 16^th season, Shakespeare Behind Bars (SBB) has produced 16 plays within the confines of Kentucky’s Luther Luckett Correctional Complex. William Shakespeare, says SBB Founder and Producing Director Curt Tofteland, was “all about this journey of what it means to be human.”

Shakespeare never shied away from expressing every dimension of human emotion through his stories. Though there isn’t much space or tolerance for the expression of feelings other than anger in prison, SBB actors get the rare opportunity to fully embody raw emotion by taking on the roles of Shakespeare’s characters. Quickly the line between acting and reality begins to blur.

Tofteland sees the work of SBB as being “fundamentally about transformation and change of the human heart, soul and psyche.” Like all of us, incarcerated folks have stories to tell – ones of happiness, suffering and survival. For most of those behind bars, these stories remain locked away, suffocated by silence. “The moment an individual enters the correctional system they begin the journey as the voiceless other,” laments Tofteland.

One of the biggest developments in the criminal justice system this decade has been the emergence of community mental health courts, where people accused of crimes related to their mental illness are offered treatment instead of incarceration.

In 1997 you could count the number of them on one hand. Now there are at least 250 nationwide.

There has long been support for these courts in a smattering of states (California, for instance, has 41 of them in 29 counties), but they have yet to become a nationwide phenomenon. That may change over the next decade, though, because more evidence of their efficacy is coming in.

The Archives of General Psychiatry just published a comprehensive study of four community mental health courts, one each in, San Francisco and Santa Clara Counties in California, Hennepin County in Minnesota, and Marion County in Indiana. Entitled “Effect of Mental Health Courts on Arrests and Jail Days,” the study concludes:

“Mental health courts meet the public safety objectives of lowering posttreatment arrest rates and days of incarceration. Both clinical and criminal justice factors are associated with better public safety outcomes for MHC participants.”

The Los Angeles Times ran a nice feature that puts a face on the people cycling through these courts. The article's author profiles a gentleman named Milton Conley who is involved with the mental health court in San Francisco. He has been abused, addicted to crack cocaine and sent to prison four times. He's also schizophrenic. In his own words: “It's been a terrible life, but it's getting better, as long as I stay off drugs and alcohol and take my medication.” Conley has been in and out of grace with the court, and slipped more than once. In short: He's exactly the type community mental health courts were designed for.

What do you imagine the halls of a juvenile detention facility sound like? Loud and rowdy? These youth weren’t incarcerated for being docile and submissive, after all, so it would seem highly unlikely one could find a quiet spot in such an institution, right? But, according to some, the sounds of juvenile detention centers have changed drastically over the past several decades -- they've gotten a lot quieter -- largely due to the use of prescription sedation.

A study released this week by Youth Today suggests that children behind bars are being overmedicated and given anti-psychotic drugs when they have no applicable mental diagnosis. While gone are the days of tying unruly juvenile offenders down, the organization says there is much evidence pointing to the use of these powerful drugs as the new restraints.

Called “atypicals," these anti-psychotic drugs are intended for severe mental illnesses, particularly schizophrenia and bipolar disorder. This group of drugs emerged in the 1990s but many of them were being prescribed to incarcerated juveniles long before they were approved for use in adolescents. Abilify, Risperdal, Seroquel and Zyprexa are some of the drugs included in this classification. Another, Geodon, is still not approved for youth -- though that doesn’t mean officials at juvenile facilities aren't using them.

The Youth Today investigation asked officials in all 50 states for information on their use of atypicals and the diagnosis they were prescribed to treat. For a variety of reasons, only 16 states responded, and their openness varied widely.

Of the states who responded wholly to Youth Today’s requests (there were only 5), 3,709 out of 5,299 atypical prescriptions were filled for diagnoses other than schizophrenia and bipolar disorder, or 70 percent. General mood disorders, ADHD and post traumatic stress disorder made up the bulk of the other diagnoses.

This, Youth Today says, is evidence of the overuse of atypical drugs in detention facilities. And with little research to back the use of such potent anti-psychotic drugs in the treatment of minor mental disorders like ADHD, their rationale is persuasive.

But are these facilities intentionally using the atypicals for sedation, to have a more easily managed population, or is it better explained by the lack of mental health resources within the facilities and an explosion in the number of mentally ill kids being locked up? (Read more after the jump.)

A scathing report released last week by the Office of the Correctional Investigator of Canada is calling on the Correctional Service of Canada (CSC) to make major changes in the way it delivers mental health treatment to the prisoners within its custody. According to this report, Canada’s penitentiaries have become nothing more than warehouses for the mentally ill, which serves neither the people they incarcerate nor the general public once they are released.

The Corrections and Conditional Release Act (CCRA) was passed in 2004 and funded with $50 million in the years that followed. It was designed to implement a “Mental Health Strategy” into the CSC penitentiaries and ensure sufficient mental health programming and treatment. The CCRA tasked the CSC was providing inmates with “reasonable access” to mental health services. Unfortunately, this latest report shows the CSC has failed.

"Under Warrant: A Review of the Implementation of the Correctional Service of Canada’s Mental Health Strategy," shows that despite the funding and the frequently used terms “Mental Health Strategy” by the CSC, there is actually no formal strategy in place. No document outlining objectives, timelines or concrete plans exists. Instead, the system of mental health within the CSC seems to rely loosely on a number of draft quality policy documents. With no implementation document or plan, the CSC is sort of winging it when it comes to the mental health needs of federal offenders.

The needs of inmates with mental illness should not be trivialized. Those offenders are more likely to spend time in isolation, more likely to have disruptions and more likely to serve their full sentence than those without such health needs. Without programs and treatment options, their disorders can only get worse, negatively impacting them personally but also impacting the potential safety of other in the institutions in which they are housed. (Read more after the jump.)

To understand the inequality and injustice of the death penalty, we don’t need to look further than the case of Gregory Wilson, who is scheduled to die next week in Kentucky.

Wilson mostly represented himself at trial, because his lawyer -- whose business card listed his address at a bar -- failed to show up on many days. Wilson’s co-defendant, who testified that she helped him commit a robbery and murder, was shuttled down the hallway after court each day to have sex with a judge. The list goes on, but somehow appeals courts have allowed Wilson’s conviction to stand; he is set to be killed by the state (with its dwindling supply of drugs) on September 16.

If Kentucky allows Wilson to be executed next week, with him will perish any illusion of a system of safeguards to ensure justice before we carry out the ultimate punishment.

Please take a moment to read Andrew Wolfson’s excellent article on the case in the Louisville Courier-Journal, and then join me in calling on Kentucky Gov. Steve Beshear to commute Wilson’s sentence to life.

If Wilson weren’t one week from the death chamber, I would call the details o

The three institutions that house the most mentally ill people in the United States aren't hospitals or health care facilities.  They're the Los Angeles County Jail, the Cook County Jail in Chicago and Riker's Island in New York City.

As the United States dismantled its system of mental hospitals in the last century, some former patients integrated into communities and families, but many did not. Homelessness spiked among the mentally ill, as did admissions to prisons and jails.

Which brings us to today: too often, when we have nowhere else to send mentally ill people in need of treatment, they end up in jail.

But in budget-strapped jails, mentally ill prisoners aren't getting the care that they need. Some people never get proper care, and their illness is simply never diagnosed.

In 1955, nearly a million Americans lived in state mental health facilties, as Te-Ping's previously written here. Today, that number is 60,000. Many of those Americans with mental illnesses who've since left mental health facilities are in prison or on probation. About 15% of prisoners in American jails suffer from some form of mental illness, and the number is about the same in prisons — which means more than 300,000 mentally ill Americans live behind bars.  And when a short stay in jail doesn't include any services or evaluation, these individuals will be convicted and sentenced to prison — or released without a safety net, in which case they're more likely to return.

Colin blogged this week about the fact that suicide is the leading cause of death in American jails. There's no doubt in my mind that many of these deaths could be prevented if we offered treatment and services — rather than a revolving jail door — to the thousands of mentally ill individuals living on the fringes of American society.

Thousands of people from across the United States are calling Senate leadership today to support the creation of a national criminal justice commission. Will you join them?

As we've written before, Sen. Jim Web's proposed commission is a key step for criminal justice reform in this country. And the good news is that legislation backing the creation of such a bipartisan panel is gaining steam in both the Senate and the House. Already, the Senate version, S. 714, has more than three dozen co-sponsors from both sides of the aisle.

Today's call-in day is already a success. Since I first started working on this post, I got word that the offices of Senate Majority Leader Harry Reid and Majority Whip Richard Durbin have heard our voices loud and clear and asked us to stop calling.

So now we're turning our attention to Sen. Mitch McConnell (the minority leader) and Sen. Jon Kyl (the minority whip). Please take a few minutes to make these two calls today. Talking points and phone numbers are here.

There is no pretty way to execute someone. No matter how sophisticated we get, capital punishment is an ugly thing — one that from time to time tends to go horrifically awry.

My home state of Maine abolished the death penalty in 1887, two years after the badly botched execution of Daniel Wilkinson on Nov. 21, 1885. Wilkinson — the last person to be executed in Maine — had been convicted on murder charges after shooting a constable after a foiled burglary attempt. His death was....let's put it this way, untidy. As the state tried to hang him, something went wrong with the noose. Wilkinson wriggled there on the rope for 15 minutes before ultimately strangling to death. His last words to the Sheriff? “You fellas get $50 a day for such work!”

Now, many decades later, Maine has discovered a new method of execution. It is neat, efficient and random. The public loves it, because it seems comparatively humane. It's called solitary confinement.

Though corrections officials in Maine have vigorously defended the state's policies as complying with “nationally accepted standards," the recent record of death in Maine's solitary cells suggest that's not a very high bar to cross.