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U.S. Prisons and Offenders with Mental Illness
SUMMARY
The Scope of
this Report
A Note on
Methodology
II. RECOMMENDATIONS
Recommendations
to the U.S. Congress
Recommendations
to Public Officials, Community Leaders and the General Public
Recommendations
to Prison Officials and Staff
III.BACKGROUND
Rates of
Incarceration of the Mentally Ill
Deinstitutionalization,
Crime and Punishment, and the Rise in the Mentally Ill Prisoner Population
"Criminalizing
the Mentally Ill"
Diversion
IV.WHO ARE THE MENTALLY ILL
IN PRISON?
Overview of
Mental Illness
Examples of
Mentally Ill Prisoners
MENTAL ILLNESS AND
WOMEN PRISONERS
Case Study:
R.M. and Seriously Mentally Ill Women Prisoners in Vermont.
VI.SYSTEMS IN TRANSITION
Reform
through Litigation
The Problem
of Funding Mental Health Services in Prisons
VII.DIFFICULTIES MENTALLY ILL
PRISONERS FACE COPING IN PRISON
Physical
Conditions
Vulnerability
of Mentally Ill Prisoners to Abuse by Other Prisoners
Rule-Breaking
by Mentally Ill Prisoners
Discipline
for Misconduct
I.J., New
York
VIII.INADEQUATE RESPONSES AND
ABUSES BY CORRECTIONAL STAFF
The Mental
Health Role of Correctional Staff
Mental Health
Training for Custodial Staff
Correctional
Officers' Use of Excessive Force
Other Abuses
and Inappropriate Responses by Correctional Officers
Timothy
Perry, Connecticut
Y.D.,
California
Mark
Edward Walker, Montana
IX.INADEQUATE MENTAL HEALTH
TREATMENT IN PRISONS
Understaffing
Poor
Screening and Tracking of Mentally Ill Prisoners101
Lack of
Timely Access to Mental Health Staff103
Diagnoses of
Malingering106
Medication as
the Sole Treatment109
Lack of
Confidentiality114
Medication115
Proper
Medication115
Delivery117
Medication
Discontinuity118
Inadequate
Monitoring of Medication Side Effects120
Protecting
Prisoners on Medication from Heat Reactions122
Inadequate
Efforts to Ensure Medication Compliance125
INSUFFICIENT PROVISION
OF SPECIALIZED FACILITIES FOR SERIOUSLY ILL PRISONERS128
Crisis Care128
Specialized
Intermediate Care Units130
Expansion of
Specialized Care Facilities133
XI.CASE STUDY: ALABAMA, A
SYSTEM IN CRISIS135
V.K., New
York141
XII.MENTALLY ILL PRISONERS
AND SEGREGATION 145
Overview of
Segregation145
Mentally Ill
in Segregation147
Impact of
Segregation on the Mentally Ill149
Lost in Segregation153
The Lack of
Quality Mental Health Services for Segregated Prisoners.154
From
Segregation Units to Psychiatric Centers and Back161
Keeping the
Mentally Ill Out of Segregation164
R.P., New
York169
L.J., New
York171
XIII.SUICIDE AND
SELF-MUTILATION 174
Self-Mutilation174
Suicide178
Increased
Risk of Self-harm and Suicide in Segregation Units179
Suicide
Protocols181
Punitive
Responses to Suicide Attempts185
Felix
Jorge, New York189
XIV.FAILURE TO PROVIDE
DISCHARGE SERVICES192
Recidivism 193
Discharge
Planning194
Financial
Assistance195
States that
Confer Eligibility on the Date of Release196
States that
Help Prisoners Fill Out Applications197
States that
Provide Minimal Help199
Ex-offender
Programs199
XV.LEGAL STANDARDS203
International
Protections204
The Rights of
Prisoners to be Free of Abuse204
The Right to
the Highest Attainable Standard of Health206
The United
States and International Human Rights Law 207
Constitutional
Protections for Prisoners with Mental Illness209
The Right to
Mental Health Treatment211
Constitutionally
Required Components of Mental Health Services213
Americans
With Disabilities Act214
Prison
Litigation Reform Act214