Lost in the prisons - Penal facilities struggle to deal with mentally ill inmates

Lost in the prisons - Penal facilities struggle to deal with mentally ill inmates
Jamaica Gleaner Online http://www.jamaica-gleaner.com/gleaner/20101017/lead/lead7.html
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Lost in the prisons - Penal facilities struggle to deal with mentally ill inmates
Published: Sunday | October 17, 2010 Susan Callum, Gleaner intern
For 20 years, Delroy McIntosh has been locked away in correctional facilities - most of that time at the maximum-security Tower Street Adult Correctional Centre. There, he has lived among some of Jamaica's most hardened criminals. But Delroy was never sentenced or tried prior to his two-decade-long imprisonment.
In 1990, Delroy was charged with possession of quarter-pound of ganja by the police in Westmoreland.
When he went to court, the judge suspected that he might have been mentally ill and sent him to the correctional centre for psychiatric evaluation, and treatment, if necessary.
Since that fateful day in June 1990, Delroy has yet to return to court. He is among inmates who are listed as unfit to plead and awaiting trial.
Delroy is just one of the many mentally ill offenders in Jamaica who have been lost in a penal system not equipped to provide proper mental-health care services, and who are not taken to court as stipulated by the law.
Under Section 25 of the Criminal Justice (Administrative) Act, the court is mandated to hold a monthly fitness hearing for all mentally ill offenders it sends into the penal system for evaluation and care.
Not retroactive
This amendment to the Constitution became effective in March 2006. However, the law is not retroactive, and the amendment, therefore, does not apply to mentally ill offenders held in prison before March 2006.
So, for inmates like Delroy, who have been in prison for decades, there is no law to ensure that they are sent back to court. So they easily get lost in the system, especially if there are no relatives eager to have them home or pushing for their release.
They depend on psychiatrists who have to prepare a fitness report for every detained mentally ill offender. These reports are presented at fitness-evaluation hearings when the courts send back for the offender.
But consultant psychiatrist with the Department of Correctional Services (DCS), Dr Clayton Sewell, said monthly fitness evaluations are prepared to no end for some mentally ill inmates in the system.
"Many of them who have been there for 10, 20 years have no court date. (They) have no idea when they are going back to court (and) nobody reviews their case. So sometimes it's like you are just going through the formality of doing their evaluation and the court report without the court acting on it," Sewell said.
Gile Campbell, acting commis-sioner of custodial services at the DCS, said he was not aware of any mentally ill person lost in the system.
Lawsuit
Campbell said that had changed following a lawsuit against the State brought by lawyers representing a man who was being held in prison as being unfit to plead.
He was supported by Laura Plunkett, director of offender management in the Ministry of National Security, who claimed that the Government had taken the necessary steps to ensure that no other mentally ill offender gets lost in the system since it lost the lawsuit.
But inmate and orderly at the Tower Street Adult Correctional Centre, Linton Berry, disagrees.
According to Berry, he uses an assistant to keep records on the mentally ill in the prison.
Berry also acts as a lawyer for them. He writes to the clerks of the various courthouses and petitions the governor general on their behalf to get them out of prison.
However, he is facing a hard, long battle, especially when it comes to those still being held at the governor general's pleasure.
The governor general's pleasure sentence is an indefinite sentence given to juveniles who commit crimes, and to mentally ill persons who commit crimes while deluded.
The terms of this sentence calls for the governor general to occasionally review these offenders and decide whether they have become fit for release.
But since the Privy Council ruled in 2003 that the governor general, an executive arm of government, should have no power in matters of the court, the sentence was scrapped in favour of being sentenced at the court's pleasure.
Still, those sentenced at the governor general's pleasure before 2003 are stuck in limbo, allowing them to languish in prison for years.
50 years in the system
Joseph Dunn is one such person, sentenced at the governor general's pleasure since 1960.
Joseph is now 75 years old, losing sight in one eye and walking at a snail's pace. He said the last time he was visited by a relative was some 12 years ago, and since then, he has been left to the mercy and compassion of those around him.
Dr Myo Oo, consultant psychiatrist with the DCS, said prisons are not the proper place to treat mentally ill prisoners.
"Mentally ill persons should not be in prisons because prisons are not the right place to be rehabilitated. In fact, there is no rehabilitative process in prison, and mentally ill inmates rarely partake of social activities," Oo said.
He believes Jamaica is in need of a high-security mental facility to house mentally ill persons who need to be imprisoned or detained.
That high-risk mental facility, Dr Oo hopes, will have staff at a proportionate ratio to the mentally ill, and will be trained in forensic psychology and psychiatry. He also said the facility should have medication to treat a wide range of mental illness.
Susan Callum submitted this piece as a part of her research work while reading for her degree at CARIMAC, University of the West Indies, Mona Campus.

Interim Guidance for Correctional and Detention Facilities on Novel Influenza A (H1N1) Virus

http://www.cdc.gov/h1n1flu/guidance/correctional_facilities.htm
"This document provides interim guidance specific for correctional facilities during the outbreak of novel influenza A (H1N1) virus to ensure continuation of essential public services and protection of the health and safety of inmates, staff and visitors. Recommendations may need to be revised as more information becomes available.
Background
Correctional institutions pose special risks and considerations due to the nature of their unique environment. Inmates are in mandatory custody and options are limited for isolation and removal of ill persons from the environment. The workforce must be maintained and options are limited for work alternatives (e.g., work from home, reduced or alternate schedules, etc.). In addition, many inmates and workforce may have medical conditions that increase their risk of influenza-related complications. The focus of this guidance is on general preventive measures for institutions, risk reduction of introduction of the virus into institutions, rapid detection of persons with novel influenza A (H1N1) infections, and management and isolation of identified cases. In this document, institution refers to staff, inmates, and visitors. Correctional facilities should contact and collaborate with their state, local, tribal and territorial health departments for more specific guidance."

Florida Innocence Project Link

http://floridainnocence.org/index.php

Re-Entry Policy Council - Mental Health: About the Project- Issue, Challenges, Response

http://reentrypolicy.org/mental_health_about
The Issue
Individuals with mental illnesses are significantly overrepresented in corrections settings. Prevalence estimates of serious mental illness in jails are similarly high, ranging from 7 to 16 percent, or rates four times higher for men and eight times higher for women than rates found in the general population.1 Given the high rates of mental illnesses among the jail and prison populations, and their unique service needs, corrections officials should seek to engage community-based behavioral health care providers to offer pre- and post-release services to inmates with mental illnesses.
Challenges
Inconsistent and ineffective screening and identification of prisoners for mental health disorders
Narrow focus on emergency treatment needs of people who are incarcerated rather than their long-term health and public health generally
Compartmentalized, uncoordinated treatment of co-occurring disorders, particularly substance abuse and mental illness
Inadequate communication and cooperation between correctional health officials and community service providers
Limited capacity of existing community-based services and general reluctance of providers to serve people with criminal records
Delivery of services and use of medications that do not reflect the most current, evidence-based practices
Shortages of qualified health care professionals in prison and jail, and high cost of medications
The Response
The Justice Center, with support from a variety of federal agencies and private foundations, manages the Criminal Justice/Mental Health Consensus Project
http://www.consensusproject.org/, a national effort to help local, state, and federal policymakers and criminal justice and mental health professionals improve the response to people with mental illnesses who come into contact with the criminal justice system. Click here http://consensusproject.org/ to learn more about the Consensus Project.
Through funding support from a number of federal agencies including the Bureau of Justice Assistance (BJA), the National Institute of Corrections (NIC), and the Center for Mental Health Services (CMHS), as well as private foundations including the MacArthur Foundation, the Justice Center has developed a number of publications and tools for policymakers focusing on the needs of people with mental illnesses under corrections supervision. For more information about the Justice Center’s corrections and mental health work, please click here http://consensusproject.org/issue-areas/corrections.
In addition, the Justice Center is working with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, the JEHT foundation and the Robert Wood Johnson Foundation to assist individuals with mental illnesses who are eligible for federal benefits connect to needed services. Click here http://reentrypolicy.org/special_projects/reentry_federal_benefits for more information about the federal benefits project.

Contact:Elizabeth DoddResearch AssistantCouncil of State Governments Justice Centeredodd@csg.orgTel.: (646) 383-5749Fax: (212) 482-2344
1 Abram, K.M. and Teplin, L.A. (1991). Co-occurring disorders among mentally ill jail detainees: Implications for Public Policy. American Psychologist, 46(10): 1,036-1,045; Abram, K.M., Teplin, L.A., and McClelland, G.M. (2003). Comorbidity of severe psychiatric disorders and substance use disorders among women in jail. American Journal of Psychiatry. 160: 1007-1010; Cox, J.F., Morschauser, P.C., Banks, S., and Stone, J.L. (2001) A five-year population study of persons involved in the mental health and local correctional systems: Implications for service planning. Journal of Behavioral Health Services & Research 28(2): 177-187; Ditton, P. (1999) Mental health and treatment: Inmates and probationers. Washington DC: Bureau of Justice Statistics; Green, B.L., Miranda, J., Daroowalla, A., and Siddique, J. (2005). Trauma exposure, mental health functioning and program needs of women in jail. Crime and Delinquency. 51(1): 133-151; Hammett, T.M., Roberts, C., and Kennedy, S. (2001). Health-related issues in prisoner re-entry. Crime and Delinquency. 47(3): 390-409; Lamb, H.R. and Weinberger, L.E. (1998). Persons with severe mental illness in jails and prisons: A review. Psychiatric Services. 49: 483-492; Sabol, W.J., Minton, T.D., and Harrison, P.M. (2007). Prison and jail inmates at midyear 2006. Bureau of Justice Statistics Bulletin. U.S. Department of Justice Statistics, NCJ 217675; Teplin, L.A. (1990). The prevalence of severe mental disorder among male urban jail detainees: Comparison with the epidemiologic catchment area program. American Journal of Public Health. 80(6): 663-669; Teplin, L.A. (1994). Psychiatric and substance abuse disorders among male urban jail detainees. American Journal of Public Health. 84(2): 290-293.

Upcoming Social Medicine Events: Department of Family & Social Medicine

http://www.socialmedicine.org/category/prison-health/
October 22 to November 18, 2009: RPSM Orientation Month, Click Click here for the complete calendar. http://www.socialmedicine.org/department-of-family-social-medicine/residency-program-in-social-medicine/2009-orientation-calendar/
October 27, 2009: Social Medicine Rounds: Dr. Aaron Fox & others: "Physician Advocacy & Health Care Reform." Cherkasky Auditorium, Montefiore Medical Center, 111 E. 210th St., Bronx, NY. 4:30-6PM
November 10, 2009: Social Medicine Rounds: Dr. Luis Barrios (John Jay College of Criminal Justice): Beyond Gangs: Identities and Resistance. 3rd Floor Conference Conference Room, 3544 Jerome Ave., Bronx, NY. 4:30-6PM
November 17, 2009: Social Medicine Rounds: Presentation of RPSM Orientation Project by Intern Class. 3rd Floor Conference Conference Room, 3544 Jerome Ave., Bronx, NY. 4:30-6PM

Trating the Mentally Ill 1999

Prison health care in crisis - Aging inmates, hard cases and a violent environment contribute.
By SYDNEY P. FREEDBERG
© St. Petersburg Times, published August 15, 1999
http://www.sptimes.com/News/81599/news_pf/State/Prison_health_care_in.shtml
Treating the mentally ill
“At Florida State Prison, many of the 1,300 prisoners spend days, weeks, months -- and until Valdes' death last month -- years in confinement cells. Some cells have metal doors and have been likened to coffins, space capsules, and dungeons. Inside, most of what can be seen is another wall. Human contact is minimal. Inmates tap into the gossip mill by plunging all the water out of their toilet and shouting down the pipe.
As researchers study the effects of sensory-deprivation conditions on inmates' mental health, Burke said confinement units nationwide will come under increasing scrutiny. The jury is still out, he said.
But prison advocates say the verdict is in: Inmates in isolation experience audio and visual distortions, hallucinations, aggressive fantasies, paranoia, suicide attempts and violent outbursts.
Before he was allegedly beaten to death, Valdes spent years off and on in solitary confinement at FSP, said his family's lawyer, Stuart Goldenberg. He said guards repeatedly tried to provoke Valdes and break him down.
Though it is not clear whether he had any trouble understanding instructions, Susan Cary, a prisoner attorney, said the mentally ill are trapped in a prison system they can't comprehend.
"These seriously mentally disturbed people sometimes don't understand what officers are telling them to do," she said. "The assumption by people in the system is that the inmate is lying if he says he wants to commit suicide. The assumption is he's faking illnesses to get better housing.”

7 prison guards, 4 nurses under fire after inmate beaten

An inmate was beaten by guards after he threw feces at them. Seven prison guards have been placed on administrative leave and four nurses have been fired over the incident. BY STEVE BOUSQUET
Herald/Times Tallahassee Bureau
TALLAHASSEE -- Seven prison guards were placed on paid leave and four nurses were fired after the severe beating of an inmate at Union Correctional Institution last weekend that went unreported for nearly 48 hours.
Corrections Secretary Walt McNeil ordered a full-scale internal investigation and asked the Florida Department of Law Enforcement and FBI to determine whether the inmate's civil rights were violated, and whether the guards and nurses should face criminal charges. http://www.miamiherald.com/news/southflorida/story/1197358.html Posted on Saturday, 08.22.09

8/21/09: Investigation launched into Inmate Beating at Union Correctional Institution
Raiford, Florida - Department of Corrections Secretary Walt McNeil has ordered his Inspector General’s Office to launch a full investigation into allegations of the beating of an inmate at Union Correctional Institution (UCI) in Raiford, Florida over a two-day period. The abuse allegedly occurred on Saturday and Sunday, August 15 and 16. Click here for more information... http://www.dc.state.fl.us/secretary/press/2009/UnionCI-Investigation.html