Read these figures carefully, by the way, and contemplate them in the context of a prisoner population of nearly 40,000. First, there's the acknowledgment that over 25% of Arizona prisoners are mentally ill enough for the system to recognize them as such. That says we have serious problems before they ever even hit the prison system.
Also of note, no way are only 4 (four) of the 8,000+ SMI prisoners in the entire ADC system at a level 5 intensity of MH need - they just throw a lot of those folks in detention or a Special Management Unit for disciplinary infractions where they can be crazy without bothering anyone or taxing the pharmaceutical and treatment budget. Who really "needs" psychiatric care when you can just put them in a stripped down cell alone for an eternity - no store, no visits, no tv, nothing but their own screams? Hell, they even double-bunk them with really dangerous people so they can partake in each other's company - two psychotic SMI prisoners have been murdered by their cellies in the past year, in fact, including Shannon Palmer. One of the killers even admitted that his cellmate's ranting all night about Obama was driving him nuts - yet those folks could be counted as not having an illness needing any "treatment" at all...
Finally, it's my understanding that the last round of budget cuts to eliminate mental health treatment funding for AHCCCS patients resulted in instructions to law enforcement that certain individuals no longer qualifying for public MH treatment coverage should be transported to jail instead of the psychiatric hospital should their symptoms bring them into contact with the criminal justice system. That means that at some level it was decided that investing $20,000/year in incarcerating the mentally ill instead of committing a lesser expense to treating and housing them in the community is a more politically salient intervention in the budget crisis - likely because we can extort public money via fear of "dangerous and repeat offenders"much better than via compelling ethical arguments here.
So people like Governor Jan Brewer, AZ State Senate Judiciary Chair Ron Gould, and ADC Director Chuck Ryan continue to promote the gross generalizations and conclusions of the discredited Fischer report justifying the high incarceration rate in this state, while knowing full well that their dysfunctional social policies and inadequate mental health services - before, during, and after episodes of incarceration - are responsible for a large part of seriously mentally ill and impoverished Arizonans being in custody, and not their exceptional criminal proclivities. In order to maintain the prison industry's access to raw materials (people), they're promoting ideologies, correctional practices, and social policies which are actually contributing to more crime and victimization, not less - that includes the victimization of those we criminalize...
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Mental Health Treatment in Correctional Facilities
Mental Health America Position Paper 56
By Carl ToersBijns
The Mental Health America treatment group states that "on any given day, between 300,000 and 400,000 people with mental illnesses are incarcerated in jails and prisons across the United States, and more than 500,000 people with mental illnesses are under correctional control in the community. Contrary to some administrators and politicians, incarcerated mentally ill inmates have specific rights when they are confined within a correctional setting in lieu of a state hospital and because they have the most potential to be cut the least amount of slack for treatment while in prison."
Arizona, according to its last available report dated 2/22/2010 listed 8,003 inmates classified as MH 3 inmates; 98 inmates as MH 4 and 4 inmates as MH5 for a total of 8,105 inmates classified requiring Moderate to High needs to the extreme levels of care of high need to acute needs which requires placement in the Arizona Department of Corrections licensed behavioral health treatment facility. This makes up approximately 26 per cent of the adult prison population last year. A report released by the Treatment Advocacy Center showed that in Arizona, 9 persons are incarcerated with mental health illness or disorder compared to 1 admitted in the state hospital.
Code
MH-5 Acute Need '" Offender requires placement in the ADC licensed behavioral health treatment facility.
MH-4 High Need '" Offender requires specialized placement in a mental health program.
MH-3S Moderate to High Need '" Offender requires placement in a prison complex that has regular, full-time psychological and psychiatric staffing and services. In addition, these and other mental health inmates are covered under the American Disabilities Act and are entitled to specific civil rights and treatment rights as endorsed by the Mental Health America organization. Action needs to be taken to ensure their rights are preserved as well as those scoring a MH 3 or higher.
Specific Rights:
1. The right to adequate medical and mental health care, to protection from harm including staff abuse, and to a facility in which the vulnerable can be protected: a safe, sanitary and humane environment
2. The right to informed consent to treatment. Staff should discuss with the prisoner the nature, purpose, risks, and benefits of types of mental health treatment.
3. The qualified right to refuse treatment, including psychotropic medications, on the same basis as any other person.
4. The right to the least restrictive environment and the least intrusive response to an apparent need for mental health services.
5. The right to be confined in a place that can provide the treatment needed.
6. The right to confidentiality in the delivery of mental health services and in mental health and related facility records.
7. The right to have regular and timely access to medical and mental health staff who are culturally competent and qualified to provide adequate treatment and supervision.
8. The right to be transferred to an appropriate medical or mental health facility or unit when conditions warrant.
9. The right to be free from corporal punishment, chemical restraints, and sexual abuse or coercion.
10. The right to assert grievances, to have grievances considered in a fair, timely and impartial manner, and to exercise rights without reprisal.
11. The right to an individualized written treatment plan, to the treatment specified in the plan, to periodic review and revision of the plan based on the prisoner's needs. The family should participate in the development, review, reassessment and revision of both the treatment plan and the discharge plan, unless the prisoner refuses such participation.
MHA and its affiliates should work to inform members of law enforcement and correctional groups, judges and attorneys, mental health professionals and advocates, prisoners and their families, the community and the media about the excessive number of persons with mental illnesses and addictive disorders in prisons and jails and the inherent difficulties involved in providing decent and humane care to such persons in these settings and should develop and advocate for effective strategies addressing these problems.
Sources:
http://www.mentalhealthamerica.net/go/position-statements/56
Arizona Department of Corrections Medical (M) and Mental Health (MH) Score Inmate Distribution by Complex as of 2/22/10
www.treatmentadvocacycenter.com
Mental Health America Position Paper 56
By Carl ToersBijns
The Mental Health America treatment group states that "on any given day, between 300,000 and 400,000 people with mental illnesses are incarcerated in jails and prisons across the United States, and more than 500,000 people with mental illnesses are under correctional control in the community. Contrary to some administrators and politicians, incarcerated mentally ill inmates have specific rights when they are confined within a correctional setting in lieu of a state hospital and because they have the most potential to be cut the least amount of slack for treatment while in prison."
Arizona, according to its last available report dated 2/22/2010 listed 8,003 inmates classified as MH 3 inmates; 98 inmates as MH 4 and 4 inmates as MH5 for a total of 8,105 inmates classified requiring Moderate to High needs to the extreme levels of care of high need to acute needs which requires placement in the Arizona Department of Corrections licensed behavioral health treatment facility. This makes up approximately 26 per cent of the adult prison population last year. A report released by the Treatment Advocacy Center showed that in Arizona, 9 persons are incarcerated with mental health illness or disorder compared to 1 admitted in the state hospital.
Code
MH-5 Acute Need '" Offender requires placement in the ADC licensed behavioral health treatment facility.
MH-4 High Need '" Offender requires specialized placement in a mental health program.
MH-3S Moderate to High Need '" Offender requires placement in a prison complex that has regular, full-time psychological and psychiatric staffing and services. In addition, these and other mental health inmates are covered under the American Disabilities Act and are entitled to specific civil rights and treatment rights as endorsed by the Mental Health America organization. Action needs to be taken to ensure their rights are preserved as well as those scoring a MH 3 or higher.
Specific Rights:
1. The right to adequate medical and mental health care, to protection from harm including staff abuse, and to a facility in which the vulnerable can be protected: a safe, sanitary and humane environment
2. The right to informed consent to treatment. Staff should discuss with the prisoner the nature, purpose, risks, and benefits of types of mental health treatment.
3. The qualified right to refuse treatment, including psychotropic medications, on the same basis as any other person.
4. The right to the least restrictive environment and the least intrusive response to an apparent need for mental health services.
5. The right to be confined in a place that can provide the treatment needed.
6. The right to confidentiality in the delivery of mental health services and in mental health and related facility records.
7. The right to have regular and timely access to medical and mental health staff who are culturally competent and qualified to provide adequate treatment and supervision.
8. The right to be transferred to an appropriate medical or mental health facility or unit when conditions warrant.
9. The right to be free from corporal punishment, chemical restraints, and sexual abuse or coercion.
10. The right to assert grievances, to have grievances considered in a fair, timely and impartial manner, and to exercise rights without reprisal.
11. The right to an individualized written treatment plan, to the treatment specified in the plan, to periodic review and revision of the plan based on the prisoner's needs. The family should participate in the development, review, reassessment and revision of both the treatment plan and the discharge plan, unless the prisoner refuses such participation.
MHA and its affiliates should work to inform members of law enforcement and correctional groups, judges and attorneys, mental health professionals and advocates, prisoners and their families, the community and the media about the excessive number of persons with mental illnesses and addictive disorders in prisons and jails and the inherent difficulties involved in providing decent and humane care to such persons in these settings and should develop and advocate for effective strategies addressing these problems.
Sources:
http://www.mentalhealthamerica.net/go/position-statements/56
Arizona Department of Corrections Medical (M) and Mental Health (MH) Score Inmate Distribution by Complex as of 2/22/10
www.treatmentadvocacycenter.com
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