Insanity On Death Row
Nov. 11, 2007
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(CBS) When it comes to prisoners on death row who are insane, the law is very clear: you cannot execute them. The Supreme Court has ruled it unconstitutional and deemed it "cruel and unusual punishment."
But can medication make a prisoner sane enough to be executed? That question is being asked in the case of convicted killer Greg Thompson.
As correspondent Lara Logan reports, Thompson was originally found competent to stand trial, but prison doctors have concluded he is mentally ill and they give him medication every day.
Thompson's lawyers argue that he is still insane on the medication, which he was taking the day 60 Minutes met with him.
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Thompson told Logan he had to stab his food to eat it. "Especially eggs. They be popping up," he said. "Hit me in the face. You got to stab it. And then you gotta eat it quick. Real quick."
60 Minutes met Thompson inside a maximum security prison in Nashville.
He has been diagnosed as schizophrenic and psychotic by both prison doctors and those hired by his lawyers. And he has been medicated by the state for most of his 22 years on death row. Thompson receives a daily cocktail of anti-psychotic mood-stabilizing pills, and injections twice a month.
Asked if he knows why he's getting medication, Thompson told Logan, "Yeah, I’m nuts."
He says he only takes 10 pills a day now.
"What happens if you don’t take them?" Logan asked.
"I go lulu," Thompson replied.
"Tell me what going lulu is for you," Logan asked.
"In a few days I would like lose my mind and it would be trying to explode on me," he replied. "I got in a fight with the guards a lot of times, you know. Tried to kill a few."
"Did you kill any of them?" Logan asked.
"No," Thompson said. "But at the time they was turning into insects. And I wanted to kill them."
"The guards were turning into insects?" Logan asked.
"Yeah, they were giant insects," Thompson said. "They was acting just like the guards, but they were aliens. And I had to kill the aliens. They were attacking the world."
A psychologist who has been evaluating Thompson for nine years says he sees, hears and smells things that aren’t there, and suffers from extreme paranoid delusions and hallucinations.
But when Thompson was put on trial for murder 22 years ago, his lawyers did not raise insanity as a defense. He confessed, was convicted and sentenced to death for killing Brenda Lane. She was 28 years old, well-liked in her community and she had been married just a few months.
The facts of what happened on New Year's Day in 1985 have never been in dispute. Thompson and his girlfriend, a juvenile, wanted to get from Tennessee to Georgia, so they kidnapped Brenda Lane, stole her car and then drove around for an hour and a half on remote country roads, as Thompson searched for a place to kill her.
They stopped along a rural country road near a field. Thompson then stabbed Brenda four times in the back and drove off, leaving her to die alone in the cold and the dark.
"I thought I had to kill to survive," Thompson told Logan.
Thompson told 60 Minutes he heard voices in his head that night.
"You thought people were after you," Logan remarked.
"Yes," he replied.
And then in chilling detail, he described exactly how he killed Brenda Lane.
"She got into the front seat driver's seat. And I had the knife on her. And I sat in the back seat. And…," Thompson said.
"You jumped in the car and pulled a knife on her?" Logan asked.
"Yeah. Uh-huh," Thompson acknowledged. "Knife was already out. It was a butcher knife."
"She must have been scared," Logan remarked.
"Yeah, she was crying," Thompson said.
"She was terrified for her life," Logan said.
"I know. I know," Thompson replied.
Asked what he felt, Thompson said, "She knows she’s going to die."
Why did he kill her?
"There was no reasoning at that point," Thompson said. "It was just get away."
"Tell me how it happened. Describe it for me," Logan asked.
"Just turned her around and she didn't move and I stabbed her four times," Thompson recalled. "I wanted her to die quickly."
Asked why he wanted her to die quickly, Thompson told Logan, "Not in pain. I didn't want her to be suffering in pain."
"You think if somebody stabbed you four times in the back you're not gonna suffer?" Logan asked.
"Not really, no," Thompson said.
"You know she was still alive when you drove away," Logan pointed out.
"I heard her scream," Thompson said.
Thompson managed to escape to Georgia but was arrested there after setting Brenda Lane's car on fire. Frankie Floied, an investigator in the case back in Tennessee, says it could have taken months to find the body if Thompson -- over the telephone - hadn't given such precise, intricate, directions to the place he killed her.
"What was going through your mind at the time when you were talking to him on the phone?" Logan asked Floied.
"How calm he was," the investigator remembered. "There was no remorse. There was no passion. It was just matter of fact. 'If you'll take, you take this road, this road, this road and this road.'"
"So exact," Logan remarked.
"It’s like you telling me how to find a Frisbee that you've tossed and lost," Floied said.
"So what did that mean to you?" Logan asked.
"Cold, impassioned. Just a cruel person," Floied replied.
That was the picture prosecutors painted of Thompson at his trial. But it wasn't a complete picture, according to Thompson’s current lawyers, Dana Chavis and Steve Kissinger, who are appealing his case. They say Thompson had severe mental problems dating back to his childhood and they are fighting to keep him alive.
"If he knew what he was doing at the time, and he was competent to be executed at the time that sentence was given, why shouldn't he die for what he did?" Logan asked.
"I think the evidence points overwhelmingly to the fact that he was insane at the time," Kissinger said.
"But it was never proved," Logan said.
"Of the offense," Kissinger said.
"And it wasn’t raised at the trial," Logan said.
"Right," Kissinger said.
"He told them exactly what he’d done. He even told them where he’d thrown out the murder weapon, so they could find that on the side of the road," Logan remarked.
"I think the fact that Greg Thompson can remember things does not detract from the fact that at the time of the crime he was suffering delusions and he was hearing voices," Chavis said.
"Never brought up at the trial," Logan pointed out.
"That’s correct, never brought up at the trial because the trial attorneys did not consult with the proper people that would have seen those clear signs of Greg’s psychosis at the time, the clear signs of psychosis that everybody agrees about right now," Chavis said.
Three years ago, a federal appeals court ruled that a lower court should examine evidence that Thompson was mentally ill at the time of the crime. One judge called it "powerful mitigating evidence." But then the Supreme Court narrowly overruled the decision, saying it was too late to raise that issue. Barbara Brown, Brenda Lane’s only sister, who sat through every day of Thompson’s trial, is frustrated by the lengthy legal process.
"I don't believe that he was insane at the time he killed her. Uh, now I don't know. He's been sitting on death row 22 years. Almost anyone might be insane after this period of time," Barbara said. "It's just not right that he was given a death sentence and it not carried out."
Brenda Lane is buried on a hillside about a mile from her sister Barbara’s house. Every Sunday, Barbara goes back to the same church where she and her sister played piano, sang and prayed together. Barbara thinks the legal system is protecting Thompson and has forgotten her sister.
"It destroyed my family basically. My mother certainly never got over it," she said. "And my dad absolutely wanted to see him executed."
Both parents and Brenda's husband have all died since she was killed. "Even my husband has now passed away," Barbara said.
"I think our hearts go out to the sister," Chavis said. "And of course, what happened is a terrible tragedy. But the point now is that Greg Thompson is psychotic, that he's delusional, that he does not have a rational understanding of why the state seeks to execute him."
In what could be a last-chance appeal, Thompson's lawyers only have to prove he is insane now and doesn't understand what's happening to him, even when he is on medication, as he was during the 60 Minutes interview. He appeared most of the time to be delusional.
"Well, see I wrote some songs and sent them to Hollywood," Thompson told Logan.
Asked who he'd written them for, he said, "Garth Brooks, Reba McIntyre."
Thompson told Logan he likes country music, and that the first song he wrote was "Dirty Dishes in the Sink."
He also said he had gotten paid twice, and that the last check that was sent to him was for $444,000.
"$444,000? What did you do with that money?" Logan asked.
"I sent it to Brenda Lane's family," Thompson said.
"You sure about that?" Logan asked.
"Yeah," Thompson said.
"What if I said to you there was no check?" Logan asked.
"It’s in my name," Thompson insisted.
"What if I said to you, though, there was no check, it’s in your head, not in your name?" Logan asked.
"No, there was a check. It wasn’t in my head, you know," he claimed.
"Are you a con man? Are you acting for me?" Logan asked.
"No. I’m serious. This is me. This is who I am," Thompson replied.
"How can you be sure that Greg Thompson is not just acting up, that he’s not just pretending?" Logan asked attorney Dana Chavis.
"For over 20 years, prison doctors have administered very powerful anti-psychotic drugs to Greg Thompson. I don’t know of any doctor that would prescribe or force that type of medication upon a person unless they believed they were truly psychotic," Chavis replied.
Asked what the effect of that medication is, Chavis said, "It doesn't take away his mental illness. He's always insane. But what it does is that it hides that insanity."
"But it doesn't actually make him normal?" Logan asked.
"Not at all," Chavis replied.
But does Thompson understand that taking the medication may make him appear sane enough to be executed?
"Well, I had a -- I made a choice years ago. That if I were to get to that point I'd rather be normal than insane," Thompson told Logan.
"Why is that?" she asked.
"Because it hurts. I’m tired of being mentally ill, you know. So if they want to kill me at the end, then they kill me at the end," he replied.
"I think I have to forgive him," Brenda Lane's sister Barbara Brown said. "I am a Christian and we are to forgive people. It's hard."
"But you want him to die for what he did," Logan remarked.
"Yes, I do want to see him executed," Barbara said.
Thompson's lawyers are going back to federal court this month and hope eventually to get a ruling that Thompson -- despite his medication -- is mentally incompetent and should not be executed. The Tennessee attorney general, who declined 60 Minutes' request for an interview, is expected to argue that Thompson understands why he is being punished, is not insane, and therefore should be executed.
Asked if he's afraid to die, Thompson said, "I'm on drugs right now. And I feel good. I'm not afraid. When I -- when these drugs wear off a little bit I'll be afraid again."
"If you were executed what do you think would happen to you afterwards? What comes next?" Logan asked.
"Well, I know that the dead can speak," Thompson said.
"The dead can speak? You think you would die?" Logan asked.
"I think it'd be a horrible ending," Thompson said. "Because if the dead can speak that means you got thought in the grave. You got thoughts going on in the grave. I don't know about that."
Sunday, November 11, 2007
Monday, October 22, 2007
Our Brush with Homeland Security: Can Better Understanding of Mental Illness be Legislated?
Posted October 22, 2007 | 12:26 PM (EST)
June 21, 2002. JFK airport in New York. Just nine months after September 11th, my friend and I have just been asked to disembark our flight to California by the airline's head of security. My jaw is a vice. I grind my teeth. It's 9:00 a.m.
My friend, Sam, is also the subject of my first feature-length documentary, A Summer in the Cage. The film chronicles Sam's battle with manic-depressive illness, also known as bipolar disorder. I'm traveling with Sam that June of 2002 while he is in the midst of a delusional, paranoid manic episode. He has spent the last two hours with his shirt off, genuflecting in front of the jetway, praising God, and swaying back and forth. He's 6'7" and weighs 300 pounds.
When we finally board another flight, I spend the next seven hours trying to contain his psychological torrent. Sam praises Osama bin Laden (in the context of fighting for what he believes, however unpopular). He accuses passengers of being armed federal air marshals sent to capture him. The in-flight film, I Am Sam, unglues him as he begins to audibly bawl over the coincidence and poignancy of Sean Penn playing a mentally challenged father named "Sam." Eventually, we finally arrive in Los Angeles where five policemen are waiting to take Sam into custody for his alarming behavior.
Fortunately, I was with Sam that day to explain what was going on to flight attendants, passengers, and eventually the LAPD (they took Sam to a mental health facility instead of to jail and possibly worse with the climate of federal legislation on terrorism). It was one of many moments throughout the course of shooting my film where being a filmmaker was sacrificed so that I could help Sam as a friend. Had I not been accompanying Sam, the episode could very well have ended up like the bloody gun battle that happened to Sam's beloved Oakland Raiders player, Barrett Robbins, who also suffers from bipolar disorder. During a manic episode in Miami, Robbins was shot by the police after he took on several Miami policemen who wanted to arrest him for trespassing. It is imperative that we better educate both the police and medical responders of the symptoms and manifestations of mental illnesses so tragic conflicts and misunderstandings like these can be avoided in the future.
In addition, a better understanding of mental illness needs to extend beyond first-responders to the criminal justice system that is faced with a growing number of people with mental illnesses. According to Human Rights Watch and Bureau of Justice Statistics (BJS) report, "Mental Health Problems of Prison and Jail Inmates" (2006), "the rate of reported mental health disorders in the state prison population is five times greater (56.2 percent) than in the general adult population (11 percent)." The stresses involved in navigating the penal system can severely exacerbate the symptoms of a mental illness. The pressures of lock-up, confinement, isolation, intimidation, sanitary conditions, and the mercurial pace of adjudication create an environment where detainees with mental illnesses are set to fail. Unfortunately, these symptoms of mental illness are often not recognized or understood by the prison staff, leading to violent outbursts or unnecessary harsh treatments and punishments for the unstable inmates. If we want to instill proper rehabilitation and start breaking the cycle of recidivism that faces those who suffer from mistreated mental illnesses, our prisons must be better equipped to recognize and properly treat mentally ill inmates. (Pete Earley's Crazy: A Father's Search Through America's Mental Health Madness is an excellent personal and journalistic inquiry into the penal and court systems' failings, contradictions and inhumanities).
Sam and I were lucky that day when we got off the plane. I was educated on bipolar disorder and the symptoms of mania. I know Sam as a loving and peaceful person who suffers from a mental illness and I was able to convey that to the LA police officers. But I have witnessed and read about countless instances of first responders who misunderstand the symptoms of mental illness to tragic results. I hope that my film, and others like it, can help spark interest and motivate people to better educate themselves about the symptoms and signs of mental illnesses. With that knowledge, I hope that viewers will encourage legislators to support increased education and training for the first responders and correctional officers that are increasingly coming into contact with people suffering from mental illnesses.
A Summer in the Cage will air on Sundance Channel at 9 p.m. EST Monday, October 22, 2007 check local listings. More information about bipolar disorder and the film can be found here.
June 21, 2002. JFK airport in New York. Just nine months after September 11th, my friend and I have just been asked to disembark our flight to California by the airline's head of security. My jaw is a vice. I grind my teeth. It's 9:00 a.m.
My friend, Sam, is also the subject of my first feature-length documentary, A Summer in the Cage. The film chronicles Sam's battle with manic-depressive illness, also known as bipolar disorder. I'm traveling with Sam that June of 2002 while he is in the midst of a delusional, paranoid manic episode. He has spent the last two hours with his shirt off, genuflecting in front of the jetway, praising God, and swaying back and forth. He's 6'7" and weighs 300 pounds.
When we finally board another flight, I spend the next seven hours trying to contain his psychological torrent. Sam praises Osama bin Laden (in the context of fighting for what he believes, however unpopular). He accuses passengers of being armed federal air marshals sent to capture him. The in-flight film, I Am Sam, unglues him as he begins to audibly bawl over the coincidence and poignancy of Sean Penn playing a mentally challenged father named "Sam." Eventually, we finally arrive in Los Angeles where five policemen are waiting to take Sam into custody for his alarming behavior.
Fortunately, I was with Sam that day to explain what was going on to flight attendants, passengers, and eventually the LAPD (they took Sam to a mental health facility instead of to jail and possibly worse with the climate of federal legislation on terrorism). It was one of many moments throughout the course of shooting my film where being a filmmaker was sacrificed so that I could help Sam as a friend. Had I not been accompanying Sam, the episode could very well have ended up like the bloody gun battle that happened to Sam's beloved Oakland Raiders player, Barrett Robbins, who also suffers from bipolar disorder. During a manic episode in Miami, Robbins was shot by the police after he took on several Miami policemen who wanted to arrest him for trespassing. It is imperative that we better educate both the police and medical responders of the symptoms and manifestations of mental illnesses so tragic conflicts and misunderstandings like these can be avoided in the future.
In addition, a better understanding of mental illness needs to extend beyond first-responders to the criminal justice system that is faced with a growing number of people with mental illnesses. According to Human Rights Watch and Bureau of Justice Statistics (BJS) report, "Mental Health Problems of Prison and Jail Inmates" (2006), "the rate of reported mental health disorders in the state prison population is five times greater (56.2 percent) than in the general adult population (11 percent)." The stresses involved in navigating the penal system can severely exacerbate the symptoms of a mental illness. The pressures of lock-up, confinement, isolation, intimidation, sanitary conditions, and the mercurial pace of adjudication create an environment where detainees with mental illnesses are set to fail. Unfortunately, these symptoms of mental illness are often not recognized or understood by the prison staff, leading to violent outbursts or unnecessary harsh treatments and punishments for the unstable inmates. If we want to instill proper rehabilitation and start breaking the cycle of recidivism that faces those who suffer from mistreated mental illnesses, our prisons must be better equipped to recognize and properly treat mentally ill inmates. (Pete Earley's Crazy: A Father's Search Through America's Mental Health Madness is an excellent personal and journalistic inquiry into the penal and court systems' failings, contradictions and inhumanities).
Sam and I were lucky that day when we got off the plane. I was educated on bipolar disorder and the symptoms of mania. I know Sam as a loving and peaceful person who suffers from a mental illness and I was able to convey that to the LA police officers. But I have witnessed and read about countless instances of first responders who misunderstand the symptoms of mental illness to tragic results. I hope that my film, and others like it, can help spark interest and motivate people to better educate themselves about the symptoms and signs of mental illnesses. With that knowledge, I hope that viewers will encourage legislators to support increased education and training for the first responders and correctional officers that are increasingly coming into contact with people suffering from mental illnesses.
A Summer in the Cage will air on Sundance Channel at 9 p.m. EST Monday, October 22, 2007 check local listings. More information about bipolar disorder and the film can be found here.
Monday, October 15, 2007
Early treatment works for those with mental illnesses
By Ella Kaple
Guest Columnist
Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others, and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), and borderline personality disorder. The good news about mental illness is that recovery is possible.
Mental illnesses can affect persons of any age, race, religion, or income. They are not the result of personal weakness, lack of character, or poor upbringing. Most importantly, mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.
In addition to medication treatment, psychosocial treatment such as cognitive behavioral therapy, interpersonal therapy, peer support groups, and other community services can also be components of a treatment plan and that assist with recovery.
In Crawford County, those services are provided each day by Community Counseling Services, Inc., and funded by the Crawford-Marion Board of Alcohol, Drug Addiction and Mental Health Services. Last year alone, over 4,000 individuals received services from our system of care.
Here are some important facts about mental illness and recovery:
Mental illnesses are biologically based brain disorders. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence.
Mental disorders fall along a continuum of severity. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion -- about 6 percent, or 1 in 17 Americans -- who suffer from a serious mental illness. It is estimated that mental illness affects 1 in 5 families in America.
Mental illnesses usually strike individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable.
Without treatment the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives.
The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.
With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.
Early identification and treatment is of vital importance. By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and the further harm related to the course of illness is minimized.
Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.
According to the president's New Freedom Commission on Mental Illness, the annual cost of untreated mental illness is $70 billion in the United States. Untreated depression alone costs the nation a staggering $40 billion a year. While anyone who's ever suffered from a mental illness, or had a family member of friend suffer from a mental illness, can easily understand the human cost of untreated mental illnesses, there is also strong evidence for the financial tolls involved. Recent research indicates that mental health treatment can more than pay for itself through sustaining a healthy workforce -- enhancing what can be viewed as "human capital."
Here are some startling facts:
Approximately 50 percent of students with a mental illness aged 14 or older drop out of high school. This is the highest dropout rate of any disability group.
Twenty-four percent of state prisons and 21 percent of local jail inmates have a recent history of a mental disorder.
An estimated 65 percent of boys and 75 percent of girls in juvenile detention have at least one diagnosable mental disorder.
Between 2000 and 2003, emergency department visits with a primary diagnosis of mental illness increased at four times the rate of other emergency department visits.
We know that treatment outcomes for people with even the most serious mental illnesses are comparable to outcomes for well-established general medical or surgical treatments for other chronic diseases. Early treatment success rates for mental illnesses are 60 to 80 percent. This is well above the estimated 40 to 60 percent success rates for common surgical treatments for heart disease.
As a nurse who has worked with individuals with serious mental illness and substance abuse disorders and as a long time member of the Crawford-Marion ADAMH Board, I know that treatment works and that people recover. Recovering people work. Working people pay taxes. Investing in good mental health services is an investment in our community.
Guest Columnist
Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others, and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), and borderline personality disorder. The good news about mental illness is that recovery is possible.
Mental illnesses can affect persons of any age, race, religion, or income. They are not the result of personal weakness, lack of character, or poor upbringing. Most importantly, mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.
In addition to medication treatment, psychosocial treatment such as cognitive behavioral therapy, interpersonal therapy, peer support groups, and other community services can also be components of a treatment plan and that assist with recovery.
In Crawford County, those services are provided each day by Community Counseling Services, Inc., and funded by the Crawford-Marion Board of Alcohol, Drug Addiction and Mental Health Services. Last year alone, over 4,000 individuals received services from our system of care.
Here are some important facts about mental illness and recovery:
Mental illnesses are biologically based brain disorders. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence.
Mental disorders fall along a continuum of severity. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion -- about 6 percent, or 1 in 17 Americans -- who suffer from a serious mental illness. It is estimated that mental illness affects 1 in 5 families in America.
Mental illnesses usually strike individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable.
Without treatment the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives.
The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.
With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.
Early identification and treatment is of vital importance. By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and the further harm related to the course of illness is minimized.
Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.
According to the president's New Freedom Commission on Mental Illness, the annual cost of untreated mental illness is $70 billion in the United States. Untreated depression alone costs the nation a staggering $40 billion a year. While anyone who's ever suffered from a mental illness, or had a family member of friend suffer from a mental illness, can easily understand the human cost of untreated mental illnesses, there is also strong evidence for the financial tolls involved. Recent research indicates that mental health treatment can more than pay for itself through sustaining a healthy workforce -- enhancing what can be viewed as "human capital."
Here are some startling facts:
Approximately 50 percent of students with a mental illness aged 14 or older drop out of high school. This is the highest dropout rate of any disability group.
Twenty-four percent of state prisons and 21 percent of local jail inmates have a recent history of a mental disorder.
An estimated 65 percent of boys and 75 percent of girls in juvenile detention have at least one diagnosable mental disorder.
Between 2000 and 2003, emergency department visits with a primary diagnosis of mental illness increased at four times the rate of other emergency department visits.
We know that treatment outcomes for people with even the most serious mental illnesses are comparable to outcomes for well-established general medical or surgical treatments for other chronic diseases. Early treatment success rates for mental illnesses are 60 to 80 percent. This is well above the estimated 40 to 60 percent success rates for common surgical treatments for heart disease.
As a nurse who has worked with individuals with serious mental illness and substance abuse disorders and as a long time member of the Crawford-Marion ADAMH Board, I know that treatment works and that people recover. Recovering people work. Working people pay taxes. Investing in good mental health services is an investment in our community.
Sunday, October 7, 2007
Death penalty: Eye for eye
But opponents want moratoriumS to halt 'murder of murderers.'
Sunday, October 07, 2007
By TONY NAUROTH
The Express-Times
The Supreme Court of the United States will soon be considering one of the most important death penalty cases in decades.
The issue centers on the use of lethal injection as the executioner's tool in a case involving two inmates on Kentucky's death row.
Ralph Baze and Thomas Clyde Bowling Jr. sued the Bluegrass State in 2004, claiming the needle amounted to cruel and unusual punishment.
Locally, some say any form of capital punishment is just plain wrong.
Lehigh University Chaplain Lloyd Steffen is a longtime opponent of the death penalty. He's even written a book about it -- "Executing Justice: The Moral Meaning of the Death Penalty."
Steffen is a professor of religion and a minister with the United Church of Christ, which is taking a strong stand against the death penalty.
Karen Berry, head of the Social Action Committee of the Unitarian Universalist Church of the Lehigh Valley, says her church adopted a moratorium resolution earlier this summer and is hoping for formal action from the Pennsylvania Legislature to make some type of death penalty moratorium official statewide.
And during the weekend of Oct. 19-20, Amnesty International is sponsoring the 2007 National Weekend of Faith in Action on the Death Penalty when churches throughout the country will hold events to bring attention to the issue.
The fight is in the courts
This connection between religious and secular organizations is at the forefront of the struggle to rid states of what organizers see as a barbaric and unfairly administered penalty for the crime of murder.
The courts are where the fighting has begun.
All 37 states that perform lethal injection use the same three-drug cocktail, but at least 10 of those states suspended its use after opponents alleged it was ineffective and cruel, according to the Death Penalty Information Center.
The three consist of an anesthetic, a muscle paralyzer, and a substance to stop the heart. Death penalty foes have argued that if the condemned prisoner is not given enough anesthetic, he -- or she -- can suffer excruciating pain without being able to cry out.
Baze, 52, has been on death row for 14 years. He was sentenced for the 1992 shooting deaths of Powell County Sheriff Steve Bennett and Deputy Arthur Briscoe.
Bennett and Briscoe were serving warrants on Baze when he shot them. Baze has said the shootings were the result of a family dispute that got out of hand and resulted in the sheriff being called.
Bowling was sentenced to death for killing Edward and Tina Earley and shooting their 2-year-old son outside the couple's Lexington, Ky., dry-cleaning business in 1990.
Lethal injection is just one battle; the war consists of opponents fighting against all forms of capital punishment.
'Seamless garment of life'
When asked if churches have any business getting mixed up in the politics of whether states should, or should not, execute criminals for the most heinous crimes, Steffen says, "Sure they should. All the mainline churches have taken positions opposing the death penalty, and Pope John Paul II has said the death penalty is inimical to the 'seamless garment of life.' "
Steffen is not encouraging the justice system to let the most vile criminals out onto the streets, he's just looking for the same kind of consideration parents use when their kids act out -- give them a time out.
"If people took a time out to study the problem," he says, "they would be against the death penalty."
Perhaps the Bible verse from Hebrews 10:30 applies here: "'Vengeance is mine,' saith the Lord." And from Deuteronomy 32:36: "For the Lord will be judge of his people."
But what do the people do when a Timothy McVeigh blows up an office building in Oklahoma City, snuffing out 168 souls? Or -- much closer to home -- when Martin Appel robbed the bank in East Allen Township, executing three to leave no witnesses. Appel was sentenced to death, but got off death row through appeals.
Death for 'horrific crimes'
Northampton County District Attorney John Morganelli still chafes at that decision.
"We need to keep the death penalty on the books for any horrific crimes that come along," Morganelli says. He maintains Appel is one of those criminals. Besides, Morganelli says Pennsylvania has had a "de facto" moratorium on death sentences for decades.
"We've only had three executions, and all of those came after they stopped appealing their cases.
Steffen refers to those same three cases as "voluntary" executions. He has visited death rows in Pennsylvania and Tennessee and says death row confinement usually means solitary confinement for years.
"There are a lot of suicides," he says. "It's torturous for them. All three executions have been volunteers. They drop all appeals; it's a mental illness situation."
Pennsylvania's primary method of execution is by lethal injection which, according to Amnesty International, is the same method used by China, Guatemala, the Philippines and Thailand.
New Jersey's method of execution is also by lethal injection. However, The Garden State does have a formal moratorium on executions, due to legislation passed in 2006.
Steffen says too many convicts who were innocent slip through the cracks.
"There have been 124 nationwide," he says.
Return to Martin Appel case
When Illinois Gov. George Ryan commuted his state's death sentences in a blanket order in January 2003, he was making a statement against the death penalty. He was nominated for a Nobel Peace Prize for that action and has stumped in Harrisburg for a moratorium on the death penalty in the Keystone State.
Morganelli, who authored his own book about the Appel case, says those seeking a death penalty moratorium in Pennsylvania "are all do-good organizations that don't believe in punishment and that everybody can be rehabilitated. They're just anti-law and don't carry much credibility."
Morganelli's book is titled "The D-Day Bank Massacre: The True Story Behind the Martin Appel Case."
Morganelli says he's more concerned about inmates who manage to get paroled and end up killing again. He names Reginald McFadden and "Mudman" Simon as two examples.
He also says the American justice system already has a built-in safeguard against making mistakes -- a jury of 12 who must vote unanimously for the death penalty.
"We just had a case where it went 11 to 1," Morganelli says, citing the Andrew D. Paschal verdict. Paschal was convicted of gunning down Marcellus McDuffie outside Larry Holmes Ringside Restaurant and Lounge, in Easton on May 14, 2006.
Death penalty not logical
Maria Weick of the Lehigh Valley Committee Against Killing and the Pennsylvania Death Penalty Abolition Coordinator for Amnesty International, says "Pennsylvania is a really hard case when it comes to the death penalty."
Both she and Steffen say the single most difficult roadblock to a moratorium is politicians.
"Pennsylvania politicians," Weick scoffs, "are married to the idea that supporting the death penalty means they're tough on crime."
Weick says Pennsylvanians are split 50-50 for and against the death penalty.
She admits, "Moratoriums are an act of desperation. But they are a way of getting people to think about the issue."
Steffen says they act to increase public awareness.
Weick adds that the death penalty makes no logical sense.
"Think about it," she says, "Do we drug the drug dealer? Do we rape the rapist? Then why do we murder the murderer?"
Tony Nauroth is a features writer with The Express-Times. He can be reached at 610-258-7171 or by e-mail at tnauroth@express-times.com.
The Associated Press contributed to this report.
Sunday, October 07, 2007
By TONY NAUROTH
The Express-Times
The Supreme Court of the United States will soon be considering one of the most important death penalty cases in decades.
The issue centers on the use of lethal injection as the executioner's tool in a case involving two inmates on Kentucky's death row.
Ralph Baze and Thomas Clyde Bowling Jr. sued the Bluegrass State in 2004, claiming the needle amounted to cruel and unusual punishment.
Locally, some say any form of capital punishment is just plain wrong.
Lehigh University Chaplain Lloyd Steffen is a longtime opponent of the death penalty. He's even written a book about it -- "Executing Justice: The Moral Meaning of the Death Penalty."
Steffen is a professor of religion and a minister with the United Church of Christ, which is taking a strong stand against the death penalty.
Karen Berry, head of the Social Action Committee of the Unitarian Universalist Church of the Lehigh Valley, says her church adopted a moratorium resolution earlier this summer and is hoping for formal action from the Pennsylvania Legislature to make some type of death penalty moratorium official statewide.
And during the weekend of Oct. 19-20, Amnesty International is sponsoring the 2007 National Weekend of Faith in Action on the Death Penalty when churches throughout the country will hold events to bring attention to the issue.
The fight is in the courts
This connection between religious and secular organizations is at the forefront of the struggle to rid states of what organizers see as a barbaric and unfairly administered penalty for the crime of murder.
The courts are where the fighting has begun.
All 37 states that perform lethal injection use the same three-drug cocktail, but at least 10 of those states suspended its use after opponents alleged it was ineffective and cruel, according to the Death Penalty Information Center.
The three consist of an anesthetic, a muscle paralyzer, and a substance to stop the heart. Death penalty foes have argued that if the condemned prisoner is not given enough anesthetic, he -- or she -- can suffer excruciating pain without being able to cry out.
Baze, 52, has been on death row for 14 years. He was sentenced for the 1992 shooting deaths of Powell County Sheriff Steve Bennett and Deputy Arthur Briscoe.
Bennett and Briscoe were serving warrants on Baze when he shot them. Baze has said the shootings were the result of a family dispute that got out of hand and resulted in the sheriff being called.
Bowling was sentenced to death for killing Edward and Tina Earley and shooting their 2-year-old son outside the couple's Lexington, Ky., dry-cleaning business in 1990.
Lethal injection is just one battle; the war consists of opponents fighting against all forms of capital punishment.
'Seamless garment of life'
When asked if churches have any business getting mixed up in the politics of whether states should, or should not, execute criminals for the most heinous crimes, Steffen says, "Sure they should. All the mainline churches have taken positions opposing the death penalty, and Pope John Paul II has said the death penalty is inimical to the 'seamless garment of life.' "
Steffen is not encouraging the justice system to let the most vile criminals out onto the streets, he's just looking for the same kind of consideration parents use when their kids act out -- give them a time out.
"If people took a time out to study the problem," he says, "they would be against the death penalty."
Perhaps the Bible verse from Hebrews 10:30 applies here: "'Vengeance is mine,' saith the Lord." And from Deuteronomy 32:36: "For the Lord will be judge of his people."
But what do the people do when a Timothy McVeigh blows up an office building in Oklahoma City, snuffing out 168 souls? Or -- much closer to home -- when Martin Appel robbed the bank in East Allen Township, executing three to leave no witnesses. Appel was sentenced to death, but got off death row through appeals.
Death for 'horrific crimes'
Northampton County District Attorney John Morganelli still chafes at that decision.
"We need to keep the death penalty on the books for any horrific crimes that come along," Morganelli says. He maintains Appel is one of those criminals. Besides, Morganelli says Pennsylvania has had a "de facto" moratorium on death sentences for decades.
"We've only had three executions, and all of those came after they stopped appealing their cases.
Steffen refers to those same three cases as "voluntary" executions. He has visited death rows in Pennsylvania and Tennessee and says death row confinement usually means solitary confinement for years.
"There are a lot of suicides," he says. "It's torturous for them. All three executions have been volunteers. They drop all appeals; it's a mental illness situation."
Pennsylvania's primary method of execution is by lethal injection which, according to Amnesty International, is the same method used by China, Guatemala, the Philippines and Thailand.
New Jersey's method of execution is also by lethal injection. However, The Garden State does have a formal moratorium on executions, due to legislation passed in 2006.
Steffen says too many convicts who were innocent slip through the cracks.
"There have been 124 nationwide," he says.
Return to Martin Appel case
When Illinois Gov. George Ryan commuted his state's death sentences in a blanket order in January 2003, he was making a statement against the death penalty. He was nominated for a Nobel Peace Prize for that action and has stumped in Harrisburg for a moratorium on the death penalty in the Keystone State.
Morganelli, who authored his own book about the Appel case, says those seeking a death penalty moratorium in Pennsylvania "are all do-good organizations that don't believe in punishment and that everybody can be rehabilitated. They're just anti-law and don't carry much credibility."
Morganelli's book is titled "The D-Day Bank Massacre: The True Story Behind the Martin Appel Case."
Morganelli says he's more concerned about inmates who manage to get paroled and end up killing again. He names Reginald McFadden and "Mudman" Simon as two examples.
He also says the American justice system already has a built-in safeguard against making mistakes -- a jury of 12 who must vote unanimously for the death penalty.
"We just had a case where it went 11 to 1," Morganelli says, citing the Andrew D. Paschal verdict. Paschal was convicted of gunning down Marcellus McDuffie outside Larry Holmes Ringside Restaurant and Lounge, in Easton on May 14, 2006.
Death penalty not logical
Maria Weick of the Lehigh Valley Committee Against Killing and the Pennsylvania Death Penalty Abolition Coordinator for Amnesty International, says "Pennsylvania is a really hard case when it comes to the death penalty."
Both she and Steffen say the single most difficult roadblock to a moratorium is politicians.
"Pennsylvania politicians," Weick scoffs, "are married to the idea that supporting the death penalty means they're tough on crime."
Weick says Pennsylvanians are split 50-50 for and against the death penalty.
She admits, "Moratoriums are an act of desperation. But they are a way of getting people to think about the issue."
Steffen says they act to increase public awareness.
Weick adds that the death penalty makes no logical sense.
"Think about it," she says, "Do we drug the drug dealer? Do we rape the rapist? Then why do we murder the murderer?"
Tony Nauroth is a features writer with The Express-Times. He can be reached at 610-258-7171 or by e-mail at tnauroth@express-times.com.
The Associated Press contributed to this report.
Saturday, September 29, 2007
Mental health courts and activism are topics of conference
09/28/07
WMNF Evening News Friday
By Seán Kinane
Today was the final day of this week’s Mental Health Conference at the TradeWinds Island Resorts in St. Pete Beach.
The three-day conference was co-hosted by the Florida Council for Community Mental Health and the Florida Psychiatric Rehabilitation Association.
This morning’s plenary speech was by David Shern, president and CEO of the advocacy group Mental Health America.
A year ago Shern left his tenured position as Dean of USF’s Florida Mental Health Institute because he felt he could be a more effective advocate for people with mental illness from outside of academia. Shern said that his decision had a lot to do with frustration that his nephew Kyle could not receive adequate mental health care.
The title of Shern’s plenary was "Mental Health In America: Where is the Outrage?" Shern feels that the topic of mental health is so important but that people don’t care enough about it.
Shern said that another reason people should be outraged is because the U.S. has the worst mental health in the developed world.
The high rates of mental illness in the United States contribute to the overall healthcare crisis in the country, according to Shern.
One of the meeting’s breakout sessions dealt with Mental Health Courts -- How to provide recovery and hope. Mental Health Courts attempt to take people with mental health issues out of the criminal justice system to get them the care they need.
Ginger Lerner-Wren has been the judge of the nation’s first mental health court since its establishment in Broward County in 1997. Lerner said the purpose of court-based diversion models such as a mental health court was to stop the criminalization of mental illness and there are several questions that can be asked to see if mental health courts are successful.
Judge Lerner shared in David Shern’s outrage and said that motivated her community to form Broward’s pioneering Mental Health Court.
Lerner told the mental health professionals in the audience some of the reasons why she and her coworkers are so committed to the goals of the mental health court.
Lerner said that the rate of repeat arrests of people who have gone through her misdemeanor court is between 9 and 12 percent. Even though the court doesn’t receive funding, Judge Lerner is able to brag about its success.
For more information:
Mental Health America
Broward / 17th Circuit
FCCMH
WMNF Evening News Friday
By Seán Kinane
Today was the final day of this week’s Mental Health Conference at the TradeWinds Island Resorts in St. Pete Beach.
The three-day conference was co-hosted by the Florida Council for Community Mental Health and the Florida Psychiatric Rehabilitation Association.
This morning’s plenary speech was by David Shern, president and CEO of the advocacy group Mental Health America.
A year ago Shern left his tenured position as Dean of USF’s Florida Mental Health Institute because he felt he could be a more effective advocate for people with mental illness from outside of academia. Shern said that his decision had a lot to do with frustration that his nephew Kyle could not receive adequate mental health care.
The title of Shern’s plenary was "Mental Health In America: Where is the Outrage?" Shern feels that the topic of mental health is so important but that people don’t care enough about it.
Shern said that another reason people should be outraged is because the U.S. has the worst mental health in the developed world.
The high rates of mental illness in the United States contribute to the overall healthcare crisis in the country, according to Shern.
One of the meeting’s breakout sessions dealt with Mental Health Courts -- How to provide recovery and hope. Mental Health Courts attempt to take people with mental health issues out of the criminal justice system to get them the care they need.
Ginger Lerner-Wren has been the judge of the nation’s first mental health court since its establishment in Broward County in 1997. Lerner said the purpose of court-based diversion models such as a mental health court was to stop the criminalization of mental illness and there are several questions that can be asked to see if mental health courts are successful.
Judge Lerner shared in David Shern’s outrage and said that motivated her community to form Broward’s pioneering Mental Health Court.
Lerner told the mental health professionals in the audience some of the reasons why she and her coworkers are so committed to the goals of the mental health court.
Lerner said that the rate of repeat arrests of people who have gone through her misdemeanor court is between 9 and 12 percent. Even though the court doesn’t receive funding, Judge Lerner is able to brag about its success.
For more information:
Mental Health America
Broward / 17th Circuit
FCCMH
Friday, August 10, 2007
Mentally ill offender re-entry: silent crisis in our communities
By GARY BEMBRY
guest columnist
Friday, August 10, 2007
On May 22, Department of Corrections Secretary James R. McDonough announced a subtle, but significant, change to the agency's mission statement. Normally, such a change would not be compelling, but to those concerned with the safety of our communities and the well-being of its citizens, it is indeed an important — and noteworthy — change of direction.
The revision, according to McDonough, places a "renewed emphasis on the preparation of inmates for re-entry into society as part of our mission. This is an anti-crime measure of the utmost importance to our state."
We commend the secretary's vision, understanding of the problem and firm commitment to address the issue of offender re-entry. But this is not a battle he — or any one person — can win on his own. He will need the help of our Legislature, other state agencies and Florida's communities to accomplish this ambitious goal.
Here's why.
Too many ex-offenders leave prison unprepared for life on the outside and eventually return. In fact, in April 2007 there were almost 92,000 inmates in Florida's prisons, and more than 44 percent of them had been in prison before.
The issue of recidivism is especially troublesome for those incarcerated with a mental illness. It is estimated that 20 percent of the prison population has a serious mental illness and that almost three-fourths of inmates with a mental illness have a co-occurring substance-abuse disorder. Mentally ill offenders also have a higher-than-average rate of recidivism, cycling in and out of criminal justice and corrections settings with alarming regularity.
As McDonough moves forward with his progressive plans, we hope that he focuses on issues such as having transitional housing for ex-offenders with a mental illness when they are released. If we don't, then we are placing them directly into homelessness, for which they can be sent back to jail.
Those with a known mental illness also should be connected to local mental health and substance-abuse counseling services before they are released. We need to maintain some sort of tracking that may include a period of parole and a way to know if they are treated in a hospital emergency room or have an encounter with police. In fact, we need to work directly with law enforcement to explore additional means of intervention that can resolve issues in ways other than re-incarceration.
In addition to being a public-safety issue, our lack of success in keeping ex-offenders from re-entering the corrections system costs Florida taxpayers millions each year. With 20 percent of the 10,000 ex-offenders released every year having a significant mental illness, we are paying $120 million annually for their re-entry into the prison system.
That is more than our state spends on all children's mental-health services in a year.
Investing in community-based mental health programs that can provide transitional centers and support staff is the key to tracking, counseling and guiding ex-offenders with mental illness toward safe and healthy actions and away from our prison gates.
It's what is best for them and our communities, and we applaud McDonough for taking the first steps to address this complicated issue. Now it is up to all of us to ensure that he is successful and that some of our most vulnerable citizens have a fighting chance to succeed.
Bembry is chair of the Florida Council for Community Mental Health and CEO of the Lakeview Center in Pensacola. E-mail: gbembry@bhcpns.org
guest columnist
Friday, August 10, 2007
On May 22, Department of Corrections Secretary James R. McDonough announced a subtle, but significant, change to the agency's mission statement. Normally, such a change would not be compelling, but to those concerned with the safety of our communities and the well-being of its citizens, it is indeed an important — and noteworthy — change of direction.
The revision, according to McDonough, places a "renewed emphasis on the preparation of inmates for re-entry into society as part of our mission. This is an anti-crime measure of the utmost importance to our state."
We commend the secretary's vision, understanding of the problem and firm commitment to address the issue of offender re-entry. But this is not a battle he — or any one person — can win on his own. He will need the help of our Legislature, other state agencies and Florida's communities to accomplish this ambitious goal.
Here's why.
Too many ex-offenders leave prison unprepared for life on the outside and eventually return. In fact, in April 2007 there were almost 92,000 inmates in Florida's prisons, and more than 44 percent of them had been in prison before.
The issue of recidivism is especially troublesome for those incarcerated with a mental illness. It is estimated that 20 percent of the prison population has a serious mental illness and that almost three-fourths of inmates with a mental illness have a co-occurring substance-abuse disorder. Mentally ill offenders also have a higher-than-average rate of recidivism, cycling in and out of criminal justice and corrections settings with alarming regularity.
As McDonough moves forward with his progressive plans, we hope that he focuses on issues such as having transitional housing for ex-offenders with a mental illness when they are released. If we don't, then we are placing them directly into homelessness, for which they can be sent back to jail.
Those with a known mental illness also should be connected to local mental health and substance-abuse counseling services before they are released. We need to maintain some sort of tracking that may include a period of parole and a way to know if they are treated in a hospital emergency room or have an encounter with police. In fact, we need to work directly with law enforcement to explore additional means of intervention that can resolve issues in ways other than re-incarceration.
In addition to being a public-safety issue, our lack of success in keeping ex-offenders from re-entering the corrections system costs Florida taxpayers millions each year. With 20 percent of the 10,000 ex-offenders released every year having a significant mental illness, we are paying $120 million annually for their re-entry into the prison system.
That is more than our state spends on all children's mental-health services in a year.
Investing in community-based mental health programs that can provide transitional centers and support staff is the key to tracking, counseling and guiding ex-offenders with mental illness toward safe and healthy actions and away from our prison gates.
It's what is best for them and our communities, and we applaud McDonough for taking the first steps to address this complicated issue. Now it is up to all of us to ensure that he is successful and that some of our most vulnerable citizens have a fighting chance to succeed.
Bembry is chair of the Florida Council for Community Mental Health and CEO of the Lakeview Center in Pensacola. E-mail: gbembry@bhcpns.org
Tuesday, August 7, 2007
Mentally ill ex-cons need help in order to adjust
On May 22, Department of Corrections Secretary James R. McDonough announced a subtle, but significant, change to the agency’s mission statement. Normally, such a change would not be compelling, but to those concerned with the safety of our communities and the well-being of its residents, it is indeed an important — and noteworthy — change of direction.
The revision, according to Secretary McDonough, places a “renewed emphasis on the preparation of inmates for re-entry into society as part of our mission. This is an anti-crime measure of the utmost importance to our state.”
We commend the secretary’s vision. But this is not a battle he — or any one person — can win on his own. He will need the help of the Legislature, other state agencies and Florida’s communities to accomplish this ambitious goal. Here’s why.
Too many ex-offenders leave prison unprepared for life on the outside and eventually return. In fact, in April 2007 there were nearly 92,000 inmates in Florida’s prisons, and more than 44 percent of them had been in prison before.
The issue of recidivism is especially troublesome for those incarcerated with a mental illness. It is estimated that 20 percent of the prison population has a serious mental illness and that nearly three-fourths of inmates with a mental illness have a co-occurring substance-abuse disorder. Mentally ill offenders also have a higher-than-average rate of recidivism, cycling in and out of criminal justice and corrections settings with alarming regularity.
It is easy to see why this is such a problem. In prison, those with mental illness often experience rapidly declining physical and mental health, which makes a life of homelessness, poverty and a pattern of recurring crime, arrest and re-incarceration all the more likely.
So what happens to them? The sad truth is that unless they are arrested again, we often have no idea. Because those with a mental illness are the most ill equipped to succeed in re-entry to society, we are indeed setting them up for failure.
We hope Secretary McDonough focuses on issues such as transitional housing for ex-offenders with a mental illness when they are released. If not, then we are placing them directly into homelessness, for which they can be sent back to jail.
Those with a known mental illness also should be connected to local mental health and substance abuse counseling services before they are released.
We need to maintain some sort of tracking that may include a period of parole and a way to know if they are treated in a hospital emergency room or have an encounter with police. In fact, we need to work directly with law enforcement to explore additional means of intervention that can resolve issues in ways other than re-incarceration.
Establishing this tracking system is crucial as the highest risk of recidivism of mentally ill ex-offenders is in the first six months after release from prison.
In addition to being a public safety issue, we are paying $120 million annually for their re-entry into the prison system.
That is more than our state spends on all children’s mental health services in a year.
Investing in community-based mental health programs that can provide transitional centers and support staff is the key to tracking, counseling and guiding ex-offenders with mental illness.
— Gary Bembry is chairman of the Florida Council for Community Mental Health and CEO of the Lakeview Center in Pensacola. He can be reached at (850) 469-3702 or gbembry@bhcpns.org.
The revision, according to Secretary McDonough, places a “renewed emphasis on the preparation of inmates for re-entry into society as part of our mission. This is an anti-crime measure of the utmost importance to our state.”
We commend the secretary’s vision. But this is not a battle he — or any one person — can win on his own. He will need the help of the Legislature, other state agencies and Florida’s communities to accomplish this ambitious goal. Here’s why.
Too many ex-offenders leave prison unprepared for life on the outside and eventually return. In fact, in April 2007 there were nearly 92,000 inmates in Florida’s prisons, and more than 44 percent of them had been in prison before.
The issue of recidivism is especially troublesome for those incarcerated with a mental illness. It is estimated that 20 percent of the prison population has a serious mental illness and that nearly three-fourths of inmates with a mental illness have a co-occurring substance-abuse disorder. Mentally ill offenders also have a higher-than-average rate of recidivism, cycling in and out of criminal justice and corrections settings with alarming regularity.
It is easy to see why this is such a problem. In prison, those with mental illness often experience rapidly declining physical and mental health, which makes a life of homelessness, poverty and a pattern of recurring crime, arrest and re-incarceration all the more likely.
So what happens to them? The sad truth is that unless they are arrested again, we often have no idea. Because those with a mental illness are the most ill equipped to succeed in re-entry to society, we are indeed setting them up for failure.
We hope Secretary McDonough focuses on issues such as transitional housing for ex-offenders with a mental illness when they are released. If not, then we are placing them directly into homelessness, for which they can be sent back to jail.
Those with a known mental illness also should be connected to local mental health and substance abuse counseling services before they are released.
We need to maintain some sort of tracking that may include a period of parole and a way to know if they are treated in a hospital emergency room or have an encounter with police. In fact, we need to work directly with law enforcement to explore additional means of intervention that can resolve issues in ways other than re-incarceration.
Establishing this tracking system is crucial as the highest risk of recidivism of mentally ill ex-offenders is in the first six months after release from prison.
In addition to being a public safety issue, we are paying $120 million annually for their re-entry into the prison system.
That is more than our state spends on all children’s mental health services in a year.
Investing in community-based mental health programs that can provide transitional centers and support staff is the key to tracking, counseling and guiding ex-offenders with mental illness.
— Gary Bembry is chairman of the Florida Council for Community Mental Health and CEO of the Lakeview Center in Pensacola. He can be reached at (850) 469-3702 or gbembry@bhcpns.org.
Wednesday, July 25, 2007
Mental Disabilities
The ABA assessment team concluded:
The State of Florida has a significant number of people with severe mental disabilities on death row, some of whom were disabled at the time of the offense and others of whom became seriously ill after conviction and sentence.@ ABA Report on Florida at ix.
And, while Florida has recently excluded individuals suffering from mental retardation from the death penalty, it has not extended its logic to those suffering from severe mental disabilities. Id. at xi.
The ABA assessment team recommends that the logic regarding those with mental retardation be extended to those with severe mental disabilities, noting that mental illness can effect every stage of a capital trial. Id at xxxviii.
Certainly, the distinction between the mental impairment of the mental retarded and the mental impairment of the mental ill and corresponding culpability of those inflicted with each condition appears to be arbitrary.
Furthermore, even in the case of the mentally retarded, Florida has created a procedure that will produce arbitrary results, as ABA assessment team acknowledges.
The legislation and rule governing mental retardation procedures makes a distinction between those individuals whose cases are final and those who are not. See Fla. Stat. ' 921.137; Fla. R. Crim. P. 3.203. Those whose cases are final receive none of the protections as those whose cases are not final, including, but not limited to a jury`s consideration of the issue and the sixth amendment guarantee to effective assistance of counsel. These distinction depending on where a defendant is in his criminal process are arbitrary.
The ABA assessment team also criticized the burden of proof imposed on capital defendants and recommended that the State be required to disprove a defendant`s substantial showing that he is mentally retarded. ABA Report on Florida at xxxviii.
The imposition of the burden of proof on the defendant will undoubtedly cause the decision as to who is mental retarded and does not get executed and who is not retarded and gets executed to turn on arbitrary factors, such as whether records demonstrating onset before the age of 18 exist, are family members still alive who can advise mental health experts as to the defendant=s adaptive skills, etc.
The State of Florida has a significant number of people with severe mental disabilities on death row, some of whom were disabled at the time of the offense and others of whom became seriously ill after conviction and sentence.@ ABA Report on Florida at ix.
And, while Florida has recently excluded individuals suffering from mental retardation from the death penalty, it has not extended its logic to those suffering from severe mental disabilities. Id. at xi.
The ABA assessment team recommends that the logic regarding those with mental retardation be extended to those with severe mental disabilities, noting that mental illness can effect every stage of a capital trial. Id at xxxviii.
Certainly, the distinction between the mental impairment of the mental retarded and the mental impairment of the mental ill and corresponding culpability of those inflicted with each condition appears to be arbitrary.
Furthermore, even in the case of the mentally retarded, Florida has created a procedure that will produce arbitrary results, as ABA assessment team acknowledges.
The legislation and rule governing mental retardation procedures makes a distinction between those individuals whose cases are final and those who are not. See Fla. Stat. ' 921.137; Fla. R. Crim. P. 3.203. Those whose cases are final receive none of the protections as those whose cases are not final, including, but not limited to a jury`s consideration of the issue and the sixth amendment guarantee to effective assistance of counsel. These distinction depending on where a defendant is in his criminal process are arbitrary.
The ABA assessment team also criticized the burden of proof imposed on capital defendants and recommended that the State be required to disprove a defendant`s substantial showing that he is mentally retarded. ABA Report on Florida at xxxviii.
The imposition of the burden of proof on the defendant will undoubtedly cause the decision as to who is mental retarded and does not get executed and who is not retarded and gets executed to turn on arbitrary factors, such as whether records demonstrating onset before the age of 18 exist, are family members still alive who can advise mental health experts as to the defendant=s adaptive skills, etc.
Sunday, July 8, 2007
The Wrong Place to Treat Mental Illness
By Marcia Kraft Goin
Sunday, July 8, 2007
Last month the Supreme Court rightly blocked the execution of Scott Panetti, a Texas man who was convicted of a double murder and who suffers from delusional schizophrenia. The case drew public attention to the intersection between mental illnesses and executions.
But what about those who are mentally ill and imprisoned but not on death row? A national conversation on this issue is urgently needed.
There is a pervasive attitude in this country that such people are getting what they deserve: After all, like Panetti, they are in jail for something.
But did you know that the Los Angeles County Jail houses the largest psychiatric population in the country? That's not justice. That's emblematic of a national emergency.
Before the 1960s, people with mental illnesses were generally cared for in institutional settings, mostly state-run psychiatric facilities. Many advocates correctly saw this as "warehousing" people who could be cared for in less restrictive settings. Federal legislation and the courts powered a move toward deinstitutionalization, calling on states and counties to provide resources for social services, vocational rehabilitation and treatment services. The introduction of effective antipsychotic medications also drove the trend toward deinstitutionalization.
In the decades since, community-based services have helped many people. But the situation today constitutes a national failure.
What's gone wrong?
Most important, the necessary community resources didn't materialize in anywhere near the level that was needed. Also, antipsychotic medications, while powerful treatments, don't work in isolation. Patients need a relationship with a psychiatrist, clinic or other stabilizing force to ensure adherence to drug regimens and achieve the best possible recovery.
Deinstitutionalization has succeeded in decreasing the overall number of hospital beds, but an unforeseen consequence has been the proportional increase in the number of people with mental illnesses housed in the criminal justice system. Worse, once imprisoned, people with mental illness are shown to have much longer incarcerations than other inmates, primarily because a prison environment and lack of treatment aggravate the very illness that has led to their objectionable or antisocial behavior.
While no one would argue that Scott Panetti belongs on the streets, his case compels us to consider the justice system's role: Is it to mete out punishment that seeks retribution, or are there cases where real justice means effective treatment that seeks rehabilitation?
Consider again Los Angeles County: In 2002 there were 38,600 psychiatric evaluations at the inmate reception center of the Twin Towers jail. Of these, 23,190 people (60 percent) were found to be in need of mental health treatment. A reasonable person could not fail to see the correlation between decreased funding for mental health resources, the closure of hospital beds, homelessness and the criminalization of mental illnesses. Untreated and lacking access to long-term care, people with mental illnesses often end up with symptoms and behaviors that result in jail time.
Cuts in state Medicaid budgets promise to exacerbate these problems. Not only is this shift in funding a blight on our society, it also costs money -- a lot of money. Corrections officials, mental health workers, medication, amortization of buildings and time spent by police in court all cost more than treating patients appropriately in their community. This doesn't make financial sense, much less humanitarian sense.
When considering the direction of public policies that affect those with mental illnesses, politicians and other officials must be guided by the latest research.
Government-funded studies have shown in recent years that jail-diversion programs, which help people get the treatment they need, result in positive outcomes for individuals, communities and the criminal justice system. While jail diversion does generally result in lower criminal-justice costs and greater treatment costs, studies are underway to analyze the differential.
The question the court answered in the Panetti case was about one's fitness to be executed, but in many more cases, the question is about the appropriateness of incarceration at all.
The writer is a past president of the American Psychiatric Association and director of residency training in the Psychiatric Outpatient Department at Los Angeles County General Hospital/University of Southern California School of Medicine.
Sunday, July 8, 2007
Last month the Supreme Court rightly blocked the execution of Scott Panetti, a Texas man who was convicted of a double murder and who suffers from delusional schizophrenia. The case drew public attention to the intersection between mental illnesses and executions.
But what about those who are mentally ill and imprisoned but not on death row? A national conversation on this issue is urgently needed.
There is a pervasive attitude in this country that such people are getting what they deserve: After all, like Panetti, they are in jail for something.
But did you know that the Los Angeles County Jail houses the largest psychiatric population in the country? That's not justice. That's emblematic of a national emergency.
Before the 1960s, people with mental illnesses were generally cared for in institutional settings, mostly state-run psychiatric facilities. Many advocates correctly saw this as "warehousing" people who could be cared for in less restrictive settings. Federal legislation and the courts powered a move toward deinstitutionalization, calling on states and counties to provide resources for social services, vocational rehabilitation and treatment services. The introduction of effective antipsychotic medications also drove the trend toward deinstitutionalization.
In the decades since, community-based services have helped many people. But the situation today constitutes a national failure.
What's gone wrong?
Most important, the necessary community resources didn't materialize in anywhere near the level that was needed. Also, antipsychotic medications, while powerful treatments, don't work in isolation. Patients need a relationship with a psychiatrist, clinic or other stabilizing force to ensure adherence to drug regimens and achieve the best possible recovery.
Deinstitutionalization has succeeded in decreasing the overall number of hospital beds, but an unforeseen consequence has been the proportional increase in the number of people with mental illnesses housed in the criminal justice system. Worse, once imprisoned, people with mental illness are shown to have much longer incarcerations than other inmates, primarily because a prison environment and lack of treatment aggravate the very illness that has led to their objectionable or antisocial behavior.
While no one would argue that Scott Panetti belongs on the streets, his case compels us to consider the justice system's role: Is it to mete out punishment that seeks retribution, or are there cases where real justice means effective treatment that seeks rehabilitation?
Consider again Los Angeles County: In 2002 there were 38,600 psychiatric evaluations at the inmate reception center of the Twin Towers jail. Of these, 23,190 people (60 percent) were found to be in need of mental health treatment. A reasonable person could not fail to see the correlation between decreased funding for mental health resources, the closure of hospital beds, homelessness and the criminalization of mental illnesses. Untreated and lacking access to long-term care, people with mental illnesses often end up with symptoms and behaviors that result in jail time.
Cuts in state Medicaid budgets promise to exacerbate these problems. Not only is this shift in funding a blight on our society, it also costs money -- a lot of money. Corrections officials, mental health workers, medication, amortization of buildings and time spent by police in court all cost more than treating patients appropriately in their community. This doesn't make financial sense, much less humanitarian sense.
When considering the direction of public policies that affect those with mental illnesses, politicians and other officials must be guided by the latest research.
Government-funded studies have shown in recent years that jail-diversion programs, which help people get the treatment they need, result in positive outcomes for individuals, communities and the criminal justice system. While jail diversion does generally result in lower criminal-justice costs and greater treatment costs, studies are underway to analyze the differential.
The question the court answered in the Panetti case was about one's fitness to be executed, but in many more cases, the question is about the appropriateness of incarceration at all.
The writer is a past president of the American Psychiatric Association and director of residency training in the Psychiatric Outpatient Department at Los Angeles County General Hospital/University of Southern California School of Medicine.
Thursday, July 5, 2007
Coping with Mental Illness: Help Is Here
COURT HOUSE— More than 44 million Americans suffer from a mental health disorder according to the National Institutes of Mental Health, 80 percent of which also have a sub-stance abuse problem.
“He’s been through counseling, seven rehabs, overdosed four of five times,” said the North Wildwood resident and mother of a schitzo-affected adult son suffering from severe anxiety, bi-polar disease, and substance abuses.
The Herald is withholding the names of mother and son to protect their privacy.
What this mother described is termed by psychiatric professionals as a dual diagnosis, oc-curring when an individual is affected by both an emotional or psychiatric illness and chemical dependency.
The woman describes her son as a shy boy, who experienced extreme emotional highs and lows and delusions of grandeur.
“He doesn’t listen,” said the North Wildwood resident, “he does not think logically.”
She said she feels alcohol and drug use was what escalated the situation with her son’s mental health.
“We had a lot alcoholism in our family, mostly functioning alcoholics, but in those days we didn’t know. People didn’t talk about their problems.”
At 14, her son had his first suicidal overdose.
Afterward, she sought assistance from Cape Counseling Center in Court House.
“It’s very hard for kids,” she said. “He came out of rehab and re-entered school at 16 so-ber, but his friends were drinking and smoking pot. Of course he wanted to do what they were doing.”
Her son, now in his thirties, was in the Ancora facility last year where he connected with Rachel Parzio-Corso, an advocate with New Jersey Protection and Advocacy, Inc. (NJP&A).
Designated by Gov. Christine Todd Whitman in 1994, NJP&A serves as a free service agency of attorneys and advocates who monitor investigations, respond to cases and teach people to be self-advocates.
Parzio-Corso, who also has a son with mental health issues, attends a jail task force monthly and responds to cases such as when a person is in jail and doesn’t have access to proper medication, or in the case of this North Wildwood mother’s son, assists patients in receiving the best treatment for their particular situation and assuring their rights are pro-tected.
Parzio-Corso said issues she comes in contact with are overmedication in psychiatric hospi-tals and extended incarceration for offences that may have been escalated into extended is-sues because the person is mentally ill.
She said she also deals with more minor issues in psychiatric hospitals such as laundry be-ing returned to a mentally ill person with holes and burns, or not returning at all.
“We’re trying to put an end to issues like that,” Parzio-Corso said.
The Group for the Advancement of Psychiatry reports that 320,000 people who suffer from severe mental illness are incarcerated in our jails and prisons today.
Parzio-Corso told the Herald that 15 to 20 percent of inmates are mentally ill, and they will spend an average of eight times longer incarcerated than other inmates due to infrac-tions stemming from response to lack of proper treatment and medication.
Cape Counseling is working to change this situation by heading it off before mentally ill individuals get into trouble.
The non-profit group provides mental health education programs throughout the county, support groups for patients and families, and a free service program, Families F.I.R.S.T., which provides education and support for family members of loved ones with mental ill-ness, to assist them in situations such as this North Wildwood mother and her son.
Cape Counseling also provides psycho-educative services to local police departments in how to interact with a mentally ill suspect, or just in an everyday situation.
“Lower Township has been wonderful,” said Samantha Knocke, a family support special-ist at Cape Counseling’s center in Court House.
Some police departments in Gloucester and Camden counties employ special agents to handle situations with mental health issues because they can be so particular and difficult to manage.
“I’ve seen the police beat my son,” the North Wildwood mother said. “He gets scared, you back him in to a corner, and he reacts. But you have to look at both sides. The person is afflicted and afraid, those interacting with them don’t know how to properly handle them.”
It’s situations like these that called for the creation of the Families F.I.R.S.T. program.
The program defines mental illnesses as physical brain disorders that profoundly disrupt a person’s ability to think, feel, and relate to others and their environment.
Mental illnesses, according to their literature, are more common than cancer, diabetes, or heart disease.
The program has over 40 active participating families in this county; another 60 participants are what the program terms “inactive.”
“But they are always welcome. Once you are a part of Families F.I.R.S.T, you are always welcome to come back,” program manager Jodi Hynes told the Herald.
“You just have to hope you get the right kind of help. It’s scary,” the North Wildwood mother said.
“We work to protect what we call the patient bill of rights,” Parzio-Corso said. “We focus on making sure these people are treated with dignity and respect.”
She told the Herald the three biggest problems she has seen through her work are; lack of housing, affordable and also availability of half-way house situations, safety, because of hos-pital incidents, and mentally ill patients continually being incarcerated, instead of receiving proper treatment.
“It (mental illness) comes in so many shapes and forms. As long as a person gets the treatment, they can live a normal life,” said Parzio-Corso.
Contact Gillin-Schwartz at (609) 886-8600 Ext 24 or at: mschwartz@cmcherald.com
“He’s been through counseling, seven rehabs, overdosed four of five times,” said the North Wildwood resident and mother of a schitzo-affected adult son suffering from severe anxiety, bi-polar disease, and substance abuses.
The Herald is withholding the names of mother and son to protect their privacy.
What this mother described is termed by psychiatric professionals as a dual diagnosis, oc-curring when an individual is affected by both an emotional or psychiatric illness and chemical dependency.
The woman describes her son as a shy boy, who experienced extreme emotional highs and lows and delusions of grandeur.
“He doesn’t listen,” said the North Wildwood resident, “he does not think logically.”
She said she feels alcohol and drug use was what escalated the situation with her son’s mental health.
“We had a lot alcoholism in our family, mostly functioning alcoholics, but in those days we didn’t know. People didn’t talk about their problems.”
At 14, her son had his first suicidal overdose.
Afterward, she sought assistance from Cape Counseling Center in Court House.
“It’s very hard for kids,” she said. “He came out of rehab and re-entered school at 16 so-ber, but his friends were drinking and smoking pot. Of course he wanted to do what they were doing.”
Her son, now in his thirties, was in the Ancora facility last year where he connected with Rachel Parzio-Corso, an advocate with New Jersey Protection and Advocacy, Inc. (NJP&A).
Designated by Gov. Christine Todd Whitman in 1994, NJP&A serves as a free service agency of attorneys and advocates who monitor investigations, respond to cases and teach people to be self-advocates.
Parzio-Corso, who also has a son with mental health issues, attends a jail task force monthly and responds to cases such as when a person is in jail and doesn’t have access to proper medication, or in the case of this North Wildwood mother’s son, assists patients in receiving the best treatment for their particular situation and assuring their rights are pro-tected.
Parzio-Corso said issues she comes in contact with are overmedication in psychiatric hospi-tals and extended incarceration for offences that may have been escalated into extended is-sues because the person is mentally ill.
She said she also deals with more minor issues in psychiatric hospitals such as laundry be-ing returned to a mentally ill person with holes and burns, or not returning at all.
“We’re trying to put an end to issues like that,” Parzio-Corso said.
The Group for the Advancement of Psychiatry reports that 320,000 people who suffer from severe mental illness are incarcerated in our jails and prisons today.
Parzio-Corso told the Herald that 15 to 20 percent of inmates are mentally ill, and they will spend an average of eight times longer incarcerated than other inmates due to infrac-tions stemming from response to lack of proper treatment and medication.
Cape Counseling is working to change this situation by heading it off before mentally ill individuals get into trouble.
The non-profit group provides mental health education programs throughout the county, support groups for patients and families, and a free service program, Families F.I.R.S.T., which provides education and support for family members of loved ones with mental ill-ness, to assist them in situations such as this North Wildwood mother and her son.
Cape Counseling also provides psycho-educative services to local police departments in how to interact with a mentally ill suspect, or just in an everyday situation.
“Lower Township has been wonderful,” said Samantha Knocke, a family support special-ist at Cape Counseling’s center in Court House.
Some police departments in Gloucester and Camden counties employ special agents to handle situations with mental health issues because they can be so particular and difficult to manage.
“I’ve seen the police beat my son,” the North Wildwood mother said. “He gets scared, you back him in to a corner, and he reacts. But you have to look at both sides. The person is afflicted and afraid, those interacting with them don’t know how to properly handle them.”
It’s situations like these that called for the creation of the Families F.I.R.S.T. program.
The program defines mental illnesses as physical brain disorders that profoundly disrupt a person’s ability to think, feel, and relate to others and their environment.
Mental illnesses, according to their literature, are more common than cancer, diabetes, or heart disease.
The program has over 40 active participating families in this county; another 60 participants are what the program terms “inactive.”
“But they are always welcome. Once you are a part of Families F.I.R.S.T, you are always welcome to come back,” program manager Jodi Hynes told the Herald.
“You just have to hope you get the right kind of help. It’s scary,” the North Wildwood mother said.
“We work to protect what we call the patient bill of rights,” Parzio-Corso said. “We focus on making sure these people are treated with dignity and respect.”
She told the Herald the three biggest problems she has seen through her work are; lack of housing, affordable and also availability of half-way house situations, safety, because of hos-pital incidents, and mentally ill patients continually being incarcerated, instead of receiving proper treatment.
“It (mental illness) comes in so many shapes and forms. As long as a person gets the treatment, they can live a normal life,” said Parzio-Corso.
Contact Gillin-Schwartz at (609) 886-8600 Ext 24 or at: mschwartz@cmcherald.com
Sunday, June 24, 2007
Inmate care declines
AUDIT ON PRISON MENTAL HEALTH TREATMENT
Inmate care declines
Turnover, lack of therapists partly to blame
By CARLOS CAMPOS
The Atlanta Journal-Constitution
Published on: 06/23/07
Mentally ill inmates in Georgia's prison system — many of whom are eventually released — are not getting enough treatment and care, and in some cases are getting worse due to a host of problems outlined in a recently-conducted independent audit.
Inmates suffer from a lack of therapy and counseling as a result of insufficient staffing, employee turnover, technological glitches and other concerns, problems that persist in spite of previous audits that sounded the same alarm, the report says.
The consequences are grave, according to an Atlanta human rights law firm tracking the issue. Six mentally ill inmates have either been slain, or killed themselves, since October 2005 at three of the 33 Georgia prisons that care for inmates who need specialized mental health treatment.
"From our experience, when you don't have enough mental health professionals to oversee this population, people start dying, people start coming out of prison in body bags," said Sarah Geraghty, a lawyer for the Southern Center for Human Rights.
The report is critical of the "lockdown" of some mentally ill inmates in isolation cells for 23 hours a day, causing them to "clinically deteriorate" or "not clinically improve." Given that roughly 95 percent of inmates are eventually released, it means that thousands of mentally ill criminals return to the street as sick — or sicker — than before.
The 37-page audit, obtained by The Atlanta Journal-Constitution under the state's Open Records Act, calls the problems "serious" and "systemic."
The health of mentally ill inmates isn't the only issue on the line. Taxpayers could again end up footing the bill for costly litigation related to poor mental health care.
Threat of suit looms
The prison system estimates it spent "millions" of dollars complying with a series of consent orders from a 1984 federal class-action lawsuit covering every aspect of prison conditions, including deficiencies in its mental health care system. The system was released from federal supervision in 1998.
The threat of another costly federal lawsuit looms large, because the Southern Center for Human Rights — which specializes in prison and jail conditions — has set its sights on mental health care delivery in Georgia prisons.
Department of Corrections officials acknowledge many of the problems cited by correctional health care expert Dr. Jeffrey L. Metzner, but say some of the most serious results of poor mental health care — violent attacks on inmates and staff — have recently gone down inside of Georgia's prisons even as the number of ill inmates has grown.
"There are cracks in the system," said James DeGroot, supervisor of the Department of Corrections' mental health services division. "The system's not broken, but we do have to tend to the infrastructure now stressed by the rapid growth."
DeGroot provided the AJC with numbers of incidents involving mental health inmates that show suicides dropped from 6 in 2005 to 2 in 2006 and one so far in 2007; assaults on prison staff fell from 371 in 2005 to 308 in 2006; assaults among inmates fell from 971 in 2005 to 821 in 2006.
The number of homicides, however, has grown. There was one homicide in 2005 and one in 2006 among the mentally ill population. But there have been two slayings of mental health inmates so far in 2007. Five of the alleged perpetrators in this year's homicides were also mental health inmates.
Southern Center lawyers are confident they can document at least two more violent deaths among the mental health population, Geraghty said.
DeGroot said the deaths must be put in a broader context.
"I don't want to abdicate responsibility for any homicides, suicides or assaults — one is too many," DeGroot said. "But the incidents are relatively low. "
The report was addressed to Georgia Department of Corrections Commissioner James Donald, who declined an interview request for this article.
Metzner, who was paid $10,000 to conduct the audit at the prison system's request, declined comment and deferred questions to the state Department of Corrections.
More mentally ill inmates
Robin Graham, whose mentally ill son Bryan was hospitalized following a scuffle with guards, said she has had a difficult time getting proper treatment for him.
"They look at them simply as 'they broke the law,' not 'they have a problem,'" said Graham, who has hired a lawyer to look into her son's incident. "And there's hundreds of thousands of cases across the United States of people who have had mental illness and done something [illegal] and are never paid any attention to. Your departments of correction, your police forces, your judicial systems have no clue. Absolutely none"
Prison officials say they are dealing with a potentially volatile, difficult population, some of whom have compounded their illnesses with drug abuse.
About 16 percent of the prison population in Georgia receives mental health services.
Those services range from routine outpatient treatment — medication and therapy similar to what functioning people in private life get — to hospitalization for the sickest. Inmates with more serious problems are segregated from the general population in mental health wings inside prisons. Thirty-three of the state's prisons and probation detention centers offer mental health services.
The number of mentally ill inmates in Georgia's prisons has surged since 1999, the year after the system was released from the supervision of federal court. But as the population of mentally ill inmates has grown, the amount of professional help provided to them has gone down.
In August 1999, there were 132 counselors who provided 2,382 hours of psychiatric and psychological help to 4,425 mentally ill inmates, according to Metzner's report. In December 2006, 188 counselors provided 1,830 hours of care for 8,054 inmates.
Prison officials have been repeatedly warned of the shortcomings.
Geraghty, of the human rights group, called the persistent problems "disturbing." "The mental health caseload is skyrocketing and the number of mental health professionals is plummeting."
While under the supervision of the federal courts, the prison system increased staffing levels to make sure mentally ill inmates were cared for. DeGroot said the prison system "began losing ground" in 2000 because of budget cuts.
As a result, unlicensed counselors — who are allowed in prison — are not receiving clinical supervision, raising "serious risk management issues," Metzner wrote. Turnover and vacancy rates among mental health staff and correctional officers in prisons are also high. At Chatham County's Coastal State Prison alone, the vacancy rate among guards is about 40 percent, according to the report.
DeGroot said 2006 — the year covered by the most recent Metzner report — was particularly bad because of a spike in the number of sentenced inmates transferred from crowded county jails into the prison system. "We've grown so fast in calendar year '06 that without the staff growing now there are cracks in the infrastructure," DeGroot said.
Basic therapy
DeGroot led a tour June 13 for an AJC reporter and photographer of some of the mental health units at Phillips State Prison in north Gwinnett County.
The housing units were clean, and most of the inmates appeared calm while participating in therapeutic exercises. Some stared off into space, some held their heads in their hands and some rocked back and forth or twitched nervously.
Therapists talked to the inmates about the importance of proper hygiene in one class. In another, a therapist asked a group of mentally ill inmates to name their favorite color and their reason for choosing it.
An African-American inmate responded "white." When asked by the therapist why he chose white, he matter-of-factly responded "That's the color I am. I'm just in disguise."
A couple of the inmates who spoke with an AJC reporter said they felt safe and treated well inside the mental health wing by most staff members and guards. They had minor complaints about being forced to take medication, or the occasional surly prison guard.
In contrast, Geraghty of the Southern Center for Human Rights showed the AJC a folder full of photos of mental health inmates who had cut themselves at Phillips State Prison.
Some of the inmates had cut their forearms, throats and chests, spilling blood onto their cell floors and uniforms. The photos were gathered during a 2004 lawsuit against the prison system in which the center claimed an "epidemic of self-injury" among mental health inmates at Phillips.
Graham, who had a son at Phillips (he is now at Georgia State Prison in Reidsville), said she's not surprised by the report's findings. "They're basically nonexistent," Graham said of corrections' mental health services.
Graham said there were a few mental health personnel who have been helpful to her. But mostly, she felt ignored and kept in the dark about her son's needs.
On March 21, her son attacked a female prison guard at Phillips. When asked why, according to a report of the incident, he told authorities "Jesus told him to do it." Graham, who suffers from shizo-affective disorder, landed in an Atlanta hospital with a collapsed lung, cracked ribs and other injuries in the ensuing scuffle with guards who responded to the attack. Graham, who was serving five years for assaulting a Cobb County police officer, now faces additional criminal charges in Gwinnett.
DeGroot said he doesn't think the prison system's mental health system is in crisis.
"We could improve. The staff's hearts, most of them, are in the right place, and doing a good job. I think we're providing help to people who for so long have not received much, if any, help. We're dealing with the most disenfranchised population."
Inmate care declines
Turnover, lack of therapists partly to blame
By CARLOS CAMPOS
The Atlanta Journal-Constitution
Published on: 06/23/07
Mentally ill inmates in Georgia's prison system — many of whom are eventually released — are not getting enough treatment and care, and in some cases are getting worse due to a host of problems outlined in a recently-conducted independent audit.
Inmates suffer from a lack of therapy and counseling as a result of insufficient staffing, employee turnover, technological glitches and other concerns, problems that persist in spite of previous audits that sounded the same alarm, the report says.
The consequences are grave, according to an Atlanta human rights law firm tracking the issue. Six mentally ill inmates have either been slain, or killed themselves, since October 2005 at three of the 33 Georgia prisons that care for inmates who need specialized mental health treatment.
"From our experience, when you don't have enough mental health professionals to oversee this population, people start dying, people start coming out of prison in body bags," said Sarah Geraghty, a lawyer for the Southern Center for Human Rights.
The report is critical of the "lockdown" of some mentally ill inmates in isolation cells for 23 hours a day, causing them to "clinically deteriorate" or "not clinically improve." Given that roughly 95 percent of inmates are eventually released, it means that thousands of mentally ill criminals return to the street as sick — or sicker — than before.
The 37-page audit, obtained by The Atlanta Journal-Constitution under the state's Open Records Act, calls the problems "serious" and "systemic."
The health of mentally ill inmates isn't the only issue on the line. Taxpayers could again end up footing the bill for costly litigation related to poor mental health care.
Threat of suit looms
The prison system estimates it spent "millions" of dollars complying with a series of consent orders from a 1984 federal class-action lawsuit covering every aspect of prison conditions, including deficiencies in its mental health care system. The system was released from federal supervision in 1998.
The threat of another costly federal lawsuit looms large, because the Southern Center for Human Rights — which specializes in prison and jail conditions — has set its sights on mental health care delivery in Georgia prisons.
Department of Corrections officials acknowledge many of the problems cited by correctional health care expert Dr. Jeffrey L. Metzner, but say some of the most serious results of poor mental health care — violent attacks on inmates and staff — have recently gone down inside of Georgia's prisons even as the number of ill inmates has grown.
"There are cracks in the system," said James DeGroot, supervisor of the Department of Corrections' mental health services division. "The system's not broken, but we do have to tend to the infrastructure now stressed by the rapid growth."
DeGroot provided the AJC with numbers of incidents involving mental health inmates that show suicides dropped from 6 in 2005 to 2 in 2006 and one so far in 2007; assaults on prison staff fell from 371 in 2005 to 308 in 2006; assaults among inmates fell from 971 in 2005 to 821 in 2006.
The number of homicides, however, has grown. There was one homicide in 2005 and one in 2006 among the mentally ill population. But there have been two slayings of mental health inmates so far in 2007. Five of the alleged perpetrators in this year's homicides were also mental health inmates.
Southern Center lawyers are confident they can document at least two more violent deaths among the mental health population, Geraghty said.
DeGroot said the deaths must be put in a broader context.
"I don't want to abdicate responsibility for any homicides, suicides or assaults — one is too many," DeGroot said. "But the incidents are relatively low. "
The report was addressed to Georgia Department of Corrections Commissioner James Donald, who declined an interview request for this article.
Metzner, who was paid $10,000 to conduct the audit at the prison system's request, declined comment and deferred questions to the state Department of Corrections.
More mentally ill inmates
Robin Graham, whose mentally ill son Bryan was hospitalized following a scuffle with guards, said she has had a difficult time getting proper treatment for him.
"They look at them simply as 'they broke the law,' not 'they have a problem,'" said Graham, who has hired a lawyer to look into her son's incident. "And there's hundreds of thousands of cases across the United States of people who have had mental illness and done something [illegal] and are never paid any attention to. Your departments of correction, your police forces, your judicial systems have no clue. Absolutely none"
Prison officials say they are dealing with a potentially volatile, difficult population, some of whom have compounded their illnesses with drug abuse.
About 16 percent of the prison population in Georgia receives mental health services.
Those services range from routine outpatient treatment — medication and therapy similar to what functioning people in private life get — to hospitalization for the sickest. Inmates with more serious problems are segregated from the general population in mental health wings inside prisons. Thirty-three of the state's prisons and probation detention centers offer mental health services.
The number of mentally ill inmates in Georgia's prisons has surged since 1999, the year after the system was released from the supervision of federal court. But as the population of mentally ill inmates has grown, the amount of professional help provided to them has gone down.
In August 1999, there were 132 counselors who provided 2,382 hours of psychiatric and psychological help to 4,425 mentally ill inmates, according to Metzner's report. In December 2006, 188 counselors provided 1,830 hours of care for 8,054 inmates.
Prison officials have been repeatedly warned of the shortcomings.
Geraghty, of the human rights group, called the persistent problems "disturbing." "The mental health caseload is skyrocketing and the number of mental health professionals is plummeting."
While under the supervision of the federal courts, the prison system increased staffing levels to make sure mentally ill inmates were cared for. DeGroot said the prison system "began losing ground" in 2000 because of budget cuts.
As a result, unlicensed counselors — who are allowed in prison — are not receiving clinical supervision, raising "serious risk management issues," Metzner wrote. Turnover and vacancy rates among mental health staff and correctional officers in prisons are also high. At Chatham County's Coastal State Prison alone, the vacancy rate among guards is about 40 percent, according to the report.
DeGroot said 2006 — the year covered by the most recent Metzner report — was particularly bad because of a spike in the number of sentenced inmates transferred from crowded county jails into the prison system. "We've grown so fast in calendar year '06 that without the staff growing now there are cracks in the infrastructure," DeGroot said.
Basic therapy
DeGroot led a tour June 13 for an AJC reporter and photographer of some of the mental health units at Phillips State Prison in north Gwinnett County.
The housing units were clean, and most of the inmates appeared calm while participating in therapeutic exercises. Some stared off into space, some held their heads in their hands and some rocked back and forth or twitched nervously.
Therapists talked to the inmates about the importance of proper hygiene in one class. In another, a therapist asked a group of mentally ill inmates to name their favorite color and their reason for choosing it.
An African-American inmate responded "white." When asked by the therapist why he chose white, he matter-of-factly responded "That's the color I am. I'm just in disguise."
A couple of the inmates who spoke with an AJC reporter said they felt safe and treated well inside the mental health wing by most staff members and guards. They had minor complaints about being forced to take medication, or the occasional surly prison guard.
In contrast, Geraghty of the Southern Center for Human Rights showed the AJC a folder full of photos of mental health inmates who had cut themselves at Phillips State Prison.
Some of the inmates had cut their forearms, throats and chests, spilling blood onto their cell floors and uniforms. The photos were gathered during a 2004 lawsuit against the prison system in which the center claimed an "epidemic of self-injury" among mental health inmates at Phillips.
Graham, who had a son at Phillips (he is now at Georgia State Prison in Reidsville), said she's not surprised by the report's findings. "They're basically nonexistent," Graham said of corrections' mental health services.
Graham said there were a few mental health personnel who have been helpful to her. But mostly, she felt ignored and kept in the dark about her son's needs.
On March 21, her son attacked a female prison guard at Phillips. When asked why, according to a report of the incident, he told authorities "Jesus told him to do it." Graham, who suffers from shizo-affective disorder, landed in an Atlanta hospital with a collapsed lung, cracked ribs and other injuries in the ensuing scuffle with guards who responded to the attack. Graham, who was serving five years for assaulting a Cobb County police officer, now faces additional criminal charges in Gwinnett.
DeGroot said he doesn't think the prison system's mental health system is in crisis.
"We could improve. The staff's hearts, most of them, are in the right place, and doing a good job. I think we're providing help to people who for so long have not received much, if any, help. We're dealing with the most disenfranchised population."
Saturday, June 23, 2007
The criminalization of mental illness under capitalism
Friday, June 22, 2007
By: Crystal Kim
Prisons replace hospital care
The writer is a member of the Party for Socialism and Liberation and research coordinator of a free-standing psychiatric clinic.
Whether it is Cho Seung-Hui and the Virginia Tech killings or Angela Yates and the murders of her young children, mental illness is an underlying factor in many tragedies in the United States. Approximately 1,000 homicides a year are committed by mentally ill individuals who are not receiving proper treatment.
This comes as no surprise. In the United States—the richest country in the world—the healthcare system is not designed to treat the mentally ill. Rather, mental illness is ignored until the problem explodes.
The largest mental health facility in the United States is not a hospital. It is the Los Angeles County Jail, which holds 3,000 mentally ill inmates on any given day.
The more than 10,000 mentally ill inmates incarcerated in New York state prisons surpass the number of patients in the state’s psychiatric hospitals.
About 10 percent of prisoners suffer from mental illness. Most have committed misdemeanors caused either in whole or in part by psychiatric disorders. They need treatment, not incarceration. Yet, the federal government and state authorities use tax dollars to keep them locked up in subhuman conditions, exacerbating the problem.
This alarming trend began in the 1960s. Since then, jails and prisons have become the new psychiatric hospitals for the mentally ill. Driven by corporate greed, the mentally ill in the United States are being punished for their mental ailments.
Working-class people with mental health problems are the most vulnerable to becoming victims of the system.
Corporate and government collaboration
In 1955, 560,000 people in the United States were being treated for mental health problems in state hospitals. Adjusting for population increase, we would expect there to be about 930,000 individuals being treated in state hospitals today. This is not the case. Fewer than 55,000 people are being treated in such facilities.
Where then are the hundreds of thousands of people with mental health issues? Most are imprisoned by, or otherwise caught up in, the legal system. Between 170,000 and 300,000 mentally ill individuals suffer today in jails and prisons. Another 500,000 are on court-ordered probation.
Since 1960, more than 90 percent of state psychiatric hospital beds have been eliminated. Mental health professionals and sociologists call this "deinstitutionalization." As a result of this phenomenon, many mentally ill patients who need hospital care are in prison instead.
What’s behind deinstitutionalization? In short, the culprit is capitalism.
In 1952, French surgeon Henri Laborit began experimenting with a drug called chlorpromazine. Chlorpromazine was originally developed to treat allergies, but Laborit tested it to see if it could sedate his patients before surgery. Laborit found that chlorpromazine made his patients feel very relaxed. Laborit convinced his colleagues, psychiatrists Jean Delay and Pierre Deniker, to administer chlorpromazine to schizophrenic patients. To their surprise, the most disturbed patients became calm and placid. This was a major breakthrough in psychopharmacology.
Upon hearing about the success of chlorpromazine as a psychiatric drug, the pharmaceutical company that had developed chlorpromazine, Rhone-Poulec, sold the rights to another pharmaceutical company—Smith Kline & French. Known today as GlaxoSmithKline, it is the second largest pharmaceutical company in the world. In 2006, GSK earned $13billion in profits.
Smith Kline flew Deniker all around the United States to speak with psychiatrists about the psychiatric treatment properties of chlorpromazine. The company hoped it could sell chlorpromazine on the U.S. market. When this plan failed, Smith Kline undertook a new approach.
Smith Kline arranged for Deniker to meet with state legislators. Deniker explained to them that state governments could save millions of dollars by prescribing chlorpromazine to mentally ill patients housed in state hospitals. He argued that this would allow patients to be deemed well enough to be discharged. This, of course, would earn Smith Kline billions in profits.
Without regard for whether a patient could continue to afford the drug after discharge, and ignoring its dangerous side effects, state legislators were thrilled by the prospect of no longer having to fund treatment for the mentally ill. State hospitals were already under fire for cruel and inhumane treatment of mentally ill patients. Such treatment was depicted in the popular novel-turned-film "One Flew Over the Cuckoo’s Nest."
With chlorpromazine, state legislators were able to kill two birds with one stone. They could save millions of dollars by emptying psychiatric hospital beds, while also escaping public criticism for the appalling quality of treatment in state hospitals. The lawmakers enthusiastically accepted Smith Kline’s proposal.
Smith Kline marketed chlorpromazine under the name Thorazine. In the first eight months on the market, it was administered to over 2 million patients. In the first 10 years, it was administered to 50 million people. Within 15 years, Smith Kline’s revenues had doubled three times.
The advent of Thorazine, followed by the establishment of Medicaid and Medicare, led the White House to believe that perhaps state psychiatric hospitals were not necessary at all.
In 1963, President John F. Kennedy signed the Community Mental Health Centers Act. This law authorized Congress to spend up to $3 billion to build a national network of community mental health centers to replace state psychiatric hospitals. Congress proudly stated that the community mental health centers would allow even the most severely ill patients to be near home as long as they were taking Thorazine.
State hospitals began emptying their beds almost immediately. Between 1955 and 1994, the number of patients in state psychiatric hospitals decreased from over 500,000 to less than 100,000. From 1963 to 1980, alone, the inpatient population fell more than 75 percent.
The community mental health centers that were promised by Kennedy and Congress, however, were never built. The promise of $3 billion in funding was a big lie. The government turned its attention to "more pressing" matters, namely prosecuting the war of aggression against the Vietnamese people and covering up the Watergate scandal.
Hundreds of thousands of mentally ill patients were dumped onto the streets. This was due to government collaboration to meet the capitalists’ bottom line. By the 1980s, many former patients began arriving in jails and prisons. This trend is called "transinstitutionalization."
Into the prison system
The U.S. population increased by 16 percent between 1980 and 1995. In that period, the number of incarcerated people rose from 501,886 to 1,587,791—an increase of 216 percent!
Have people in the United States become that much more "criminal?" No. The repressive capitalist state apparatus has been extended. Deinstitutionalization has made jails a "repository" of the mentally ill. Instead of being treated as a medical matter, mental illness is being punished as a criminal matter.
A 1973 study of Santa Clara County in California shows that the county jail population rose 300 percent in four years. This jump followed the closure of Agnews State Psychiatric Hospital, located in the same county. (L.A. Teplin, "Journal of Hospital & Community Psychiatry," 1983)
A 1992 Public Citizen survey showed that 29 percent of jails in the United States incarcerate people who have no charges against them but are simply waiting for a psychiatric evaluation, a hospital bed, or transportation to a psychiatric hospital.
Moreover, most severely mentally ill people in jail are incarcerated because they have been charged with a misdemeanor due to an underlying psychiatric disorder. (E.F. Torrey, "Out of the shadows: Confronting America’s mental illness crisis." John Wiley & Sons, 1997)
For example, one mentally ill prisoner in Miami was arrested 26 times in six years for minor crimes such as panhandling and being a "sanitary nuisance." A schizophrenic prisoner in Denver was jailed over 28 times in two years for causing disturbances. In his lifetime, he had been jailed over 100 times.
On average, the mentally ill are jailed six times longer than other inmates charged with the same crime.
Case in point: Miami
What are the conditions like for the mentally ill in U.S. jails and prisons?
Former Washington Post reporter Pete Earley got an unprecedented look at Miami’s main jail—Miami-Dade Pretrial Detention Center. Earley’s investigation was prompted when his own son was thrown into the criminal "justice" system due to a severe mental illness. Earley described his observations of the Miami jail in "Crazy: A Father’s Search Through America’s Mental Health Madness." (G.P. Putnam’s Sons, 2006)
Earley’s description is purely observational, not analytical. Nonetheless, he gives valuable insight into the plight of the mentally ill.
According to Earley, on an average day Miami-Dade Pretrial Detention Center has 700 inmates on antipsychotic drugs. Most of these inmates get locked up on the ninth floor, officially known as the "primary psychiatric unit" but referred to as the "forgotten floor." Inmates are held in large group cells with as many as 50 persons in each cell.
The guards on the ninth floor do not receive special training on how to handle mentally ill inmates. Nurses on the ninth floor earn $2,000 less per year than nurses in Miami hospitals.
The ninth floor has three wings, one of which is reserved for suicidal inmates. Mentally ill inmates who have attempted suicide are held in solitary confinement in cells that have shatter-resistant glass fronts. They are kept naked, and the temperature of the entire wing is kept at around 50 degrees F (10 degrees C) to deter "trouble."
Each cell has a plastic bed built so the prisoner can be strapped to it spread-eagled. Suicidal inmates are not given sheets, blankets or pillows. They are not allowed to have any sort of entertainment, including radio, magazines and books. They have nothing to do but sleep or look out the glass front. Under these sadistic conditions, a suicidal individual’s mental health can only further deteriorate.
There is only one psychiatrist for the entire ninth floor, which allows him to spend an average of 12.7 seconds with each inmate on any given day. He has no authority or time to perform comprehensive mental exams. There is no doctor-patient confidentiality.
The psychiatrist is required to prescribe cheaper drugs to mentally ill inmates even if they report responding well to a different drug. Switching drugs can cause a mentally ill person’s condition to rapidly deteriorate. But this is a risk that Miami’s decision-makers are willing to take to cut down on expenses.
This is a snapshot of what life is like for hundreds of thousands of mentally ill people in the United States today.
Crisis rooted in capitalism
Until the early 19th century, the mentally ill were regularly imprisoned. The work of activists like Dorothea Dix forced legislators to build psychiatric hospitals so that the mentally ill could be treated.
Two hundred years later, the gains have been negated by the inexhaustible greed of capitalists and the politicians they keep in their pockets.
The U.S. mental health system is one example of the wanton greed enforced by the capitalist system. Capitalism upholds the ownership of private property by a few rich capitalists, while the rest of us are exploited in varying degrees. Capitalism is geared toward generating profit, not attending to people’s needs.
Capitalism has made illness into a source of billions in profits for pharmaceutical giants like Pfizer and GlaxoSmithKline each year.
It is cheaper for the state, and more profitable for private corporations, to imprison mentally ill people than to treat them. State governments pay private companies that run psychiatric hospitals regardless how much care they provide their patients and how good or bad that care is. Keeping beds empty increases the owners’ profit margins. Therefore, hospitals push toward prematurely discharging patients rather than ensuring them sufficient treatment.
It does not have to be this way.
The healthcare system must be stripped of its profit motive. This would ensure that patient care is the very top priority. Funding could be used for research and better training of healthcare workers, so that the deplorable conditions common in state psychiatric hospitals of the past are not repeated. Without the profit motive governing health care, aggressive, community-based, long-term follow-up care and treatment could become a reality.
This can only happen through a monumental struggle to reorganize health care so that it benefits people and not predatory drug companies, insurance companies and private hospitals. The healthcare system, along with capitalism itself, must be overturned to meet the needs of all people, especially those with mental illnesses who need help the most.
By: Crystal Kim
Prisons replace hospital care
The writer is a member of the Party for Socialism and Liberation and research coordinator of a free-standing psychiatric clinic.
Whether it is Cho Seung-Hui and the Virginia Tech killings or Angela Yates and the murders of her young children, mental illness is an underlying factor in many tragedies in the United States. Approximately 1,000 homicides a year are committed by mentally ill individuals who are not receiving proper treatment.
This comes as no surprise. In the United States—the richest country in the world—the healthcare system is not designed to treat the mentally ill. Rather, mental illness is ignored until the problem explodes.
The largest mental health facility in the United States is not a hospital. It is the Los Angeles County Jail, which holds 3,000 mentally ill inmates on any given day.
The more than 10,000 mentally ill inmates incarcerated in New York state prisons surpass the number of patients in the state’s psychiatric hospitals.
About 10 percent of prisoners suffer from mental illness. Most have committed misdemeanors caused either in whole or in part by psychiatric disorders. They need treatment, not incarceration. Yet, the federal government and state authorities use tax dollars to keep them locked up in subhuman conditions, exacerbating the problem.
This alarming trend began in the 1960s. Since then, jails and prisons have become the new psychiatric hospitals for the mentally ill. Driven by corporate greed, the mentally ill in the United States are being punished for their mental ailments.
Working-class people with mental health problems are the most vulnerable to becoming victims of the system.
Corporate and government collaboration
In 1955, 560,000 people in the United States were being treated for mental health problems in state hospitals. Adjusting for population increase, we would expect there to be about 930,000 individuals being treated in state hospitals today. This is not the case. Fewer than 55,000 people are being treated in such facilities.
Where then are the hundreds of thousands of people with mental health issues? Most are imprisoned by, or otherwise caught up in, the legal system. Between 170,000 and 300,000 mentally ill individuals suffer today in jails and prisons. Another 500,000 are on court-ordered probation.
Since 1960, more than 90 percent of state psychiatric hospital beds have been eliminated. Mental health professionals and sociologists call this "deinstitutionalization." As a result of this phenomenon, many mentally ill patients who need hospital care are in prison instead.
What’s behind deinstitutionalization? In short, the culprit is capitalism.
In 1952, French surgeon Henri Laborit began experimenting with a drug called chlorpromazine. Chlorpromazine was originally developed to treat allergies, but Laborit tested it to see if it could sedate his patients before surgery. Laborit found that chlorpromazine made his patients feel very relaxed. Laborit convinced his colleagues, psychiatrists Jean Delay and Pierre Deniker, to administer chlorpromazine to schizophrenic patients. To their surprise, the most disturbed patients became calm and placid. This was a major breakthrough in psychopharmacology.
Upon hearing about the success of chlorpromazine as a psychiatric drug, the pharmaceutical company that had developed chlorpromazine, Rhone-Poulec, sold the rights to another pharmaceutical company—Smith Kline & French. Known today as GlaxoSmithKline, it is the second largest pharmaceutical company in the world. In 2006, GSK earned $13billion in profits.
Smith Kline flew Deniker all around the United States to speak with psychiatrists about the psychiatric treatment properties of chlorpromazine. The company hoped it could sell chlorpromazine on the U.S. market. When this plan failed, Smith Kline undertook a new approach.
Smith Kline arranged for Deniker to meet with state legislators. Deniker explained to them that state governments could save millions of dollars by prescribing chlorpromazine to mentally ill patients housed in state hospitals. He argued that this would allow patients to be deemed well enough to be discharged. This, of course, would earn Smith Kline billions in profits.
Without regard for whether a patient could continue to afford the drug after discharge, and ignoring its dangerous side effects, state legislators were thrilled by the prospect of no longer having to fund treatment for the mentally ill. State hospitals were already under fire for cruel and inhumane treatment of mentally ill patients. Such treatment was depicted in the popular novel-turned-film "One Flew Over the Cuckoo’s Nest."
With chlorpromazine, state legislators were able to kill two birds with one stone. They could save millions of dollars by emptying psychiatric hospital beds, while also escaping public criticism for the appalling quality of treatment in state hospitals. The lawmakers enthusiastically accepted Smith Kline’s proposal.
Smith Kline marketed chlorpromazine under the name Thorazine. In the first eight months on the market, it was administered to over 2 million patients. In the first 10 years, it was administered to 50 million people. Within 15 years, Smith Kline’s revenues had doubled three times.
The advent of Thorazine, followed by the establishment of Medicaid and Medicare, led the White House to believe that perhaps state psychiatric hospitals were not necessary at all.
In 1963, President John F. Kennedy signed the Community Mental Health Centers Act. This law authorized Congress to spend up to $3 billion to build a national network of community mental health centers to replace state psychiatric hospitals. Congress proudly stated that the community mental health centers would allow even the most severely ill patients to be near home as long as they were taking Thorazine.
State hospitals began emptying their beds almost immediately. Between 1955 and 1994, the number of patients in state psychiatric hospitals decreased from over 500,000 to less than 100,000. From 1963 to 1980, alone, the inpatient population fell more than 75 percent.
The community mental health centers that were promised by Kennedy and Congress, however, were never built. The promise of $3 billion in funding was a big lie. The government turned its attention to "more pressing" matters, namely prosecuting the war of aggression against the Vietnamese people and covering up the Watergate scandal.
Hundreds of thousands of mentally ill patients were dumped onto the streets. This was due to government collaboration to meet the capitalists’ bottom line. By the 1980s, many former patients began arriving in jails and prisons. This trend is called "transinstitutionalization."
Into the prison system
The U.S. population increased by 16 percent between 1980 and 1995. In that period, the number of incarcerated people rose from 501,886 to 1,587,791—an increase of 216 percent!
Have people in the United States become that much more "criminal?" No. The repressive capitalist state apparatus has been extended. Deinstitutionalization has made jails a "repository" of the mentally ill. Instead of being treated as a medical matter, mental illness is being punished as a criminal matter.
A 1973 study of Santa Clara County in California shows that the county jail population rose 300 percent in four years. This jump followed the closure of Agnews State Psychiatric Hospital, located in the same county. (L.A. Teplin, "Journal of Hospital & Community Psychiatry," 1983)
A 1992 Public Citizen survey showed that 29 percent of jails in the United States incarcerate people who have no charges against them but are simply waiting for a psychiatric evaluation, a hospital bed, or transportation to a psychiatric hospital.
Moreover, most severely mentally ill people in jail are incarcerated because they have been charged with a misdemeanor due to an underlying psychiatric disorder. (E.F. Torrey, "Out of the shadows: Confronting America’s mental illness crisis." John Wiley & Sons, 1997)
For example, one mentally ill prisoner in Miami was arrested 26 times in six years for minor crimes such as panhandling and being a "sanitary nuisance." A schizophrenic prisoner in Denver was jailed over 28 times in two years for causing disturbances. In his lifetime, he had been jailed over 100 times.
On average, the mentally ill are jailed six times longer than other inmates charged with the same crime.
Case in point: Miami
What are the conditions like for the mentally ill in U.S. jails and prisons?
Former Washington Post reporter Pete Earley got an unprecedented look at Miami’s main jail—Miami-Dade Pretrial Detention Center. Earley’s investigation was prompted when his own son was thrown into the criminal "justice" system due to a severe mental illness. Earley described his observations of the Miami jail in "Crazy: A Father’s Search Through America’s Mental Health Madness." (G.P. Putnam’s Sons, 2006)
Earley’s description is purely observational, not analytical. Nonetheless, he gives valuable insight into the plight of the mentally ill.
According to Earley, on an average day Miami-Dade Pretrial Detention Center has 700 inmates on antipsychotic drugs. Most of these inmates get locked up on the ninth floor, officially known as the "primary psychiatric unit" but referred to as the "forgotten floor." Inmates are held in large group cells with as many as 50 persons in each cell.
The guards on the ninth floor do not receive special training on how to handle mentally ill inmates. Nurses on the ninth floor earn $2,000 less per year than nurses in Miami hospitals.
The ninth floor has three wings, one of which is reserved for suicidal inmates. Mentally ill inmates who have attempted suicide are held in solitary confinement in cells that have shatter-resistant glass fronts. They are kept naked, and the temperature of the entire wing is kept at around 50 degrees F (10 degrees C) to deter "trouble."
Each cell has a plastic bed built so the prisoner can be strapped to it spread-eagled. Suicidal inmates are not given sheets, blankets or pillows. They are not allowed to have any sort of entertainment, including radio, magazines and books. They have nothing to do but sleep or look out the glass front. Under these sadistic conditions, a suicidal individual’s mental health can only further deteriorate.
There is only one psychiatrist for the entire ninth floor, which allows him to spend an average of 12.7 seconds with each inmate on any given day. He has no authority or time to perform comprehensive mental exams. There is no doctor-patient confidentiality.
The psychiatrist is required to prescribe cheaper drugs to mentally ill inmates even if they report responding well to a different drug. Switching drugs can cause a mentally ill person’s condition to rapidly deteriorate. But this is a risk that Miami’s decision-makers are willing to take to cut down on expenses.
This is a snapshot of what life is like for hundreds of thousands of mentally ill people in the United States today.
Crisis rooted in capitalism
Until the early 19th century, the mentally ill were regularly imprisoned. The work of activists like Dorothea Dix forced legislators to build psychiatric hospitals so that the mentally ill could be treated.
Two hundred years later, the gains have been negated by the inexhaustible greed of capitalists and the politicians they keep in their pockets.
The U.S. mental health system is one example of the wanton greed enforced by the capitalist system. Capitalism upholds the ownership of private property by a few rich capitalists, while the rest of us are exploited in varying degrees. Capitalism is geared toward generating profit, not attending to people’s needs.
Capitalism has made illness into a source of billions in profits for pharmaceutical giants like Pfizer and GlaxoSmithKline each year.
It is cheaper for the state, and more profitable for private corporations, to imprison mentally ill people than to treat them. State governments pay private companies that run psychiatric hospitals regardless how much care they provide their patients and how good or bad that care is. Keeping beds empty increases the owners’ profit margins. Therefore, hospitals push toward prematurely discharging patients rather than ensuring them sufficient treatment.
It does not have to be this way.
The healthcare system must be stripped of its profit motive. This would ensure that patient care is the very top priority. Funding could be used for research and better training of healthcare workers, so that the deplorable conditions common in state psychiatric hospitals of the past are not repeated. Without the profit motive governing health care, aggressive, community-based, long-term follow-up care and treatment could become a reality.
This can only happen through a monumental struggle to reorganize health care so that it benefits people and not predatory drug companies, insurance companies and private hospitals. The healthcare system, along with capitalism itself, must be overturned to meet the needs of all people, especially those with mental illnesses who need help the most.
Thursday, May 31, 2007
Florida Supreme Court Reduces Death Sentence Because of Mental Illness
The Florida Supreme Court reduced a death sentence to life without parole because of the defendant's serious mental illness. The court noted that this was "one of the most documented cases of serious mental illnesses this court has reviewed." In its decision rejecting the trial judge's death sentence for Christopher Offord (pictured), the justices unanimously held that the death penalty was a disproportionate punishment due to Offord's long-standing mental problems. Medical records show that Offord, who was convicted of killing his wife in 2004, suffers from schizophrenia and bipolar disorder and has been in and out of institutions since he was a young boy. The trial judge had imposed a death sentence despite the fact that she found Offord had committed the murder under the influence of extreme mental or emotional disturbance and lacked the capacity to appreciate the criminality of his conduct. The jury had unanimously recommended a death sentence.
(Associated Press, May 24, 2007). See Mental Illness.
(Associated Press, May 24, 2007). See Mental Illness.
Friday, May 18, 2007
Social workers could ease jail crunch
BY LORETTA TACKETT
PAINTSVILLE HERALD EDITOR
The Department of Public Advocacy (DPA) will submit a 2008 budget proposal which includes money to put a social worker in each of its 30 state offices, including Pikeville, hoping to address the revolving door of the justice system by getting more than half of their clients out of jail and into treatment.
Approximately 68 percent of DPA clients suffer from substance dependency and 58 percent are mentally ill, said DPA Commissioner Ernie Lewis, asserting DPA is concerned with lack of treatment options in overcrowded local jails, including the Big Sandy Regional Detention Center (BSRDC).
The Administrative Office of the Courts (AOC) shows the BSRDC, which is located in Paintsville and houses inmates from Johnson, Martin, Magoffin and Lawrence counties, held 181 inmates in a 110-bed facility last year.
DPA Public Information Officer Dawn Jenkins said Friday there were 200 in a 134-bed capacity - increased by a change in space requirements for each inmate by state law due to statewide overcrowding in jails - and one-third were sleeping on the floor.
In a 2006 visit to Pike County Jail, a University of Kentucky researcher found 236 inmates in a 142-bed facility - 89 of whom were state inmates - and one-half were on the floor, according to a special report the DPA called "Realizing justice during difficult times."
Incarceration rates in Kentucky are skyrocketing, says the DPA, with public defenders caseloads growing for the seventh consecutive year.
Over 300 salaried public defenders represented 140,000 cases last year, Lewis said, which was a 4.3 percent growth and the highest number of cases in DPA history.
The Paintsville office, which serves Johnson, Lawrence, Martin, and Magoffin counties, had 1,600 cases for four attorneys.
The problem in Eastern Kentucky has been complicated with the appearance of federally-funded programs like Operation UNITE, which makes drug-related arrests and offers some assistance to prosecution, but not to defense.
The problem prompted the DPA to hold public forums in 2005 out of concern for ineffective counsel and led to assistance from the 2006 General Assembly, decreasing the number of new cases opened per attorney.
The DPA received funding during the last legislative session to hire 36 more attorneys statewide, Lewis said, adding the goal is to get the caseload down to 400 per lawyer, which is still above the national average.
The 2006 General Assembly also funded the Social Worker Pilot Project, putting a social worker in the public defender's offices in Morehead, Owensboro, and Covington, and will place a fourth one in Bowling Green in July.
"The focus is to work with persons with substance abuse, mental illness, or both and treat them so they don't come back into the justice system," said Jenkins, adding Lewis has been meeting and will meet with legislators, judges and defenders in all trial regions before the 2008 General Assembly to seek support for a social worker in all 30 offices across the state.
The goal is to address the root causes of criminal behavior such as chronic alcohol and substance abuse, mental illness, and illiteracy, Jenkins reported
The project would cost about $1.2 million, Lewis said, asserting, "We think the state will actually save money."
"And better yet, save lives," said Public Defender Jay Barrett, who has been serving as trial division director for the DPA.
The DPA reported the Commonwealth saves $47.12 every day a Kentucky inmate is treated rather than jailed, and a program like the social work project resulted in $15 million in savings for Rhode Island.
Asserting the DPA does not have scientific evidence concerning the effectiveness of the Social Worker Pilot Project yet, as researchers at the University of Louisville are working on it, Jenkins said social workers are making referrals to whatever is available, similar to the way drug court works.
"We have to expand treatment," Lewis said, as only 20 percent of the 68 percent with substance abuse problems are getting treatment.
Many are sleeping on the floor while in withdrawal from drugs, a condition about which Lewis said, "You're not going to get better."
"The BSRDC facility is overcapacity most of the time and without mental health and substance abuse treatment," said Paintsville Public Defender Howe Baker. "Many of our clients will continue to return to the criminal justice system unless we can address their root problem."
PAINTSVILLE HERALD EDITOR
The Department of Public Advocacy (DPA) will submit a 2008 budget proposal which includes money to put a social worker in each of its 30 state offices, including Pikeville, hoping to address the revolving door of the justice system by getting more than half of their clients out of jail and into treatment.
Approximately 68 percent of DPA clients suffer from substance dependency and 58 percent are mentally ill, said DPA Commissioner Ernie Lewis, asserting DPA is concerned with lack of treatment options in overcrowded local jails, including the Big Sandy Regional Detention Center (BSRDC).
The Administrative Office of the Courts (AOC) shows the BSRDC, which is located in Paintsville and houses inmates from Johnson, Martin, Magoffin and Lawrence counties, held 181 inmates in a 110-bed facility last year.
DPA Public Information Officer Dawn Jenkins said Friday there were 200 in a 134-bed capacity - increased by a change in space requirements for each inmate by state law due to statewide overcrowding in jails - and one-third were sleeping on the floor.
In a 2006 visit to Pike County Jail, a University of Kentucky researcher found 236 inmates in a 142-bed facility - 89 of whom were state inmates - and one-half were on the floor, according to a special report the DPA called "Realizing justice during difficult times."
Incarceration rates in Kentucky are skyrocketing, says the DPA, with public defenders caseloads growing for the seventh consecutive year.
Over 300 salaried public defenders represented 140,000 cases last year, Lewis said, which was a 4.3 percent growth and the highest number of cases in DPA history.
The Paintsville office, which serves Johnson, Lawrence, Martin, and Magoffin counties, had 1,600 cases for four attorneys.
The problem in Eastern Kentucky has been complicated with the appearance of federally-funded programs like Operation UNITE, which makes drug-related arrests and offers some assistance to prosecution, but not to defense.
The problem prompted the DPA to hold public forums in 2005 out of concern for ineffective counsel and led to assistance from the 2006 General Assembly, decreasing the number of new cases opened per attorney.
The DPA received funding during the last legislative session to hire 36 more attorneys statewide, Lewis said, adding the goal is to get the caseload down to 400 per lawyer, which is still above the national average.
The 2006 General Assembly also funded the Social Worker Pilot Project, putting a social worker in the public defender's offices in Morehead, Owensboro, and Covington, and will place a fourth one in Bowling Green in July.
"The focus is to work with persons with substance abuse, mental illness, or both and treat them so they don't come back into the justice system," said Jenkins, adding Lewis has been meeting and will meet with legislators, judges and defenders in all trial regions before the 2008 General Assembly to seek support for a social worker in all 30 offices across the state.
The goal is to address the root causes of criminal behavior such as chronic alcohol and substance abuse, mental illness, and illiteracy, Jenkins reported
The project would cost about $1.2 million, Lewis said, asserting, "We think the state will actually save money."
"And better yet, save lives," said Public Defender Jay Barrett, who has been serving as trial division director for the DPA.
The DPA reported the Commonwealth saves $47.12 every day a Kentucky inmate is treated rather than jailed, and a program like the social work project resulted in $15 million in savings for Rhode Island.
Asserting the DPA does not have scientific evidence concerning the effectiveness of the Social Worker Pilot Project yet, as researchers at the University of Louisville are working on it, Jenkins said social workers are making referrals to whatever is available, similar to the way drug court works.
"We have to expand treatment," Lewis said, as only 20 percent of the 68 percent with substance abuse problems are getting treatment.
Many are sleeping on the floor while in withdrawal from drugs, a condition about which Lewis said, "You're not going to get better."
"The BSRDC facility is overcapacity most of the time and without mental health and substance abuse treatment," said Paintsville Public Defender Howe Baker. "Many of our clients will continue to return to the criminal justice system unless we can address their root problem."
Sunday, May 13, 2007
Limit to death penalty sought
Bill would protect the mentally ill
Andrea Weigl, Staff Writer
James Floyd Davis was sentenced to death for killing three people during a workplace shooting more than a decade ago at a Buncombe County tool plant. At least one psychiatrist has concluded that Davis was experiencing paranoid delusions and believed he was waging a "holy war" against co-workers conspiring against him.
A bill pending before the legislature would allow Davis, 59, who was diagnosed in 1973 as schizophrenic, to use his delusions at the time of the killings to try to have his death sentence overturned.
State Sen. Eleanor Kinnaird, a Carrboro Democrat, has proposed allowing defendants with severe mental illness to avoid the death penalty if they were too mentally ill to understand their actions at the time of their crimes. The defendant could either ask a judge to rule on the issue before trial or ask a jury to consider it during the trial's sentencing. Those already on death row could file an appeal.
Kinnaird said the bill does not allow these defendants to avoid prosecution or punishment; they could still be charged and face spending the rest of their lives in prison.
But prosecutors oppose the bill, saying the measure is so broad that it could be applied to all murder defendants facing the death penalty.
"Every time, some hired gun comes in and espouses there's mental illness," said Buncombe County District Attorney Ron Moore, whose office prosecuted Davis. "We haven't tried anyone capitally in this state without some kind of diagnosis."
The bill does not say which diagnoses qualify someone as being severely mentally ill. Rather, the bill defines severe mental illness as someone being unable to appreciate the wrongfulness of their conduct, to use rational judgment or to conform their conduct to the law. Each side is likely to present competing testimony from mental health experts, and the question would be decided by a judge or a jury.
Moore said the jury in Davis' trial considered evidence about his mental illness and still sentenced him to death. Moore said a psychiatrist recently found Davis competent enough to fire his lawyers and drop his appeals. He described Davis as "lucid" and "articulate" during recent court hearings.
The rationale behind the bill is similar to successful efforts in recent years to outlaw the death penalty for juveniles and the mentally retarded: a killer's young age, limited mental functioning and severe mental illness make them less culpable for their crimes and not deserving of the death penalty.
"By a certain reasoning, people with certain mental illnesses can be held responsible, but they aren't the worst of the worst because of the illness that they have," said Richard Dieter, executive director of the Death Penalty Information Center, a nonprofit anti-death penalty group based in Washington.
Mental health advocates agree, saying the bill extends the protection already available to those who are mentally retarded to those with severe mental illness.
"These people probably have no real understanding of what occurred," said Julia Leggett, a lobbyist for the Alliance for Disability Advocates.
A few states eyeing it
North Carolina is one of at least three states, including Indiana and Washington, considering such a proposal. Connecticut is the only state that has such a law.
In a poll earlier this spring, 52 percent of 574 North Carolina voters surveyed said they would not support the death penalty for those with severe mental disability. The poll was released by N.C. Policy Watch, a progressive think tank, that hired Public Policy Polling to conduct the survey, which had a margin of error of 4 percentage points.
Last year, the American Bar Association, as well as The American Psychiatric Association and the American Psychological Association, passed identical resolutions about mentally ill defendants and the death penalty. The resolutions said defendants should not be executed if they had severe mental illness at the time of the crime or if their illness prevents them from helping their lawyers handle their appeals, leads them to give up their appeals or makes them unable to understand the purpose of their execution. North Carolina's legislation does not go that far.
But at least one of Davis' lawyers hopes the bill could help Davis and others on death row.
"There is a significant number on death row who are suffering from mental illness," Asheville lawyer Leah Broker said. "I don't think they got fair trials, especially in my client's case. It would give another avenue for review."
She said Davis' trial lawyers didn't present enough evidence about his history of mental illness that she believes could have swayed jurors. Davis' appeal based on those issues was filed in 2000 and has never been heard, she said.
On May 17, 1995, Davis killed co-workers Gerald Allman, Frank Knox and Anthony Balogh and injured Larry Codgill. Davis had been fired two days before the shooting. Knox's widow, Phyllis Knox, declined to comment about the legislation, although she has previously said she opposes the death penalty.
Staff writer Andrea Weigl can be reached at 829-4848 or andrea.weigl@newsobserver.com.
Andrea Weigl, Staff Writer
James Floyd Davis was sentenced to death for killing three people during a workplace shooting more than a decade ago at a Buncombe County tool plant. At least one psychiatrist has concluded that Davis was experiencing paranoid delusions and believed he was waging a "holy war" against co-workers conspiring against him.
A bill pending before the legislature would allow Davis, 59, who was diagnosed in 1973 as schizophrenic, to use his delusions at the time of the killings to try to have his death sentence overturned.
State Sen. Eleanor Kinnaird, a Carrboro Democrat, has proposed allowing defendants with severe mental illness to avoid the death penalty if they were too mentally ill to understand their actions at the time of their crimes. The defendant could either ask a judge to rule on the issue before trial or ask a jury to consider it during the trial's sentencing. Those already on death row could file an appeal.
Kinnaird said the bill does not allow these defendants to avoid prosecution or punishment; they could still be charged and face spending the rest of their lives in prison.
But prosecutors oppose the bill, saying the measure is so broad that it could be applied to all murder defendants facing the death penalty.
"Every time, some hired gun comes in and espouses there's mental illness," said Buncombe County District Attorney Ron Moore, whose office prosecuted Davis. "We haven't tried anyone capitally in this state without some kind of diagnosis."
The bill does not say which diagnoses qualify someone as being severely mentally ill. Rather, the bill defines severe mental illness as someone being unable to appreciate the wrongfulness of their conduct, to use rational judgment or to conform their conduct to the law. Each side is likely to present competing testimony from mental health experts, and the question would be decided by a judge or a jury.
Moore said the jury in Davis' trial considered evidence about his mental illness and still sentenced him to death. Moore said a psychiatrist recently found Davis competent enough to fire his lawyers and drop his appeals. He described Davis as "lucid" and "articulate" during recent court hearings.
The rationale behind the bill is similar to successful efforts in recent years to outlaw the death penalty for juveniles and the mentally retarded: a killer's young age, limited mental functioning and severe mental illness make them less culpable for their crimes and not deserving of the death penalty.
"By a certain reasoning, people with certain mental illnesses can be held responsible, but they aren't the worst of the worst because of the illness that they have," said Richard Dieter, executive director of the Death Penalty Information Center, a nonprofit anti-death penalty group based in Washington.
Mental health advocates agree, saying the bill extends the protection already available to those who are mentally retarded to those with severe mental illness.
"These people probably have no real understanding of what occurred," said Julia Leggett, a lobbyist for the Alliance for Disability Advocates.
A few states eyeing it
North Carolina is one of at least three states, including Indiana and Washington, considering such a proposal. Connecticut is the only state that has such a law.
In a poll earlier this spring, 52 percent of 574 North Carolina voters surveyed said they would not support the death penalty for those with severe mental disability. The poll was released by N.C. Policy Watch, a progressive think tank, that hired Public Policy Polling to conduct the survey, which had a margin of error of 4 percentage points.
Last year, the American Bar Association, as well as The American Psychiatric Association and the American Psychological Association, passed identical resolutions about mentally ill defendants and the death penalty. The resolutions said defendants should not be executed if they had severe mental illness at the time of the crime or if their illness prevents them from helping their lawyers handle their appeals, leads them to give up their appeals or makes them unable to understand the purpose of their execution. North Carolina's legislation does not go that far.
But at least one of Davis' lawyers hopes the bill could help Davis and others on death row.
"There is a significant number on death row who are suffering from mental illness," Asheville lawyer Leah Broker said. "I don't think they got fair trials, especially in my client's case. It would give another avenue for review."
She said Davis' trial lawyers didn't present enough evidence about his history of mental illness that she believes could have swayed jurors. Davis' appeal based on those issues was filed in 2000 and has never been heard, she said.
On May 17, 1995, Davis killed co-workers Gerald Allman, Frank Knox and Anthony Balogh and injured Larry Codgill. Davis had been fired two days before the shooting. Knox's widow, Phyllis Knox, declined to comment about the legislation, although she has previously said she opposes the death penalty.
Staff writer Andrea Weigl can be reached at 829-4848 or andrea.weigl@newsobserver.com.
Sunday, May 6, 2007
Hundreds of mentally ill youth prisoners can’t see psychiatrist
Elizabeth Hernandez
May 4, 2007 - 9:37PM
AUSTIN — Young inmates on psychotropic medications at one Texas youth prison have not seen a psychiatrist since January, health providers told lawmakers Friday.
State lawmakers said they were shocked at yet more revelations of problems involving the state’s juvenile corrections agency, this time detailing major gaps in health coverage for incarcerated boys and girls.
Sen. John Whitmire, D-Houston, said health care in the Texas Youth Commission "ain’t worth a damn" and questioned whether the state should continue its contract with the University of Texas Medical Branch. He is co-chairman of a legislative committee charged with investigating the agency.
"It’s so bad, I think we need to start over, like from scratch," Whitmire said. "We got to throw this one out."
At Evins Regional Juvenile Center in Edinburg, mentally ill inmates see a psychiatrist by teleconference only and do not have face-to-face visits, a youth commission official said. At West Texas State School in Pyote, where alleged sexual abuse by administrators grabbed the attention of lawmakers in February, the doctor and psychiatrist have never even met, said Dr. Sheri Talley, who is the doctor at Pyote.
About one-third of 250 people at West Texas State School have psychiatric problems, Talley said.
At Corsicana Residential Treatment Center, there are two part-time psychiatrists for 170 youth, all of whom are diagnosed with serious mental illness and sent there to stabilize before beginning their "socialization" program at other youth commission facilities.
One of the psychiatrists is leaving at the end of May, said Nancy Slott, the agency’s health services administrator.
At Ron Jackson State Juvenile Correctional Complex in Brownwood, children have not seen psychiatrists since January, meaning mentally ill youth are on psychotropic medicine with no oversight, officials said.
There are 460 youth living in the two-prison complex.
Slott said she has hired a contract psychiatrist to go to the school there once a week beginning May 14. He will commute from San Antonio, she said.
Because it is difficult to recruit child psychiatrists to Edinburg, the youth commission lets mentally ill youth there visit with a psychiatrist in Austin by teleconference. He is available eight hours a week, Slott said.
The psychiatric problems are among many the agency’s new leaders are trying to address, said youth commission spokesman Jim Hurley. He did not know of any plans to send a psychiatrist to Brownwood before May 14 but said the agency will do what it takes to get youth proper care.
Teleconferencing for health care, like that done at Evins, is becoming increasingly popular as a way to bring medical care to rural areas, Hurley said.
"Obviously, the best would be a face-to-face meeting, but if we’re having trouble making something available, we’ve got to do something to bring medical care," he said.
The intake unit in Marlin, near Waco, where all youth are processed, is "wholly inadequate" because it is not big enough and does not ensure patients’ confidential conversations with health providers won’t be overheard, said Sandra Ferrara, director of youth services for UTMB.
Whitmire asked why lawmakers didn’t learn of these problems sooner.
Dr. Ben Raimer, UTMB’s vice president and chief executive officer for community health services, said he told the Legislature that UTMB needed more money in years past, and even asked to get out of the contract.
"There is no oversight in the current system," he said.
Elizabeth Amazeen, the facility nurse manager at Giddings State School, where children who commit murder are sent, said in the past year she has seen more mentally ill and more violent youth in the infirmary.
"They are hurting each other; they are hurting the staff," Amazeen said.
"Our nurses are weary. They cannot keep up with the injuries they are seeing."
____
Elizabeth Hernandez covers the state capital for Valley Freedom Newspapers. She is based in Austin and can be reached at (512) 323-0622.
May 4, 2007 - 9:37PM
AUSTIN — Young inmates on psychotropic medications at one Texas youth prison have not seen a psychiatrist since January, health providers told lawmakers Friday.
State lawmakers said they were shocked at yet more revelations of problems involving the state’s juvenile corrections agency, this time detailing major gaps in health coverage for incarcerated boys and girls.
Sen. John Whitmire, D-Houston, said health care in the Texas Youth Commission "ain’t worth a damn" and questioned whether the state should continue its contract with the University of Texas Medical Branch. He is co-chairman of a legislative committee charged with investigating the agency.
"It’s so bad, I think we need to start over, like from scratch," Whitmire said. "We got to throw this one out."
At Evins Regional Juvenile Center in Edinburg, mentally ill inmates see a psychiatrist by teleconference only and do not have face-to-face visits, a youth commission official said. At West Texas State School in Pyote, where alleged sexual abuse by administrators grabbed the attention of lawmakers in February, the doctor and psychiatrist have never even met, said Dr. Sheri Talley, who is the doctor at Pyote.
About one-third of 250 people at West Texas State School have psychiatric problems, Talley said.
At Corsicana Residential Treatment Center, there are two part-time psychiatrists for 170 youth, all of whom are diagnosed with serious mental illness and sent there to stabilize before beginning their "socialization" program at other youth commission facilities.
One of the psychiatrists is leaving at the end of May, said Nancy Slott, the agency’s health services administrator.
At Ron Jackson State Juvenile Correctional Complex in Brownwood, children have not seen psychiatrists since January, meaning mentally ill youth are on psychotropic medicine with no oversight, officials said.
There are 460 youth living in the two-prison complex.
Slott said she has hired a contract psychiatrist to go to the school there once a week beginning May 14. He will commute from San Antonio, she said.
Because it is difficult to recruit child psychiatrists to Edinburg, the youth commission lets mentally ill youth there visit with a psychiatrist in Austin by teleconference. He is available eight hours a week, Slott said.
The psychiatric problems are among many the agency’s new leaders are trying to address, said youth commission spokesman Jim Hurley. He did not know of any plans to send a psychiatrist to Brownwood before May 14 but said the agency will do what it takes to get youth proper care.
Teleconferencing for health care, like that done at Evins, is becoming increasingly popular as a way to bring medical care to rural areas, Hurley said.
"Obviously, the best would be a face-to-face meeting, but if we’re having trouble making something available, we’ve got to do something to bring medical care," he said.
The intake unit in Marlin, near Waco, where all youth are processed, is "wholly inadequate" because it is not big enough and does not ensure patients’ confidential conversations with health providers won’t be overheard, said Sandra Ferrara, director of youth services for UTMB.
Whitmire asked why lawmakers didn’t learn of these problems sooner.
Dr. Ben Raimer, UTMB’s vice president and chief executive officer for community health services, said he told the Legislature that UTMB needed more money in years past, and even asked to get out of the contract.
"There is no oversight in the current system," he said.
Elizabeth Amazeen, the facility nurse manager at Giddings State School, where children who commit murder are sent, said in the past year she has seen more mentally ill and more violent youth in the infirmary.
"They are hurting each other; they are hurting the staff," Amazeen said.
"Our nurses are weary. They cannot keep up with the injuries they are seeing."
____
Elizabeth Hernandez covers the state capital for Valley Freedom Newspapers. She is based in Austin and can be reached at (512) 323-0622.
Saturday, May 5, 2007
Mentally ill inmates get state boost
New initiatives and centers open to provide psychiatric treatment.
By ASSOCIATED PRESS
Published May 4, 2007
JACKSONVILLE - A $16.6-million infusion from state leaders and new initiatives will allow the Department of Children and Families to meet state requirements to get mentally ill inmates into hospitals and out of county jails.
Last fall, mental-health advocates and court officials lambasted the state for failing to meet a state law, resulting in hundreds of severely ill inmates being locked up in county jails for months instead of moving them to psychiatric hospitals in 15 days as required by law. Some judges threatened to fine former DCF Secretary Luci Hadi and hold her in contempt.
DCF statistics indicate the situation is improving.
In early January, there were 270 people on the waiting list for mental health facilities for more than 15 days, said Al Zimmerman, a DCF spokesman. By the middle of next week, that number should be zero, Zimmerman said.
DCF officials have contracted with GEO Care, which runs the South Florida Evaluation and Treatment Center in Miami, to oversee new beds at two facilities owned by the state that were turned into treatment centers.
In March, an unused Department of Corrections building in Miami became the South Florida Evaluation and Treatment Center Annex and an empty Department of Juvenile Justice building in Martin County is now Treasure Coast Forensic Treatment Center.
The two new centers have about 400 staff members to care for 275 mentally ill patients.
As part of legislation approved Wednesday and sent to Gov. Charlie Crist, the Legislature is funding 39 new beds, plus keeping open the beds it funded in December.
The legislation sets aside about $4-million to pay for community grants to try to keep people out of jail and $2.5-million for in-jail treatment.
The in-jail treatment programs are operating already in Pinellas and Orange counties, but Zimmerman said officials would like to see it go statewide.
"This bill is a win-win for everyone, " said Sen. Gwen Margolis, D-Bay Harbor Islands. "For those who are mentally ill, it moves them to centers
By ASSOCIATED PRESS
Published May 4, 2007
JACKSONVILLE - A $16.6-million infusion from state leaders and new initiatives will allow the Department of Children and Families to meet state requirements to get mentally ill inmates into hospitals and out of county jails.
Last fall, mental-health advocates and court officials lambasted the state for failing to meet a state law, resulting in hundreds of severely ill inmates being locked up in county jails for months instead of moving them to psychiatric hospitals in 15 days as required by law. Some judges threatened to fine former DCF Secretary Luci Hadi and hold her in contempt.
DCF statistics indicate the situation is improving.
In early January, there were 270 people on the waiting list for mental health facilities for more than 15 days, said Al Zimmerman, a DCF spokesman. By the middle of next week, that number should be zero, Zimmerman said.
DCF officials have contracted with GEO Care, which runs the South Florida Evaluation and Treatment Center in Miami, to oversee new beds at two facilities owned by the state that were turned into treatment centers.
In March, an unused Department of Corrections building in Miami became the South Florida Evaluation and Treatment Center Annex and an empty Department of Juvenile Justice building in Martin County is now Treasure Coast Forensic Treatment Center.
The two new centers have about 400 staff members to care for 275 mentally ill patients.
As part of legislation approved Wednesday and sent to Gov. Charlie Crist, the Legislature is funding 39 new beds, plus keeping open the beds it funded in December.
The legislation sets aside about $4-million to pay for community grants to try to keep people out of jail and $2.5-million for in-jail treatment.
The in-jail treatment programs are operating already in Pinellas and Orange counties, but Zimmerman said officials would like to see it go statewide.
"This bill is a win-win for everyone, " said Sen. Gwen Margolis, D-Bay Harbor Islands. "For those who are mentally ill, it moves them to centers
Thursday, May 3, 2007
Friday My View: Mental health isn't simply a safety issue
By Maggie Labarta
MY VIEW
Kudos to Gov. Charlie Crist for swiftly signing an executive order that establishes the Gubernatorial Task Force for University Campus Safety, which will review all security measures on Florida's college and university campuses.
One of the benefits of this important response to the tragic events at Virginia Tech will be the increased dialogue regarding the treatment of students with mental illness. As this occurs, we should consider a few important points.
The first is that the overwhelming majority of people with mental illness are not violent. In general, those with a mental illness are more likely to be the victims than the perpetrators of violent crime. The tragedy in Blacksburg should not make us afraid of those with mental illness, but it should make us realize that mental illness cannot be ignored without consequences.
Without early and consistent care, the condition of those who suffer from certain illnesses can deteriorate, making their symptoms more severe and increasingly difficulty to treat.
Second, for far too many Floridians, mental illness remains untreated because of a lack of sufficient investment in our state's mental-health system. Florida currently ranks 48th in the country in per-capita spending for mental-health services, 47th in Medicaid spending for child beneficiaries, and 43rd in Medicaid spending for adult beneficiaries.
Florida also ranks second in the number of homeless, first in the number of substantiated reports of child abuse and neglect, second in the number of children in juvenile detention facilities, and third in the number of prison inmates in comparison with other states.
A significant portion of these problems can be traced to the lack of mental-health care. It is an embarrassing and unfortunate testimony to our lack of commitment to care for those with mental illness; we are not adequately funding proven and cost-effective local mental-health programs.
The success of these programs in communities across our state proves time after time that treatment and community supports work and that access to local mental-health care is the key to providing those with mental illnesses with much-needed help at a reasonable cost to taxpayers.
Without adequate investment in the mental-health system through the funding of community-based services, we will by default be investing in hospital inpatient services, emergency-department care, shelters, foster care, juvenile detention facilities, jails and prisons.
Or worse.
Today's college campuses are more vulnerable than ever to problems associated with untreated mental illness simply because more young people than ever with mental illness are in school.
The Americans with Disabilities Act bans the exclusion of students because of mental illness, but is there enough support on campus for ill students suddenly faced with the additional financial, social and academic pressures of college life?
Florida's institutions of higher learning are assessing their capacities to deal with an increasing number of students with mental illness and are working toward needed changes. Undoubtedly, however, some of these students will require services that will be beyond our colleges' and universities' capacities to meet those needs, and they will rely on community-based programs to help.
Our communities with colleges and universities have an excellent history of collaboration on these issues, but often, students and others end up encountering mental-health services through the legal system instead. Just as we wrongly depend on emergency departments to be the front door for physical health care (instead of focusing more on routine and nonemergency care), jails often end up being the front door for mental-health care.
We must reach these people sooner - long before they are referred for treatment by the courts. That is accomplished through the recognition that mental illness can affect anyone and needs early identification.
We must remove the stigma of mental illness, continue efforts to educate the public on the facts about mental health, and encourage people to seek treatment early. Identification works only if there is an adequately funded array of community-based programs that can provide care after screening and early identification.
Establishing a task force focused on campus safety is a needed and important step. But identification and communication is just part of the battle to prevent another tragedy as happened at Virginia Tech.
Our failure to treat mental health is one of the significant health issues in this state. Until we are serious about addressing it, the number of people left untreated until they commit a crime will continue to increase. And that is an unnecessary risk that none of us should be willing to take.
Maggie Labarta is the chairman of the board for the Florida Council for Community Mental Health and the CEO of Meridian Behavioral Healthcare in Gainesville. Contact her at maggie_labarta@mbhci.org.
MY VIEW
Kudos to Gov. Charlie Crist for swiftly signing an executive order that establishes the Gubernatorial Task Force for University Campus Safety, which will review all security measures on Florida's college and university campuses.
One of the benefits of this important response to the tragic events at Virginia Tech will be the increased dialogue regarding the treatment of students with mental illness. As this occurs, we should consider a few important points.
The first is that the overwhelming majority of people with mental illness are not violent. In general, those with a mental illness are more likely to be the victims than the perpetrators of violent crime. The tragedy in Blacksburg should not make us afraid of those with mental illness, but it should make us realize that mental illness cannot be ignored without consequences.
Without early and consistent care, the condition of those who suffer from certain illnesses can deteriorate, making their symptoms more severe and increasingly difficulty to treat.
Second, for far too many Floridians, mental illness remains untreated because of a lack of sufficient investment in our state's mental-health system. Florida currently ranks 48th in the country in per-capita spending for mental-health services, 47th in Medicaid spending for child beneficiaries, and 43rd in Medicaid spending for adult beneficiaries.
Florida also ranks second in the number of homeless, first in the number of substantiated reports of child abuse and neglect, second in the number of children in juvenile detention facilities, and third in the number of prison inmates in comparison with other states.
A significant portion of these problems can be traced to the lack of mental-health care. It is an embarrassing and unfortunate testimony to our lack of commitment to care for those with mental illness; we are not adequately funding proven and cost-effective local mental-health programs.
The success of these programs in communities across our state proves time after time that treatment and community supports work and that access to local mental-health care is the key to providing those with mental illnesses with much-needed help at a reasonable cost to taxpayers.
Without adequate investment in the mental-health system through the funding of community-based services, we will by default be investing in hospital inpatient services, emergency-department care, shelters, foster care, juvenile detention facilities, jails and prisons.
Or worse.
Today's college campuses are more vulnerable than ever to problems associated with untreated mental illness simply because more young people than ever with mental illness are in school.
The Americans with Disabilities Act bans the exclusion of students because of mental illness, but is there enough support on campus for ill students suddenly faced with the additional financial, social and academic pressures of college life?
Florida's institutions of higher learning are assessing their capacities to deal with an increasing number of students with mental illness and are working toward needed changes. Undoubtedly, however, some of these students will require services that will be beyond our colleges' and universities' capacities to meet those needs, and they will rely on community-based programs to help.
Our communities with colleges and universities have an excellent history of collaboration on these issues, but often, students and others end up encountering mental-health services through the legal system instead. Just as we wrongly depend on emergency departments to be the front door for physical health care (instead of focusing more on routine and nonemergency care), jails often end up being the front door for mental-health care.
We must reach these people sooner - long before they are referred for treatment by the courts. That is accomplished through the recognition that mental illness can affect anyone and needs early identification.
We must remove the stigma of mental illness, continue efforts to educate the public on the facts about mental health, and encourage people to seek treatment early. Identification works only if there is an adequately funded array of community-based programs that can provide care after screening and early identification.
Establishing a task force focused on campus safety is a needed and important step. But identification and communication is just part of the battle to prevent another tragedy as happened at Virginia Tech.
Our failure to treat mental health is one of the significant health issues in this state. Until we are serious about addressing it, the number of people left untreated until they commit a crime will continue to increase. And that is an unnecessary risk that none of us should be willing to take.
Maggie Labarta is the chairman of the board for the Florida Council for Community Mental Health and the CEO of Meridian Behavioral Healthcare in Gainesville. Contact her at maggie_labarta@mbhci.org.
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