California prisons and jails treat more people with mental illness than hospitals and residential treatment centers combined. Mentally ill prisoners receive inadequate medical and psychiatric care, serve longer terms than the average inmate, and are released without adequate preparation and support for their return to society. As a result, these offenders are much more likely to violate parole and return to prison, cycling ever-downward. With the California prison healthcare system currently in receivership, and the state poised to spend more money on prisons than on colleges in the coming fiscal year, this paper addresses a topic that is both underreported and extremely timely.
This paper diagnoses the problems and offers solutions to the crisis in prison mental healthcare. The paper focuses on three key phases in an inmate's relationship with the prison system: intake, living in prison, and release. Currently, inmates are not adequately screened during intake for mental illnesses: any diagnosis they do receive does not travel with them through the prison system, and prisoners often go off medications as a result. While serving their sentences, prisons offer inadequate amounts of counseling and medication, and tend to treat "acting out" as a discipline problem, rather than a symptom of mental illness. As a result, mentally ill inmates face much greater rates of administrative segregation, which leads to further mental deterioration and expensive stays in mental hospitals. Finally, mentally ill prisoners are often released without adequate treatment programs or housing support. As a result, the mentally ill face much higher parole revocation rates than inmates in the general population.
[NOTE: This text is the prepublication text. For the corrected, updated text, please see the Journal of Contemporary Health Law and Policy.]