New York City's Correctional System Gets a Clue about Treating Mentally Ill Inmates
Imagine that you work at a prison and are faced with disciplining a mentally ill inmate. What would you do? Would you give the inmate a brief time out? Refer him or her to the staff psychologist to develop a treatment plan? Talk to the inmate to try to determine what may have triggered the disciplinary problem?
These might all be good options. But according to an article in the New York Times, none of these strategies was practiced over the last several decades in the New York City correctional system. Instead, any inmate who broke the rules, whether or not he or she was mentally ill, was sentenced to solitary confinement.
Huh? I was stunned to read this. Solitary confinement isolates a person in lockdown for 23 hours a day - difficult for any human being, let alone a person with serious mental illness. This is the perfect recipe for disaster. Those with serious mental disorders such as major depression and schizophrenia should not be isolated - especially if they pose a threat to themselves or others. Not only does solitary confinement worsen the symptoms of mental illness; it also fails to reduce the incidence of disciplinary problems. The fact that the New York City correctional system has been doing this for years sickens my stomach.
According to the article, over one-third of New York City's inmates have a mental disorder, and one-third of inmates with mental disorders have a grave mental illness. These are no small proportions, especially considering the size of The Big Apple.
Thankfully, the correctional system woke up and decided to improve their practices. Starting in July, severely mentally ill inmates who commit disciplinary violations will be transferred to an internal, dormitory-style clinic staffed by psychiatrists who will create treatment plans that may involve psychotropic medication and/or behavioral interventions. Those with less severe mental health diagnoses will attend counseling programs to address their behavioral issues. No mentally ill inmate will return to the regular prison population until he or she has successfully completed treatment.
Hallelujah! It's about time that this correctional department realized that whether it likes it or not, it is a major provider of mental health treatment for New York City. It has a human as well as an ethical, procedural obligation to provide its mentally ill inmates with the proper treatment. It also has an obligation to not put its mentally vulnerable inmates in situations that are practically guaranteed to fail and, in many cases, exacerbate problems for everyone.
This is a major win for patient rights organizations that report that New York City's correctional system had one of the highest rates of solitary confinement in the nation. Now we need to find out where else solitary confinement is being used as the norm for all inmates, including mentally ill inmates, and take measures to help those systems follow New York City's example of making positive changes.