Locking Mental-Health Patients Away in Prisons: Is There a Way Forward?

One of the main circulation areas with treatment rooms and and offices is seen at the of the newly opened mental health treat
One of the main circulation areas with treatment rooms and and offices is seen at the of the newly opened mental health treatment unit at the California Medical Facility in Vacaville, Calif., Thursday, Feb. 14, 2013. The $24 million treatment center for mentally ill inmates opened on Thursday as state corrections officials used the occasion to push for ending federal oversight of that aspect of prison operations. The 44,000-square-foot building includes rooms where inmates will undergo individual, group and recreational outpatient therapy. It will be used to treat inmates who are seriously mentally ill but are able to function without around-the-clock care. (AP Photo/Rich Pedroncelli)

Gov. Jerry Brown's demands that a federal court relax the judicially mandated prison-population cap not only highlight California's outlier status in prison policy, but also underscore the need for President Barack Obama's initiative to increase mental-health services.

Brown argued that California had remedied the underlying violation -- constitutionally defective mental-health care -- despite remaining substantially over capacity in the state prison system. He told the special federal court overseeing the implementation of the decree that any further releases would endanger public safety and security.

While prison-rights advocates objected to the governor's characterization, nobody in the political establishment has come to the defense of the federal judiciary, let alone of California's inmates.

Inmates have not found much recourse recently, even though their numbers had been climbing for decades. In just the past few years, most states have realized that their rates of imprisonment have become unaffordable. According to a report by the non-partisan think tank California Common Sense, California effectively spends today more on its correctional system than on higher education.

Budgetary realities have pushed many other state governments to carefully analyze aspects of their spending, including their correctional budgets. They have implemented front-end and back-end measures to decrease the prison population. Changes in sentencing laws and the creation and expansion of specialized courts, such as mental-health, drug and veterans courts, divert many low-level offenders from prisons by trying to reintegrate them. On the back end, parole boards have released early those with the most positive predictors. All of these courts and boards use evidence-based sentencing and release practices to select those who benefit the most from diversion or early release, and those who are least likely to constitute a threat to public safety.

While the precise manner in which prison populations have been decreased has varied, we are no less secure than when we incarcerated a higher number and percentage of our fellow citizens. Incarceration and release can be done smartly, and we have the data and the tools today to do so more effectively than ever before.

The most vexing population, though, comprises mentally ill inmates. President Obama has proposed increased mental-health funding in the wake of the horrible tragedy in Newtown, Conn. California's prison system came under federal oversight because the inadequate mental-health services it provided to inmates amounted to a violation of the Eighth Amendment's cruel-and-unusual-punishment clause.

As mental-health wards of the past have been replaced with prisons, the horrors remain the same: mental-health patients labeled threats are locked into small cells for 23 hours a day, with so-called recreation areas that allow them merely to pace back and forth for an hour; dementia patients are locked behind bars, incapable of doing harm but not of doing time. It may be too late for many of them to lead meaningful lives, but the next generation of mental-health patients does not have to end up in prison if we are willing to invest in mental-health services on the outside.

Immigration reform and same-sex marriage are often labeled the new civil rights struggles. Can we think in this same way of the most forgotten members of our society, those we lock away, so that we do not even have to see any reminders of their existence?

If fiscal reality and plain humanity cannot replace visceral fear and allow us to understand why the current system is a failure, then Gov. Brown will begin to resemble George Wallace, the late governor of Alabama, who also assured us that states' rights trump the orders of a federal court.