From time to time, the tabs in my web browser taunt me with the stories I’ve saved to read later. Fairly frequently, those stories have a theme, usually a subject that I’ve seen a spate of in-depth coverage on. Lately, those browser tabs have been filled with stories about health care in jails, a topic that also got some recent mentions on AHCJ’s electronic discussion list.
There are a lot of aspects to cover here: mental health, privatization, the money involved and the care decisions based on those budgets and, of course, the people affected by all of those decisions – inmates and their families. You might even think about reporting on the mental health of corrections officers. So, here are some stories I’ve been paying attention to and some resources to use as a jumping off point for your own reporting – which I hope you will send to me or post a link to in the comments.
In Modern Healthcare, Beth Kutscher writes about the privatization of jailhouse health care and critics’ questions about the quality of care and cost savings. Her story starts with a focus on Florida but points out that about 20 states have outsource all or part of their prison health care. Florida’s five-year contract for prison health care is $230 million. One expert “estimated that half of all state and local prisons and jails have outsourced healthcare services, and that these contracts are worth roughly $3 billion a year.”
Last month, ProPublica’s Christie Thompson compiled a list of reporting on mental illness in prisons that includes “the best deep-dive reporting on the mentally ill in U.S. prisons” and goes back to 2000.
In May, an organization called Community Alliance published an investigation into how the people with mental illness are treated in county jail in Fresno, Calif. The project was reported and written by journalism students Sam LoProto, Damian Marquez, Angel Moreno, Jacob Rayburn, Brianna Vaccari and Liana Whitehead and Max Arax, their professor from Fresno State University and a veteran journalist. They found the jail denies medication to inmates with mental illness. “Because they are not mentally competent to stand trial, they bounce back and forth in a perverse revolving door between the county jail and state mental hospitals, costing taxpayers even more money.”
Last month, The Fresno Bee published a 10-part series about the Fresno County Jail, finding that the jail cut back on psychiatric medicines as a cost-cutting effort but that the “policy has raised costs significantly in other areas. The project, reported by Marc Benjamin and Barbara Anderson, looks at the policy issues as well as the faces and the lives of those affected. One story addresses the privatization of jail health care.
Stephen Dark of City Weekly in Salt Lake City, Utah, took a look last year at how prisoners with mental health issues are treated in Uinta 1, the Utah State Prison’s maximum-security wing. He identified four inmates who had mental health issues and corresponded with them after the prison denied requests to interview the four, tour the unit and a request for records on how many inmates with mental health issues are in the unit and the number of suicide attempts and suicides. His article, like others, points out that inmates with mental health issues “are often unable to cope with the stress and regimentation of prison, which leads them to act up.”
Earlier this month, a Minneapolis Star Tribune investigation examined failures in Minnesota’s mental health system that have “left hundreds of psychiatric patients in limbo — many of them languishing in county jails, cycling through the criminal justice system and sinking deeper into dangerous psychoses.”
John Tuohy of The Indianapolis Star took a look at the aging prison population and the related health-care challenges that presents. He reports on “an uncommon hospice program at Wabash Valley Correctional Institute in Carlisle in which prisoners take care of other, terminally ill, inmates. Since it began three years ago, inmate volunteers have guided 50 dying convicts to their graves.”
Scott Thistle of the Maine Sun Journal reports that increasing violence at the state’s psychiatric hospital has been a catalyst for reform. The hospital’s patients include 92 people who have been declared to be “not criminally responsible” for alleged crimes.
- AHCJ tip sheet: Covering health care in jails
- AHCJ workshop presentation (2008): Monitoring jail and prison health, from Naseem Miller | PDF of PowerPoint: Medical Care Behind Bars
- AHCJ workshop presentation (2008): Health Care on Rikers Island, from Courtney Gross, city government editor, Gotham Gazette
- Health and Incarceration (PDF is free to download) is the summary of a workshop jointly sponsored by the National Academy of Sciences Committee on Law and Justice and the Institute of Medicine Board on Health and Select Populations in December 2012. It includes input from academics, practitioners, state officials and nongovernmental organization representatives from the fields of health care, prisoner advocacy and corrections.
- Lorry Schoenly, Ph.D., R.N., C.C.H.P., writes about health care in the corrections system for CorrectionsOne.com.
- Inspector general reports on problems in prison health care (2008): The OIG made 11 recommendations regarding the provision of inmate health care, and the federal Bureau of Prisons agreed with all of the recommendations.
- The 2010 State of the Bureau report explains what substance abuse treatment is available (page 11) and health service delivery (page 15). It identifies challenges in providing health care as increased costs of medical care, difficulty maintaining
- a competent and credentialed health care workforce, a higher number of older inmates with complex medical and mental health conditions requiring costly treatments and expensive medications and an aging infrastructure with outdated clinic and hospital plants. The end of that report provides locations and phone numbers for BOP institutions and offices around the country.
- Bureau of Prison’s Clinical Practice Guidelines: Information to help meet the requirements of the Correctional Officers Health and Safety Act of 1998, which requires that the Attorney General and the Secretary of Health and Human Services provide guidelines for infectious disease prevention and detection, and treatment of inmates and correctional employees who face exposure to infectious diseases in correctional facilities.
- American Correctional Health Services Association
- International Association for Correctional and Forensic Psychology
- National Institute of Corrections