Mental Health Care for Inmates with Serious Mental Health Issues: A Closer Look at the Reality

Edward E. Kramer's claims about the presence of inmates with serious mental health disorders in mainstream prison populations are often overly simplistic and misleading. This article aims to clarify common misconceptions and provide a detailed understanding of how these inmates are managed.

Balancing Care and Security: Customized Mental Health Treatment Plans

The treatment for inmates with mental health issues varies widely based on individual needs. For example, in California, inmates with severe disabling mental health issues are placed in specialized Psychiatric Units staffed with mental health professionals. One such facility is the California Health Care Facility (CHCF) in Stockton. This 1.4 million-square-foot facility is designed to provide intermediate-level care, complementing the less acute treatment available in other prisons operated by the CDCR.

At CHCF, both outpatient and inpatient mental health services are available for patients with serious mental disorders. The licensed Psychiatric Inpatient Program is tailored to provide more intensive treatment for those who cannot function adequately or stabilize in an outpatient setting.

Handicapping Steps: From Psychiatric Assessment to Gradual Reintegration

The process begins with an assessment by psych students or mental health professionals to evaluate the seriousness of the mental health issue. For instance, during my time in custody, I was observed for six months to assess my ability to cope with prison society. As someone with bipolar disorder and suicidal ideation, I was kept medicated for the next three years to manage my condition.

Initially, I underwent rigorous observation and evaluation, but similar to many other inmates with severe mental health issues, medication was a critical component of my treatment plan. Over time, I was gradually moved towards enhanced outpatient care, which allows for more flexibility and stability.

Specialized Housing to Ensure Safety and Governance

The management of inmates with severe mental health disorders is often balanced with security concerns. In some cases, such individuals are housed separately from the general population, especially if their condition poses risks to themselves or others. However, for those who can manage their mental health with appropriate medication and support, the goal is often to reintegrate them into general population settings as an “enhanced outpatient” arrangement.

For those with milder conditions, regular outpatient services are provided. It's important to note that isolation may be necessary for inmates whose mental health issues disrupt the smooth functioning of the prison environment. This is a measure taken to ensure the safety and well-being of all individuals within the prison community.

Conclusion

The treatment and management of inmates with serious mental health issues in prisons are complex and multifaceted. They involve a range of specialized care options, from inpatient and outpatient programs to specialized housing based on individual needs and risks. The goal is to balance care, security, and reintegration into the prison population while minimizing the potential harm to both the inmate and the broader prison community.

Understanding these nuances is crucial for policymakers, facility administrators, and the general public to foster a more compassionate and effective approach to managing the mental health needs of incarcerated individuals.