Jenn Ackerman (Ohio University)
The continuous withdrawal of mental health funding has turned jails and prisons across the U.S. into the default mental health facilities. The system designed for security is now trapped with treating mental illness and the mentally ill are often trapped inside the system with nowhere else to go. This project goes inside the Correctional Psychiatric Treatment Unit at the Kentucky State Reformatory to see how a state is meeting the needs of this growing population.
Here, Anthony Rosario stares out of the cell he remains in for 23 hours a day. "They are rejects of society and warehousing them in prison isnt the way to go. Most of them dont have life sentences - they will get out some day." says psychologist Dr. Tanya Young. "What do they do when they get out? There needs to be something else to absorb them or take them in," she adds.
Terry Bell, left, a caseworker at Kentucky State Reformatory laughs with some of the inmates before entering the CPTU wing after recreation time on the yard. Almost 555,000 people with mental illness in the U.S. are incarcerated while fewer than 55,000 are being treated in designated mental health hospitals.
Diagnosed with delusional paranoia, an inmate walks back and forth all day long on the second floor of A wing in CPTU. "There is an obligation as citizens and as states to fulfill to the mentally ill but the cost raises when they are in prison," says Warden Chandler. "The front end is we are getting more of them. The back door problem is we are going to release them and there is no place to release them to."
Multiple officers wait by the door before a cell entry. "We use multiple officers to decrease the chances of anyone getting hurt including the inmate," says Lt. Rioux, correctional officer and first shift supervisor. "When an inmate is in a psychotic episode or being disruptive, their strength is amazing," says Rioux. Often it takes three to four officers to get his hands restrained.
Correctional officers struggle with an inmate to secure him in the chair in order to give him a shower. After 11 months of refusal, the doctors ordered a forced shower and a cleaning of his room. Correctional officers are not only responsible for securing inmates but now help treatment staff and other mental health professionals identify and manage mentally ill inmates, says Lt. Jeremy Rioux.
An inmate on max assault status and a 23-hour lock down talks to himself in his cell. The max assault status is issued to inmates who have assaulted officers or treatment staff. The inmates have been known to throw a mixture of feces and urine, spit, hit, kick, punch or cut.
Inmates often have to be restrained by officers before medication can be administered. In order to meet the criteria for forced medication, the inmate must be found to be a danger to himself or others. The goal in CPTU is “to stabilize people and get them in the least restrictive area as safely and as expediently as possible,” says Dr. Tanya Young, CPTU program director and psychologist.
An inmate out of the CPTU shows his self-inflicted injury. Sticking pens and sporks through his midsection, he created this wound six months prior. "It's crazy. I have seen grown men cry for no reason, people cut and bleed so bad you couldn't hardly recognize them," says Lt. Rioux. "I have even seen people hang themselves."
After an unsuccessful suicide attempt in the segregation unit, an inmate admitted to CPTU just days before looks out of his cell all day. Despite their attempts to meet the needs of these inmates, many believe these men are “trapped with nowhere else to go”.
An inmate is cuffed and returned to his cell after acting out earlier that day. A spit mask is used to prevent him from spitting at the doctors and correctional officers. "Our priority is security. That mandates that we have certain security measures that cant be breached. But security can't be a stranglehold on progress," says Larry Chandler, warden of Kentucky State Reformatory.
A Hand to Hold
Julia Lish, a correctional officer, comforts an inmate during one his psychotic episodes. "Its going to be OK," she repeats as he cries and yells to the voices in his head. “The mantra for corrections is firm, fair and consistent but in a mental health environment, it needs to be firm, fair and creative,” says Warden Chandler.
Inside Their Minds
Bobby Slater looks out of his cell to an inmate watcher walking around during his 15-minute watch. "This is a miserable life experience for them but some of them don't want to leave because they have been in society and they saw what happened," says lead psychologist Dr. Tanya Young. For Bobby that day to leave the Reformatory never came. Months after being released from CPTU, he hung himself in his cell.