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Saturday, March 29, 2014

Unreal:  Prison Healthcare


          The courts have ruled that the 8th amendment guarantees those incarcerated for committing crimes access to adequate health care. In fact, many prisoners lack this access. This means that prisoners who should be paying their way in prison are prevented by illness from working. Prisoners with untreated mental illnesses and addictions endanger the communities they return to, their families, and corrections officers.

          Chronic illnesses worsen when left untreated. But the cost of healthcare both in and out of prison threatens taxpayers. To fix prison healthcare we need to explore the effects of current policies on all involved.

The Prison Healthcare Context


Rehabilitation or Recidivism

          According to the Bureau of Justice Statistics over 95% of those incarcerated in the U.S. will eventually be released into their communities. In fact annual releases now outnumber admissions.  Thus it is in our interests to rehabilitate those who commit crimes.

          According to Columbia University 85% of prisoners have substance abuse issues. For many, their addictions led to their crimes in the first place. Untreated, these addicts don’t wait until they’re released from prison to return to drugs and crime; illegal substances are usually available inside. Thus many addicts continue abusing substances and committing crimes both inside and outside of prison walls as if they’d never been arrested. Prisons are becoming unmanageable for corrections officers, while society outside prison walls remains unsafe.

          About half of those incarcerated show symptoms of serious mental illness (National Institute of Mental Health). Most mentally ill prisoners don’t receive adequate psychiatric treatment . What’s more, the prison environment can worsen psychiatric symptoms. Untreated mental illness, like addiction, increases the likelihood of recidivism.

          When left untreated, both mental illnesses and addictions create a cycle of dysfunction in which children of prisoners grow up with addictions and mental illnesses, then turn to crime themselves.

          In short, society is punishing lawbreaking in a way that creates more lawbreaking.  Why should prisoners, corrections officers, families and society all suffer from the effects of treatable illnesses?

Dollars and Sense

          Aside from drugs and mental illnesses, over one third of U.S. prisoners suffer from some chronic disease or infection (Society of Correctional Physicians). Because chronic illnesses worsen without treatment, and are often only treated once prisoners get released, these illnesses end up costing society more than they would have were they treated in prison.

          Meanwhile, health care is consuming an increasing share of corrections budgets. Reasons for this include:

          • The aging prison population
          • Communicable diseases in the close confines of prisons
          • The prevalence of substance abuse and mental illness among prisoners
          • Challenges inherent in delivering healthcare to prisons, such as distance from
             hospitals

          Enrolling prisoners in health care plans, and ensuring more oversight and accountability could help lower costs. Releasing those too sick to pose a danger to society could also ease the financial burden. Telemedicine could lower costs. Allowing more volunteers, such as those from Narcotics Anonymous, into prisons to offer counseling would provide more care at a low cost.

          What else can be done to provide effective, low cost health care to prisoners? Don’t prisoners have this right? What can the stories of stakeholders teach us? How can we collaborate to solve this problem?