Unreal: Prison Healthcare
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?
Interesting topic.....And alot of food for thought. I'm glad that the courts are making decent healthcare available to the prison population. I agree with alot of what you have said, but I really believe that your approach to the healthcare of prisoners is rather simplistic. I truly believe that the prison population needs and deserves good healthcare just to be treated in a humane way, and like you said for the health of the whole prison population and society when they are released. And I'm so glad that money will be allocated for better care of the prison population in general. It seems to me that the prison environment is a world unto itself not like that of any other environment. A more realistic approach needs to be taken when dealing with healthcare in the prison population and expectations be realistic. Mental illness just isn't cured nor are addictions. For instance, the "success rate" of AA is not as good as one might think....I wish I had access to the statistic, but alas I'm unprepared and too lazy to research the topic. An addict will always be an addict, clean or not, the disease is always lurking within. And mental illness can be very complex, subdued, but never "cured. The DSM, diagnostic catalog of mental illness and personality disorder, is now up to the Fifth edition and is 3 inchs thick by now I believe. I guess what I am saying is that it is unrealistic to expect that prisoners will be released disease and addiction free and in good health and remain that way for their lifetime outside the prison, and that the health of the prison population still incarcerated, some for life, can be maintained since some cooperation from the prisoner is needed and sometimes those administering healthcare will be at risk, and some prisoners may not want to "get well". There will be wasted money, clash of personalities, etc, in trying to improve healthcare of the prison population.....How to deal with healthcare in prisons, I don't know. It's a blessing for all involved to have access to money for this cause and I hope the money will be spent wisely with realistic expectations, knowing all the human fallibility involved in the prisoners and the administators. I wish I had more answers to the things I have presented....I guess those involved will have to push forward into the unknown and stumble their way through the process of making things as "right" as possible. Please remember that this post is by an ordinary "Joe" with not alot of writing skills, formal education nor am I brimming over with knowledge of this particular topic....Just enjoying the interaction. God Bless the prison population and those who deal with them on a daily basis.... J.D.
ReplyDeleteNot sure what is meant in the first paragraph of the original post, "This means that prisoners who should be paying their way in prison are prevented by illness from working". I don't think any prisoner pays their way do they? Am I misinterpreting the comment?
ReplyDeleteGood question. No, to my knowledge no inmate works off the full cost of their incarceration. Most inmates in both prisons and jails, however, are required to provide their own toiletries, and some inmates have other obligations. Those unable to work because the health care system has failed them thus may suffer further needless deprivations.
DeleteBut in my opinion all inmates who are physically and mentally able SHOULD pay their own way. That's what I meant. Society has already paid for their crime(s) once. I feel all able-bodied inmates should be required to work full time. A large portion of their wages should pay back the public for the costs of food, clothing and housing. That's the way it works for us on the outside. As a bonus, the work habits inmates learn would contribute to their rehabilitation.
Nonetheless inmates should earn a fair market wage. As it stands now, those inmates who work are being exploited by companies in cahoots with the prisons. Inmates earn pathetically low wages. The companies that exploit them earn profits they couldn't otherwise; thus they compete unfairly with companies playing by the rules, who don't have the advantage of what amounts to slave labor.
This has led to the "Prison Industrial Complex," in which incentives exist for throwing yet more people into prison, and for lengthening sentences. At present, companies, private prison corporations, and many government officials line their pockets at the expense of inmates and taxpayers.
Government corruption may always be with us, but the least we can do is call out those instances we see - keep the graft to a minimum. The Prison Industrial Complex is one egregious example that costs everyone except the crooks.
I don't know all the answers to these issues, but I see some problems all around. Thanks for contributing to the dialogue in this and your other comments - that alone makes you part of the solution.
Thanks for your response Paul...and some education about the "prison industrial complex". I had no idea alot of this was going on to this extent. The corruption alone is such a problem it appears, and it's so sad that it distracts from the other problems in the system! What to do? I don't have any idea.....I sometimes wonder if things like this are just the beginning of the end....
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