Mentally Ill Prisoners in the California Department of Corrections and Rehabilitation: Strategies for Improving Treatment and Reducing Recidivism

Review of Ball, W. (2007).  “Mentally ill prisoners in the California Department of Corrections and Rehabilitation: strategies for improving treatment and reducing recidivism.”  J. Contemp. Health Law Policy, 24(1), 1 – 42.

Law enforcement is given a stark choice when dealing with the mentally ill criminal: place in an in-patient psychiatric facility, or send to jail?  California prisons treat more people with mental illness than hospitals and residential treatment centers combined.  Mentally ill prisoners receive inadequate medical and psychiatric care, serve longer terms than the average inmate and are released without sufficient preparation and support for their return to society.  As a result these offenders are more likely to violate parole and return to prison.  The California prison healthcare system presently is in receivership.  The state is poised to spend more money on prisons than on colleges in the coming fiscal year.

This article focuses on three phases in an inmate’s relationship with the prison system: intake, living in prison, and release.  The author notes that inmates are not adequately screened during intake for mental illness.  Any diagnosis they do receive does not travel with them through the prison system.  As a result they frequently go off medication.  Prisons do not offer adequate counseling.  They treat disruptive behavior as a disciplinary problem rather than as a symptom of mental illness.  Because of these and other factors mentally ill inmates experience greater rates of administrative segregation, which leads to further mental deterioration and expensive stays in mental hospitals.  Mentally ill prisoners often are released without adequate treatment programs or housing support.  As a result they face higher parole revocation rates than inmates in the general population.  The author proposes a thorough overhaul of prison mental health care to redress these imbalances.  Whether this is practical in light of California’s current budget crisis remains to be seen.