Jail for the mentally ill?

August 4, 2018 12:59 PM

Sent to a Hospital, But Locked in Prison Andrew Butler’s hallucinations and paranoia began last summer. When they persisted into the fall, his father agreed to have him civilly committed — involuntarily sent to the state psychiatric hospital to receive treatment. A few months into his stay at New Hampshire Hospital, Butler was transferred. To a prison.
posted by strelitzia (13 comments total)

Unreal. Can't put it into words but Andrew's story really struck a chord. Poor guy. Really can't imagine drawing what it must be like to draw that short of a straw. Glad there was some silver lining at least.
posted by forgettable at 1:29 PM on August 4, 2018

Donna Sytek, a Republican legislator for almost two decades and a former speaker of the House of Representatives, was in office when the practice of transferring patients to prison began. She said putting the most dangerous patients together is the most efficient and budget-conscious solution.

Maybe, just maybe, budget-consciousness is not the controlling criteria you should be applying here.
posted by Nerd of the North at 1:57 PM on August 4, 2018 [51 favorites]

She said putting the most dangerous patients together is the most efficient and budget-conscious solution.

Right up until someone gets a good lawsuit going after being tased while civilly committed, maybe.
posted by dilettante at 2:02 PM on August 4, 2018 [5 favorites]

There is an argument to be made that a significant number of those who enter prison by the more usual route would be better treated through properly-funded mental health provision anyway.
posted by pipeski at 2:15 PM on August 4, 2018 [5 favorites]

Using a taser, a potentially lethal weapon, to ensure compliance with commands unrelated to immediately life-saving action should be universally condemned regardless of whether the patient is serving a prison sentence or not. And this isn't even a privately operated prison, this is operated directly by the state it looks like!
posted by vibratory manner of working at 2:25 PM on August 4, 2018 [18 favorites]

I totally thought this was illegal. Is that just California where you can only involuntarily commit someone if they are a danger to themselves, and for 72 hours?
posted by cj_ at 2:27 PM on August 4, 2018 [1 favorite]

Not all. But it seems to me a significant number of Republicans are lacking an empathy gene.
posted by notreally at 2:29 PM on August 4, 2018 [2 favorites]

Illinois also closed most (all?) of its state psychiatric hospitals that could handle violent (but not criminal) patients; Illinois's solution was to send them to state nursing homes, with predictably disastrous results.
posted by Eyebrows McGee at 4:41 PM on August 4, 2018

It is still perfectly legal in a Massachusetts center to use the equivalent of taser belts on autistic people. The legality has been challenged many times, yet the court keeps ruling in favor of taser belts as recently as this year. So having tasers used on innocent mentally ill people in a prison that were placed there involuntarily is not surprising at all. These are the interests in the USA that many voters have been allowing to grow more powerful rather than less powerful.
posted by RuvaBlue at 5:25 PM on August 4, 2018 [12 favorites]

It's crazy how psych treatment and policy varies state to state, esp for criminal offenders. NH has also sent a number of patients out of state (usually to Florida) because they were considered too dangerous for any of the their outpatient or inpatient programs. There just aren't a ton of psychiatrists working in NH. It's sad but not super surprising that the best available psych professionals are in the prison system.

In CA, most offender patients don't get any of the time spent in hospital applied to their sentence, so they're encouraged to get back to prison as soon as possible, which is almost always disruptive to whatever progress they've made or treatment plan they've developed.

(ps, hope this isn't too much of a derail. I understand that this gentleman wasn't an offender. but the system does tend to conflate mental illness with criminality in myriad ways.)
posted by es_de_bah at 7:14 PM on August 4, 2018 [2 favorites]

Though it is rare for an SPU patient to appear before the parole board, the ones that do have positive things to say about their treatment, Sytek said.

I wonder why they feel inclined to say positive things to their jailers about their imprisonment. Disgusting.
posted by justsomebodythatyouusedtoknow at 7:37 PM on August 4, 2018 [6 favorites]

Is that just California where you can only involuntarily commit someone if they are a danger to themselves, and for 72 hours?

Laws vary by state, but basically everywhere has some sort of temporary, involuntary hold for psychiatric emergencies. But those temporary holds are typically bridges to longer term involuntary commitments to psychiatric care.

Note that the intention is to provide care. Involuntary holds typically come with all sorts of checks involving requirements for skilled mental health evaluation working a set period of time, as well as automatic expirations of the hold unless reviewed and approved by a physician and/or judge. The goal is always to get the patient back to a start where they are no longer a danger to themselves or others, and are competent to care for themselves. It's not always an obtainable goal, but that's the idea.

Note the very important observation by the nurse word on the article though, about the prison not being under the review of the Joint Commission. That's an independent body which audits, reviews, and directly observes healthcare facilities to ensure they meet particular standards of care. The prison is no doubt still bound to the rules of the state regarding involuntary holds, but it is most assuredly not being run in a way that meets the goals and intentions of those holds.
posted by Panjandrum at 1:21 AM on August 5, 2018 [1 favorite]

I kept waiting for this to mention the number of severely mentally ill people who are incarcerated because of the intersection between mental illness, poverty, and DOC involvement instead of the focus on people who don't "belong" in prison. Mostly I was left wondering where New Hampshire's Protection and Advocacy agency is, and why they're not putting the smackdown on this.
posted by bile and syntax at 4:31 PM on August 6, 2018 [1 favorite]