The mentally ill in prison
Loss of Benefits upon Release has drastic impacts
Pressed by rising costs, America's states are scrambling for
ways to keep millions of people who are released from jails and prisons each
year from coming back. An obvious first step would be to abolish senselessly
punitive laws that make it difficult for felons to reconstruct their lives, like
those in all 50 states that bar former convicts from occupations that have
nothing at all to do with their crimes. Another prudent step would be to create
high- quality programs that provide newly released people with counseling and
job placement. Perhaps most crucially, those who qualify need assistance in
getting back their federal disability and Medicaid benefits; inmates typically
lose such benefits when they find themselves locked up for 30 days or more.
The loss of benefits is especially devastating for the mentally ill, who make up
one-sixth of the prison population and who are particularly susceptible to
recidivism. Most of them get psychiatric drugs and treatment for the first time
in jail. They often improve quickly, but deteriorate just as fast when they are
released without being re-enrolled in federal disability programs or Medicaid,
which would give them access to medication and psychiatric care. Homeless,
delusional and out of control, they are inevitably rearrested for behaviors
related to their illnesses. Many of them come back to jail so regularly that
corrections workers call them "frequent fliers."
Impoverished people who suffer from mental illnesses and other serious
disabilities are entitled to Supplemental Security Income assistance,
administered through the Social Security Administration. In many states, people
who are declared eligible for Social Security-based benefits are automatically
enrolled in Medicaid, which in turn provides mentally ill people with care and
drugs.
Federal law requires that people be suspended from SSI benefits when they land
in jail for even a short time. The federal government diligently enforces the
suspension rules - and even pays a small bounty to the prisons and jails in
exchange for notice that a beneficiary has been incarcerated. But the
institutions are offered no incentives to report that inmates are about to be
released and need to have their benefits restored. Moreover, the rules governing
the program are so vague and complicated that most prison officials don't
understand them.
A similar situation has developed with Medicaid, which bars states from
receiving federal matching funds for treatment given to inmates except in acute
cases requiring hospitalization. The federal government envisioned an
arrangement under which Medicaid benefits would be suspended during
incarceration and resumed upon release. But the states have resorted to
terminating inmate eligibility outright and allowing inmates, including the
mentally ill, to leave custody without access to care.
The states, which are already being shortchanged by the federal government on
Medicaid, got another scare recently when the Bush administration suggested that
it might shift even more of the burden. Pressed for money, the states have
clearly opted to save dollars by taking inmates off Medicaid rolls and leaving
them off for as long as possible.
But mentally ill inmates who are dumped onto the streets without access to care
drive up incarceration costs by going back to jail again and again. The smarter
approach would be to ensure that eligible inmates had disability and Medicaid
benefits in hand before they left jail. Setting up the new administrative
process might not be easy, but it would more than pay for itself down the line.
http://www.iht.com/articles/2005/01/17/opinion/edprison.html
Judi Chamberlin Responds to the above
Imprisonment Article
Judi Chamberlin of the National Association for Rights Protection and Advocacy (NARPA),
MadPride@aol.com, writes:
The article from the International Herald Tribune is another of a long list of
mainstream articles that mindlessly repeats psychiatric propaganda and includes
no comments or viewpoints from people with psychiatric disabilities.
Specifically, we challenge the idea that medication is equivalent to
improvement, and lack of medication inevitably leads to deterioration and
repeated incarceration. What people coming out of prison need, whether or not
they are diagnosed with mental illness, is support in obtaining housing, jobs,
and other elements of community integration.
Segregating people with psychiatric disabilities and saying that they need
"special" programs, by which is meant treatment with psychiatric drugs, is
overly simplistic and is not supported by evidence.
In fact, people with psychiatric disabilities are often in prison because they
have done things that would not result in arrest or imprisonment if they were
done by people without psychiatric disabilities. We need to look at why people
are ending up in prison, and we need to find out from people who are facing
these problems what their needs are. If they want medication, fine... but let's
not fall into the trap, promoted by drug companies and the American Psychiatric
Association, that medication is the be-all and end-all. Housing, jobs, peer
support, and an end to stigma and discrimination are at least as important.
People do recover from mental illness, with or without medication, and WE are
the experts on our own recovery.
Judi Chamberlin
Board Secretary,
National Association for Rights Protection and Advocacy
(NARPA)
Last Updated on
01/26/05
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