The right to healthcare: A false promise of health in America’s prisons

Last month’s coverage of the conditions at Riker’s Island have people across the country appalled. Dr. Vernier, former physician at Riker’s Island, shared many of his experiences with patients at the prison with NPR, describing the horrific case of Carlos Mercado, who died within 15 hours of arriving at the prison due to complications of his diabetes. He had been denied insulin during the intake process.

Prisoners are the only people in the country with a constitutional right to healthcare, under the 1976 Supreme Court Estelle v. Gamble decision, which held that withholding healthcare from prisoners constituted “cruel and unusual punishment,” prohibited by the Eighth Amendment. But isn’t the case of Carlos Mercado grounds for “cruel and unusual punishment?” The right to healthcare seems to be a false promise at Riker’s, especially when we consider the facility’s history.

Riker’s is notorious for cruelty and inhumane treatment of prisoners. Earlier in de Blasio’s appointment as city mayor, a 2014 report from U.S. attorney Preet Bharara detailed graphic human rights abuses and use of violence against adolescent males placed at Riker’s Island. One such account from 2012 reads:

“…Inmate F, a mentally impaired inmate, was repeatedly punched in the face by an officer who has been involved in well over 20 other RNDC use of force incidents. Although the officer admitted that he delivered multiple blows to the inmate’s face, the Department concluded that the force used was appropriate based on the officer’s contention that he was acting in self-defense… There is no video of the incident…

…Inmate F reported that the officer challenged him to a one-on-one fight… According to DOC records, the officer was involved in a total of 24 use of force incidents… from 2007 through early 2013, including eight incidents in 2012 alone. He also has been subject to repeated disciplinary actions.”

Unfortunately, these human rights violations persist not just at Riker’s, but as an inherent part of the nation’s correctional system. Earlier this year, approximately 1,600 prisoners at the Metropolitan Detention Center in Brooklyn were left with sporadic heating and no lighting over the course of multiple days. Families were left completely in the dark about the fact that their loved ones were suffering in the facility. No generators were powered on to restore lights and heating as detainees pounded on the windows in retaliation to being left to freeze.

There are physical health consequences of being unable to read your medication labels in the dark. However, more latent are the mental health repercussions when prisoners realize they are not just trapped, but that there is nobody to even allow them their basic rights or human dignity. The right to healthcare applies to mental as well as physical health. We need to take a close look at outcomes to truly assess whether the right to healthcare is upheld in prisons or not.

The capacity for cities like New York to harm people through incarceration is vast, and there is a poor track record of tangible benefit coming from imprisonment for those detained nationwide. In 2016, the Avid Prison Project described that solitary confinement routinely exacerbates symptoms for those with mental illness. Moreover, inmates with psychiatric needs are put on waiting lists for hospital treatment much too often, even when hundreds of beds are available. It seems that the right to healthcare is a promise to take two leaps back for every small step forward.

Broken policies that keep the mentally-ill from receiving care in prisons can change. We can start by re-routing those with mental health needs from prisons to programs focused on healing and reintegration for the 42% of inmates at Riker’s Island who suffer from mental illness. Instead of reverting to punishment-based criminal justice, we can transform the lives of those in prison and reduce incarceration rates by expanding proven alternatives to incarceration.

In particular, we should expand New York’s assertive community treatment (ACT) programs for those with mental illness. Programs like Manhattan ACT bring holistic treatment and therapy to those with mental illness who face incarceration due to a felony arrest directly to them in their communities. Manhattan ACT itself has seen a 36% decrease in psychiatric hospitalizations among program participants in Northern Manhattan. In addition to their mental health benefits, ACT programs have also reduced recidivism rates. Nathaniel ACT’s graduates since 2014 have had no violent arrests within one year of graduation and its graduates since 2013 had no new felony convictions within two years. ACT programs turn lives around and are one just solution to the crisis of housing the mentally-ill in federal and state prisons.

The right to healthcare is one of prisoners’ civil rights, protected under the Eighth Amendment to the Constitution. However, if prisoners are delayed necessary treatment and placed in conditions that worsen their health problems, then this right is far from being upheld seriously. With 45% of federal prisoners having mental health or behavioral problems, we need to expand evidence-based alternatives to incarceration like ACT programs and work with our communities instead of against them.

Syed Kaleem is a medical student at Drexel University College of Medicine. He is a fellow of Physicians for Criminal Justice Reform. @ZaneKaleem on Twitter

Petition to require that all police officers go through racial bias training

Physicians for Criminal Justice Reform, Inc. (www.pfcjreform.org) is calling for the federal government to require Implicit Racial Bias Training for police departments nationwide as a condition of eligibility for federal grant funding.

PLEASE CLICK HERE TO SIGN THE PETITION.  We need 100,000 signatures in the next 30 days at which time the White House will respond to our request, which means this petition must go viral.  Please help us make that happen.

At least 9 people were killed last week as a result of our policing crisis. CDC data shows that Native Americans, Blacks, and Latinos are killed during police interactions at higher rates than Whites. Perceived criminality and implicit racial bias are significant drivers of this problem.

Research shows that police who are made aware of their implicit biases are motivated and able to implement unbiased policing behavior.

The federal government should immediately require all police departments to implement implicit racial bias training for their officers.

PLEASE CLICK HERE TO SIGN THE PETITION.

Implicit Bias and Law Enforcement

Racial profiling has been an obvious point of contention between law enforcement and minority group members. Over the past decade, the term “bias-based policing” has been coined, and the subject has been the topic of much research and debate. It often paints the picture of ill-intentioned officers deliberately acting upon preconceived stereotypes and prejudices. What if, perhaps, there was another answer?

In the spring of 2010, professor Jerry Kang from the UCLA School of Law presented to Connecticut judges, prosecutors, public defenders, and police administrators on the topic of implicit, or hidden, bias. His talk shed light on what has become an increasingly popular subject in social science circles. In brief, researchers contend that implicit biases are predilections held by all that operate largely outside of one’s awareness. Although hidden, these biases are both pervasive and powerful.1 Much research on the topic has focused on racial bias and has netted some intriguing results.

While the science does have its detractors, the growing research and potential implications for the criminal justice field make this a topic with which all law enforcement personnel should be familiar. The reader may find this article to be interesting, provocative, and enlightening—or some combination of the three. The purpose of this piece is to raise awareness on a topic that is growing in popularity and that has begun to emerge in the criminal justice system. It is up to readers to decide whether the science is relevant and pertinent to their lives and their workplaces.

The article discusses implicit bias, the latest testing and research into the phenomenon, and practical approaches for law enforcement interventions as recommended by social scientists in the field.

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Justice Department Announces New Department-Wide Implicit Bias Training for Personnel

June 27, 2016

The Department of Justice announced that it will train all of its law enforcement agents and prosecutors to recognize and address implicit bias as part of its regular training curricula. The new training, based on the latest social science research and best practices in law enforcement, will begin across the department in the next few weeks. Deputy Attorney General Sally Q. Yates sent a memo to all law enforcement agents and prosecutors today informing them of the new Implicit Bias Training Program and its importance to a strong and fair criminal justice system.

“Our officers are more effective and our communities are more secure when law enforcement has the tools and training they need to address today’s public safety challenges,” said Attorney General Loretta E. Lynch. “At the Department of Justice, we are committed to ensuring that our own personnel are well trained in the core principles and best practices of community policing. Today’s announcement is an important step in our ongoing efforts to promote fairness, eliminate bias and build the stronger, safer, more just society that all Americans deserve.”

Click HERE to read the entire article. 

Alton Sterling and Philando Castile Killed by Police

Alton Sterling and Philando Castile are dead, joining a long roll call of black people killed by officials acting in the name of public safety. And so the nation now begins a process so familiar as to have become rote.  Read the full article here.

Physicians for Criminal Justice Reform, Inc. (PfCJR) is a group of physicians advocating to eliminate the damaging health consequences that can result from negative interactions with the criminal justice system.  Alton and Philando have suffered the ultimate of damaging health consequences — death.  Our website has been inundated with visits.  Our membership has nearly doubled in the last two days.  Physicians are ready to speak out, and we are ready to lead change.

Please know that even if you are not a physician, we need your voice as an allied supporter.  It is our duty to use our expertise and our passion to effect true, meaningful, lasting criminal justice reform in this country.

You will be hearing from us soon with specific steps for how to get involved.  Go to www.pfcjreform.org/join to stay informed.

 

 

 

Use of isolation in juvenile detention centers

Physicians for Criminal Justice Reform (PfCJR) CORE ISSUE:  Juvenile justice reform to identify and divert at-risk youth.

Isolation in juvenile detention centers persists despite ample data demonstrating the traumatizing consequences to youth who often already have been traumatized.  Dr. Brittany Raffa writes a poignant piece that was published in the December 1, 2015 issue of Family Practice News regarding the practice.  Highlights:

  • Youth are kept in isolation for several days, with a vague definition by staff on the limit of “several days.”
  • While in isolation or segregation – whatever it is called – mental illness and posttraumatic stress disorder are exacerbated. Youth do not participate in school classes, and they are barred from the daily hour of physical activity.
  • The use of isolation in juvenile centers has led to increased suicide rates in those children.
  • More than 50% of all youths’ suicides in juvenile facilities occurred while young people were isolated alone in their rooms, and … more than 60% of young people who committed suicide in custody had a history of being held in isolation.”

Read the entire article at www.familypracticenews.com

Click here to JOIN PfCJR as a physician or allied member as we advocate for criminal justice reform.

For Police, A Playbook for Conflicts Involving Mental Illness

PfCJR CORE ISSUE:  Decriminalization of mental health and addictive disorders. 

As reported by the New York Times online.

PORTLAND, Ore. — The 911 caller had reported a man with a samurai sword, lunging at people on the waterfront.

It was evening, and when the police arrived, they saw the man pacing the beach and called to him. He responded by throwing a rock at the embankment where they stood.

They shouted to him from a sheriff’s boat; he threw another rock. They told him to drop the sword; he said he would kill them. He started to leave the beach, and after warning him, they shot him in the leg with a beanbag gun. He turned back, still carrying the four-foot blade.

In another city — or in Portland itself not that long ago — the next step would almost certainly have been a direct confrontation and, had the man not put down the weapon, the use of lethal force.

But the Portland Police Bureau, prodded in part by the 2012 findings of a Justice Department investigation, has spent years putting in place an intensive training program and protocols for how officers deal with people with mental illness.

Read the entire article.

Click here to JOIN PfCJR as we advocate for criminal justice reform.

Three state juvenile lockups selected to participate in a national project designed to improve conditions

From www.chron.com:

Three state juvenile lockups that have been plagued by training and operational problems as officials struggled to deal with a more violent population of incarcerated youths have been selected to participate in a national project designed to improve conditions.

David Reilly, executive director of the Texas Juvenile Justice Department, announced Monday that the Giddings State School, Evins Regional Juvenile Center in Edinburg and the McLennan County State Juvenile Correctional Facility in Mart will be included in the 18-month program.

Three other agencies across the country will also participate: Florida Department of Juvenile Justice;
Massachusetts Department of Youth Services and StarrVista, Inc. in Wayne County, Michigan.

The project is being overseen by the national Council of Juvenile Correctional Administrators and the Center for Juvenile Justice Reform at Georgetown University.

Reilly said the project at the three Texas lockups will include training and technical assistance to help his agency improve educational and rehabilitation programming, behavioral management and health care, and transition planning to ensure success for youths after they are released from custody.

Read the entire article www.chron.com

Click here to JOIN Physicians for Criminal Justice Reform, Inc. as we advocate for criminal justice reform.

House committee approves plan to keep mentally ill out of Florida jails

Physicians for Criminal Justice Reform (PfCJR) CORE ISSUE:  Decriminalization of mental health and addictive disorders.

TALLAHASSEE | A measure that would put mentally ill people charged with crimes in medical treatment instead of correctional facilities is making its way through the legislative process.  Highlights:

  • Rep. Charles McBurney, R-Jacksonville, is the sponsor of House Bill 439. He said the goal is to help Florida prisons and jails shake their status as the state’s largest mental-health treatment facilities.
  • Among other things, the proposal:■ Allows county judges to direct people accused of misdemeanors to treatment instead of jail;

    ■ Changes the definition of the term veteran to make more people eligible for veteran courts that provide alternative resolutions to jail for veterans charged with crimes;

    ■ Allows every county to create a mental-health court that provides treatment for mentally ill people accused of crimes instead of sending them to jail; and

    ■ Creates a pilot program in Duval, Broward and Miami-Dade counties that provides treatment options for people deemed mentally incompetent to stand trial for felony offenses instead of sending them to state mental-health hospitals.

Read the entire article at www.jacksonville.com

Click here to JOIN PfCJR as a physician or allied member as we advocate for criminal justice reform.

County programs provide way out for those with mental health issues

Physicians for Criminal Justice Reform (PfCJR) CORE ISSUE:  Decriminalization of mental health and addictive disorders.

The Lyon County Forensic Assessment Safety Triage Team and Mobile Outreach Safety Team were established in August 2015 to address the significant number of individuals in the criminal justice system with a mental health diagnosis, substance use disorder or, in many cases, both.  Highlights:

  • These teams represent community collaboration between state and local government and nonprofit agencies to address the behavioral health needs of people involved in, or at risk of involvement in, the criminal justice system by providing an array of community-based diversion services designed to keep people with behavioral health issues out of the criminal justice system while also addressing issues of public safety.
  • New Sheriff McNeil described the programs as restorative justice rather than jail diversion, but said they help reduce repeat offenders by giving them the help they need to prevent them from becoming involved with law enforcement.
  • McNeil said the programs save the county money in the long run, by reducing the costs of institutionalizing the mentally ill.

Read the entire article at RGJ.com

Click here to JOIN PfCJR as a physician or allied member as we advocate for criminal justice reform.