Mental illness causes inmate housing trials

March 03, 2004|by DON AINES

The man standing behind the plexiglass screen, slack-jawed and glassy-eyed, mumbled a few incoherent responses to questions posed by Franklin County Prison Warden John Wetzel on Tuesday afternoon.

This inmate's only crime may be that he suffers from a severe mental disorder, severe enough that one of the state's three hospitals for mentally ill criminals sent him back to Franklin County Prison.

Wetzel said the man initially was charged with an assault that took place at an in-patient mental health facility.

At Mayview State Mental Hospital, the inmate committed five other assaults before he was sent to the county prison, Wetzel said.


The plexiglass was placed over the cell door because he has spit on half a dozen or more prison staff members.

Sometimes, the inmate is allowed out of his cell for a shower or phone call, but he has to wear a surgical mask, Wetzel said.

"This is not an ideal situation, like Hannibal Lector with a plexiglass cell and mask," Wetzel said.

He said, however, he is not allowed to turn away prisoners with mental illnesses.

Other inmates, about 30 a month, must be checked every 15 minutes or have an officer outside their cells at all times because they are suicidal, he said. The last inmate suicide occurred in October 2001, three months before his arrival, Wetzel said.

"It's very staff-intensive," he said.

Wetzel said about 16 percent of the 360 or more prisoners in the overcrowded jail suffer from some sort of mental illness.

"They need to be in single cells. You can't predict their behavior," he said.

In a main prison and annex built to accommodate 200 inmates, cell space for the mentally ill is hard to come by, Wetzel said.

"We should have a mental health unit or a special needs unit, whatever you want to call it," he said.

Instead, mentally ill inmates are placed throughout the complex, where they pose a threat to themselves or others, or may be abused by other inmates, Wetzel said.

"We see the whole range of mental health problems that you'd see in a community mental health center," Dr. Enos Martin said over a video teleconference link between the prison and his Harrisburg, Pa., office. That includes psychotics, schizophrenics and people with major depression and character disorders, Martin said.

About 30 inmates were scheduled for "tele-psychiatry" sessions with Martin on Tuesday. He relies heavily on clinical psychologist Warren Hartzell, who works full time at the prison, to lay the groundwork for these sessions through inmate interviews and observations by corrections officers and staff.

"I'm very confident that I'm able to make a solid psychiatric diagnosis and develop an appropriate treatment plan," Martin said, speaking through a television in a tiny room behind the mess hall. "They actually sometimes seem to enjoy being on TV."

"Their mental health symptoms are often a manifestation of a lifetime of dysfunction," Hartzell said.

Often poorly educated and from abusive homes, inmates also frequently have substance abuse problems, he said.

Deinstitutionalization from state mental hospitals in the 1970s resulted in reinstitutionalization of the mentally ill in prisons, Wetzel said. When hospitals released the mentally ill, states did not respond by building community mental health care systems for them, he said.

Of an average daily inmate population of 32,436 in Pennsylvania in 2002, about 7 percent had serious mental illnesses and 16 percent had some type of mental condition, according to the Pennsylvania Department of Corrections.

Prisons are "kind of like the community mental health center," Martin said.

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