The Real Cost of Prisons Weblog

In his 2001 book, "Going Up The River: Travels in a Prison Nation," Joseph T. Hallinan outlines in vivid detail the reasons for the growing number of inmates and the solution on the top of everyone's list -- more prisons.

Rural states are considered perfect sites for new prisons, not only to house inmates, but as money-making operations that take overflows from other states and employ poor people.

Hallinan's book describes this as the "largest silent migration in American history of young urban men to prisons in white rural America."

No doubt we will soon hear that building yet another prison, perhaps the one now being spoken of for Washington County, is a "win/win" solution

Before Maine gets sweet-talked into going into the prison business, it might be worth considering other "long-term solutions."

We believe the current crisis in Maine's prison system relates as much to failures in the health care system, in public health and in the community as it does to sentencing options.

It seems likely that ignoring these failures and the knee-jerk "building prisons" will, at best, be a temporary fix, and at worse exacerbate the situation.

Health care is in crisis in Maine. Everyone knows it from the rural mill worker to the CEO of any Maine business. Current Maine health care spending is $8.3 billion and rising.

This is a public health crisis of the first magnitude. Everyone is looking for ways to cut costs in health care and two favorite areas are substance abuse and mental health -- in the community and in the jails and prisons.

Mental health treatment in prison is not a current priority, even for those inmates who will shortly return to their communities.

Jails and prisons are filled with people who have mental health and substance abuse problems.

A 2006 report from the Bureau of Justice shows that not only is there a high prevalence of mental health problems among prison and jail inmates, these inmates are more likely to have been homeless in the year before arrest, experienced physical or sexual abuse, and are more likely to be recidivists.

Nearly a quarter of prison and jail inmates who had a mental health problem, compared to a fifth of those without, had served 3 or more prior incarcerations.

The simple truth is that people who are mentally ill or substance-abusing are being incarcerated because we as a society are choosing this solution instead of addressing the root problems in the community or treating the patients.

Fifteen percent of state prisoners and 24 percent of jail inmates meet the criteria for a psychotic disorder, as compared to 3 percent in the general population.

It used to be that we as a society were horrified by tales from old mental hospitals, where the mentally ill were kept in large open wards and never allowed outside. What about now, when we keep the mentally ill in shackles in tiny prison cells, deprived of all personal contact, and explain our conduct by calling them "criminals"?

Also troubling is the influx of thousands of returning veterans who may have traumatic brain injuries and/or depression, PTSD, substance abuse and other common psychological responses to combat.

Will they too, become fodder for the new social services safety net -- the nation's prison industry?

We can and should lead the nation by strengthening our health care system, making sure that private and public insurance covers mental illness and substance abuse, and removing the multiple...legal and policy barriers that keep people from getting the help they need before they fall into the criminal justice system.

Shame on all of us if we simply push more of our citizens into prisons.

ABOUT THE AUTHORS

Lani Graham, M.D., is a family practice physician who serves on the Governor's AdvisoryCouncil for Health Systems Development. Carol Carothers directs the National Alliance on Mental Illness of Maine.

http://pressherald.mainetoday.com/story.php?id=107404&ac=Phedi