麻豆传媒

By
Robert Landauer
30 Nov 2003

Billy Owens' death was an accident, the Oregon State Police say. Learn from this prison tragedy or more will follow, says the Oregon Advocacy Center, created by Congress to protect the civil rights of people with severe disabilities.

Owens died at the Snake River Correctional Institution in April 2002. He had severe schizophrenia and a history of psychotic breakdowns in prison. During his 70th day of disciplinary solitary confinement he began stabbing himself in the neck with a broken pen. He stopped breathing when five guards restrained him.

Owens, who had tried to kill his grandmother because he believed an evil intruder inhabited her body, is not my candidate to be any cause's poster child. Nor is there any intent to hammer the prison system even though the advocacy center called for wiser use of disciplinary segregation and inmate-restraint techniques.

Still there are powerful reasons to reflect on what Billy Owens represents.

A compelling factor is that people like him make up 22 percent of Oregon's prison population. That's 2,700 inmates in a system that makes no claim that it is equipped to treat their severe mental illnesses properly.

When individualized care declines in mental hospitals and prisons, suicides, attempted suicides, assaults, sexual assaults and disciplinary measures involving seclusion and restraint rise. This happens under conditions when the state is fully responsible for inmates' and patients' care and safety.

Oregon, whose state budget is held together by baling wire and chewing gum, cannot afford to overlook what the Oregon Advocacy Center's interest in the case might mean. If the state doesn't care appropriately for severely mentally ill prisoners, the center can flex heavyweight muscle. OAC got a $240 million settlement three years ago that forced the state to halt its shameful multiyear delays in delivering services to which children with developmental disabilities are entitled.

So, politicians ought to push this issue to the red zone of urgency.

The problem doesn't disappear when inmates leave prison on parole. Individualized treatment must be ongoing or complications intensify -- alcohol/drug addictions, job loss, homelessness. Then mental illnesses trigger run-ins with the public and police and lead to more jailings because our approach often criminalizes mental illness instead of treating it.

Many of the public costs of this unraveling are hidden. Housing options for the chronically homeless are $10,500 per month in a psychiatric hospital, $3,420 a month in a shelter bed, $1,950 per month in a county jail bed and $750 per month in a stable service-enriched housing unit, Portland's Bureau of Housing and Community Development says. If the person ends up in the state prison system, the tab runs to $23,451 a year.

Criminalizing mental illnesses causes huge waste in the overuse of jails and prisons and in lost human-life potential because all of those brain disorders can be treated, some more effectively than other physical disorders. For purposes of living independent lives, many persons with mental illnesses can be cured. Almost all can be substantially improved, minimizing disruptions, threats and costs to their communities. But it takes more than pills. It takes support services.

It's not just a matter of getting the money; it's getting the will in the communities to develop the support services -- mobile crisis teams to respond quickly when needed and sufficient case managers and counselors with various skills who are trained enough and paid well enough to build a stable foundation of high-quality care.

Right now, we have a perverse symmetry: Seriously mentally ill inmates are not getting adequate treatment within the state prisons. When they get out (as well over 90 percent do), they still get inadequate treatment. This increases the likelihood that they will go back to prison or jails, mental hospitals or shelters, preying on or being victimized by others costing taxpayers more than the price of stable housing and supportive services.

For this population, what works are consistent, enhanced services, not just confinement with triage attention during psychiatric crises.

© 2003 Oregonian Publishing Co. All rights reserved. Used with permission of The Oregonian.