How can those in the box think outside of the box?

Letters to the Portland editor, May 14, 2010

I am writing in response to Lance Tapley’s article, “Are Doctors Complicit in Prison Torture?”(April 23). I was disgusted on multiple levels with what the article revealed about the Maine State Prison. The fact that we are mentioning the word torture in connection to a state facility is hard for me to fathom. I understand that the mission of the Maine State Prison in Warren is to: “provide a safe, secure, and humane correctional environment for the incarcerated offender. Consistent with the mission of the Department of Corrections, the prison maintains appropriate control of offenders by providing various levels of security necessary to protect the public.” When it comes to solitary confinement in the Special Management Unit (SMU) they seem to have forgotten the first part of their mission.

Inmates with mental illness are common in Maine prisons and jails (according to a 2009 Issue Brief by the Muskie School of Public Service). This is especially the case with inmates found in the SMU. Many with mental illness do not receive the treatment they need to address issues in their lives that make them likely to be repeat offenders (the behaviors associated with their mental-health diagnoses, substance abuse, unemployment, etc.). In the last five to six years alone, the money spent on corrections has drastically increased while the spending on community mental health has not. Imminent budget cuts will exacerbate this already “fragmented, disconnected, and inadequate” mental health system, meaning fewer people will have access to needed services and resulting in more people ending up incarcerated. This will continue the trend of correctional facilities being mental health providers for all intents and purposes (Executive Summary, NAMI Maine, 12/2009). With this climate the State should not have dismissed LD 1611, “An Act To Ensure Humane Treatment for Special Management Prisoners,” and they certainly should not trust any investigatory report that may come out of Resolve Chapter 213, “Directing the Department of Corrections To Coordinate Review of Due Process Procedures and To Ensure Transparency in Policies Regarding the Placement of Special Management Prisoners,” which charges the Commissioner of Corrections and the mental-health and substance-abuse focus group of the State Board of Corrections with reviewing due process procedures and other policies related to special management prisoners. I do not believe the Department of Corrections can be impartial.

As Tapley noted, there is concern within the medical field that the safeguards in place for patient physical and mental health care at the Maine State Prison, as provided through Correctional Medical Services (a for-profit company) with consultation and peer review by Maine Medical Association (MMA) doctors (who receive financial compensation for their time) are insufficient. Tapley reported that the MMA reviewers look at 30 to 40 charts at a time and the information provided to them may not indicate where the inmates are housed within the prison.

I do not believe that the Department of Corrections, Correctional Medical Services, or the MMA is doing enough to protect inmates with mental illnesses. Even without arguing the exact definitions of torture, I am confident that being locked in isolation cells for 23 to 24 hours a day, being fed through solid steel doors, and not knowing when you will be let out of isolation (some inmates are in there 45 days or less and some have been in there for years), is not going to be in any book on evidence-based mental health care.

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