Privatized Mental Health Services is Bad Medicine

Last week we began a conversation about the privatization of services within correctional facilities, highlighting Ohio Governor John Kasich’s move to privatize food service throughout the state’s prison system, including juvenile detention facilities.  Today we want to examine another vital service that has been increasingly seized by private providers – health care, specifically mental health services, within correctional facilities.  

The high prevalence of mental illness among incarcerated populations is given little public attention.  In 2005, more than half of our country’s incarcerated population, a total of more than 1.2 million people, had a diagnosed mental health condition.  This fact should give us pause and raise national concerns about how mental health care is addressed in correctional settings.  Perhaps this crisis would seem more compelling if people knew that incarcerated persons with mental health issues have lower rates of employment, high rates of substance dependence or abuse, high rates of homelessness, and high prevalence of violent offenses – all of which have far reaching, negative effects.  It’s clear that mental illness among incarcerated populations is a serious, systemic issue with dire consequences for all of us. 

We are concerned.  And, we do not believe privatizing mental health services in corrections is the answer.  The myriad dangers of privatization, including deregulation and diminished accountability are grave, particularly when they impact how and whether people receive much needed care.  Private prison health care providers have been exposed for cutting corners, understaffing, negligence, and inadequate care that have had deadly consequences.  

According to a piece in The Root by Lynette Holloway, 18-year-old Aleshia Napier hanged herself with a bed sheet while incarcerated at Broward Correctional Institution in Florida in 2004.  She had been diagnosed with bipolar disorder and clinical depression with psychotic features, but according to her family’s lawyer, Randall Berg Jr., rather than being provided with medical care, she was placed in solitary confinement “with all the potential protrusions to help her commit suicide. They gave her a bed sheet instead of a shroud or tear-away clothes…” Her family settled a $500,000 lawsuit with Florida Department of Corrections and the two private health care providers contracted by the facility, Corizon Health, (formerly named PHS Correctional Healthcare) and MHM Services

In another case of failed private prison mental health care, 22-year-old Christopher Armstrong, who had a history of mental illness, died in the Guilford County Jail in North Carolina while in a hard plastic restraint chair when blood clots reached his lungs.  The jail had one medical doctor and general health nurses, employees of private prison health care company Corizon Health, on call between multiple jails in the area.  According to Sherriff BJ Barnes, the detention officers lack mental health training and did what they deemed necessary to prevent Armstrong from hurting himself or others.  We now know the consequence was death.  He went on to say that the commissioners have refused for years to pay for a full-time mental health nurse. 

Wexford Health Sources, Inc., yet another private prison health care company contracted by the Arizona Department of Corrections to provide medical care to the state’s incarcerated persons, was fined $10,000 by the DOC for negligence after multiple accounts of staff error and non-compliance.  One such account was another incidence of an inmate hanging himself with a sheet after Wexford’s failure to provide adequate medical services and administer appropriate medication. And how much is Arizona paying Wexford to deliver such stellar care? Wexford signed a $349 million 3-year contract merely seven months ago in July of last year. 

Unfortunately, outsourcing prison mental health services to private companies like Corizon Health and Wexford is not the only form of privatized mental health in corrections.  Private prison corporations, in addition to operating prisons and other correctional facilities, have also secured contracts to run entire forensic mental health facilities such as Montgomery County Mental Health Facility in Texas, operated by private prison industry giant GEO Group.  These facilities house forensic patients who are either unfit to be tried for committing a crime or found not guilty due to mental illness, and thus are ordered to be detained.  From what we know about both private prison and private prison health care companies, no matter what form privatized mental health care in corrections takes, it’s dangerous, deadly, and must be stopped.

Last year, Grassroots Leadership took part in doing just that.   Our organizing efforts paid off when state leaders heard a united message from mental health care advocates and criminal justice reform groups to stop GEO Group from taking over Kerrville State Hospital, another Texas forensic mental health facility.  Texas Department of State Health Services commissioner, David Lakey, rejected GEO Group’s bid, stating in a letter to the Governor and Legislative Budget Board on October 3, 2012 that savings in the proposal were achieved “primarily through reductions in staffing and benefits to a degree that would put both our patients and the State of Texas at risk.”  Lakey’s concerns are precisely the reason privatization of crucial services is a critical mistake.

On another high note, it seems we are not the only ones who are concerned.  Last week City Councilman Jim Kenney of Philadelphia demanded that someone from the mayor’s administration testify at his hearing on the city’s prison health care contract.  He is perplexed as to why Corizon Health is getting a new $42 million contract in spite of their multiple violations and poor track record of inadequate care. Privatization of such a critical service as health care in corrections has proven to be life threatening.  How many more will die before something is done?  Councilman Kenney wants answers.  We all should want answers.