“The biggest problem is people who need psychiatric treatment aren’t getting it.”
By Pat Shellenbarger
The Grand Rapids Press
GRAND RAPIDS — The 31-year-old man came into prison with a long history of mental illness, including a diagnosis of bipolar disorder, depression and a couple of suicide attempts. He complained of hearing voices telling him to assault others.
Yet a prison psychologist doubted the inmate was mentally ill and suggested he stop taking the medications intended to control his mood swings and quiet the voices in his head.
Such instances of mentally ill inmates being misdiagnosed or undiagnosed are fairly common, an independent psychiatrist testified Tuesday during a hearing on a long-running federal lawsuit over conditions in a Jackson prison complex.
Only about 6 percent of inmates in the three facilities -- known as the Reception and Guidance Center, Duane Waters Health Center and the C Unit -- are treated for serious mental illnesses, well below the national average of 15 percent to 30 percent, testified Dr. Terry Kupers, a California psychiatrist who specializes in prison mental health issues.
“That is way below what other states are doing,” he said.
The reason is not that Michigan’s inmates have fewer mental problems, Kupers said, but their mental illnesses are going undiagnosed.
“This creates a problem,” he said. “The biggest problem is people who need psychiatric treatment aren’t getting it.”
Kupers, called as an expert witness by attorneys representing inmates in the class-action lawsuit, spoke the day after another psychiatrist, Dr. Jeffrey Metzner, testified the state Department of Corrections is doing an adequate job of identifying mentally ill inmates.
Kupers testified some inmates told him they were advised by prison psychologists not to seek treatment for their mental illnesses, because it could hurt their ability to get into some prison programs and might discourage the parole board from releasing them.
He traced the problem to the 1980s, when the state closed most of its mental hospitals, releasing patients into the community. While funding for mental health programs was cut, many mental patients ended up homeless, and some were convicted of crimes.
“So the number of people with mental health problems in the prisons has increased massively,” Kupers said, adding that the number of mental health workers in the prisons “has not kept pace with the rising population of mentally ill inmates.”
Last July, he interviewed 37 inmates who had been diagnosed as not needing treatment and concluded several had serious mental illnesses. Many mentally ill inmates end up in segregation, sometimes known as solitary confinement, which only aggravates their illness, Kupers said. Some decline treatment for their mental illness, he said, because it could mark them as weak, making them a target for other inmates.
“They know they’re mentally ill,” he said. “They isolate themselves, which makes their mental illness worse. Prisoners tell me if you show weakness, you will be assaulted. It’s dangerous to be slight, to be gay, to be weak.”
American Civil Liberties Union attorney Elizabeth Alexander, representing the inmates, claimed the mental health care in the prisons is unconstitutionally inferior. Assistant Attorney General Peter Govorchin, representing the Department of Corrections, disagreed and wants U.S. District Judge Robert Jonker to dismiss that portion of the long-running lawsuit.
“You’d have thought we were talking about two different places,” Govorchin said during a break in the hearing.
Copyright 2008 The Grand Rapids Press