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Arizona Daily Sun

September 3, 2003

Reprinted with permission of the author. All rights reserved.

Advocate: Prison no place for mentally ill

By Larry Hendrick

Mary Zdanowicz, executive director for Treatment Advocacy Center in Arlington, Va., questions first whether prison is appropriate for mentally ill people, even if they have committed terrible crimes. She also questions whether prison systems have sufficient mental health services for the number of inmates who need those services.

The Treatment Advocacy Center is dedicated to eliminating barriers for people with severe mental illnesses in getting treatment. And one of the center's principal activities is diverting mentally ill people away from the prison setting and into a treatment setting.

Zdanowicz, speaking generally and not about the Arizona system, said prison is not the place to treat the mentally ill. Even though they may have committed terrible crimes, they are sick. Prison is for punishment.

"If they're really mentally ill, they won't even realize they're being punished," Zdanowicz said.

"They definitely need to get treatment. There usually is not enough of it available in a prison setting."

Zdanowicz said that the center is concerned with the number of treatment beds that are available for severely mentally ill people in prison. If Arizona follows the trend of the nation, there is not enough.

Zdanowicz said the center estimates the number of inmates in any prison system with severe mental illness to be between 16 percent and 20 percent.

Zdanowicz said that the severely mentally ill inmates are the most vulnerable to predators and suicide and can be the most dangerous if not on medication or if they refuse their medication.

"That can be among the most dangerous of situations," Zdanowicz said, adding that generally in prison settings, forcing medications is not done. "Then, they are psychotic and living in an isolated and very dangerous situation with other people."

Zdanowicz said another consideration is cost. Keeping and treating mentally ill people in prison is much more costly than "assertive community treatment programs" available to people who are released from hospitals after they are stabilized with medication and treatment.

If mentally ill people who committed crimes respond to medication and treatment, they should be sent to a state hospital, then conditionally released, even if they need to be supervised for the rest of their lives, Zdanowicz said.

According to the center, average community treatment programs cost $60 a day, while the cost to keep a person in prison is approximately $130 a day.

"And the thing that we know is that people who are on their medications, the risk of violent episodes is significantly decreased," Zdanowicz said.

The risk is not eliminated though, acknowledged Zdanowicz.