How Prisons Handle the Mentally Ill

About one in five prisoners in Connecticut is receiving mental health treatment – a proportion that has increased in the last decade, contributing to a rise in inmate health care costs that is now attracting lawmakers’ scrutiny.

Adding to those costs is the likelihood that inmates with serious mental health problems will end up back in the prison system after release. In its 2010 annual recidivism report, the state’s Office of Policy and Management Criminal Justice Policy and Planning Division found that inmates with mental health problems had “significantly higher recidivism rates” than other offenders.

The price of prison health care, for both mental and physical ailments, has some lawmakers pushing to look into alternatives to the prison system’s $98 million annual managed-care contract with the University of Connecticut. Connecticut’s budget for the next fiscal year is about $3.5 billion in deficit.

The most recent annual report by UConn’s Correctional Managed Health Care [CMHC] shows that about 3,500 prisoners, or 18 percent of the prison population, are receiving mental health treatment. That percentage has climbed since 2003, when an estimated 13 percent were considered mentally ill.

The prison system’s handling of the mentally ill—a longstanding topic of controversy – is now a focus of Michael Lawlor, Gov. Dannel Malloy’s new chief of criminal justice planning and policy. Lawlor said he wants the state to pursue alternatives to prison for mentally ill inmates who are convicted of lesser offenses and do not pose a danger to society.

“Some people definitely need to be in prison, but not all of them do,” Lawlor said. “If our goal is to get those [non-dangerous] people better, the worst place to do that is in prison.”

Data from CMHC show that mental health costs rose significantly from 2004 through 2007—- from 18.8 percent of total medical expenses, to more than 23 percent. But despite the continued rise in prisoners with mental health problems, CMHC has worked to hold down the costs of caring for them in the last four years, with the percentage dropping to 19.3 percent in 2010, officials said.

The most severely mentally ill male prisoners are housed at Garner Correctional Institution in Newtown, where the corrections department consolidated its mental health services in 2004 as part of a settlement in a lawsuit brought by the state Office for Protection and Advocacy for Persons.

While the overall cost per inmate for medical, mental health and dental services in 2010 was $4,780, the per-inmate health cost for Garner was significantly higher – about $12,000, according to the DOC.

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