We rehabilitate inmates, don’t we? 

October 18, 2015

I used to work for the California Department of Corrections (CDC).  My employment there ended when we moved to a different state.  We returned to California six years later to find that the CDC had been re-Christened “The California Department of Corrections and Rehabilitation (CDCR).”  Not having been here when the change was made, I don’t know if it was an administrative, political or public relations-driven switch, but whatever the reason for it, I cannot help but think that this rebranding was aspirational in nature.  Because in my experience – and in that of colleagues I know who still work for the system – the California corrections system is not about rehabilitation.

Prison is first and foremost about survival.  While it’s true that many of the individuals who are incarcerated lived difficult lives on “the outside,”[1] life “inside” requires mental and emotional adjustments that most of us could not imagine having to make.  Anyone who’s watched an episode of “Law and Order” has some sense of the horrific brutality that can occur in prison settings, but I think that very few of us have spared a thought for the simple deprivations that make the idea of rehabilitation during incarceration not only a misnomer, but a tragic farce.  Make no mistake: I am not minimizing the fact that the majority of incarcerated individuals are imprisoned because of their own behaviors, and I certainly believe that many of these individuals cannot safely function in society.  I am not (currently) addressing the issue of who should be incarcerated.  I am merely suggesting that America’s prisons lack both the capacity and will to rehabilitate their residents.

This is clearly evident when we explore medical statistics for incarcerated persons.  According to the U.S. Department of Justice, in 2011-12, over 40 percent of state and federal prisons and jail inmates were identified as having chronic medical conditions.[2]  In addition, the majority of 74 percent of prisoners in state and federal prisons and 62 percent of jail inmates were described as overweight or obese.[3]  It’s easy to argue that these statistics have little meaning to the general public.  After all, as I have heard many people argue, these people have committed crimes against society – if they are overweight and unhealthy it is of no concern to the general public.  It is if you pay taxes.

The Center on Budget and Policy Priorities reports that in 2013 states spent almost 50 billion dollars on corrections.[4]  That’s approximately thirty thousand dollars per inmate.  When inmates are unhealthy, those costs increase.  When inmates are mentally ill or addicted to drugs or alcohol, the total spending goes up again.  And many inmates have these issues.  Estimates vary, but it is generally agreed upon that the rate of mental illness in prisons is at least five times that of the general population.[5]  Similarly, at least half of incarcerated individuals are classified as substance abusers.[6]  And while prisons and jails are legally mandated to provide medical treatment to inmates with illnesses, they are not obligated to teach them how to maintain healthy lifestyles.

But not doing so represents a missed opportunity.  According to CBS News, approximately half of U.S. inmates reoffend within three years of release from incarceration.[7]  That’s because these individuals are generally returned to the same bad environments they inhabited with the same lack of care and/or bad habits they exhibited when they were locked up.  Despite evidence that demonstrates that individuals who receive substance abuse treatment while incarcerated are less likely to reoffend, states are more likely to cut than enhance such programming.[8]  The statistics for mentally ill individuals are similar.[9]  And it’s just common sense to realize that rates for diabetes and heart disease decrease when individuals exercise and eat well and the frequency of sexually transmitted diseases goes down when people are educated about high risk behaviors.  In other words, if inmates were truly “rehabilitated” in prison they might have a chance of fighting the negative behaviors and influences that brought about their criminal behavior in the first place.

The fact that they are not is neither cost-effective nor humane.  Mentally ill inmates not only receive inadequate mental health treatment in prison but they are often released into the community without being linked to community assistance.[10]  Substance abusers go right back to committing crimes both while using and in order to buy illegal drugs.  And chronically ill and obese inmates return to the streets without jobs, skills or the wherewithal to obtain health care – meaning that when their conditions deteriorate they are forced to go to emergency departments for treatment.

The really sad part is that there are programs and personnel available to remedy these issues.  Research has identified numerous mental health, substance use, and lifestyle curriculum that effectively reduce symptoms of both medical and mental disorders.  Unfortunately, institutions don’t have the money to put them in place.  That’s because voters tend to see providing programming to “criminals” as a poor use of their tax dollars.  What they don’t understand is that their tax dollars will be spent on these individuals one way or the other.  Supporting rehabilitative programming in our prisons and jails is the better way.  It is the sensible way.  It is the compassionate way – and, dare I say it? – it is the right way.

[1]Amy Levad (2014). Redeeming a Prison Society: A Liturgical and Sacramental Response to Mass Incarceration, Fortress Press.  Levad’s book is an excellent overview of ethical and theological issues related to incarceration.

[2]Laura Maruschak, Marcus Berzofsky, and Jennifer Unangst (2015), “Medical Problems of State and Federal Prisons and Jail Inmates.  U.S. Department of Justice.

[3]Laura Maruschak, Marcus Berzofsky, and Jennifer Unangst (2015), “Medical Problems of State and Federal Prisons and Jail Inmates.”  U.S. Department of Justice.

[4]Center on Budget and Policy Procedures, “Policy Basics: Where Do Our Tax Dollars Go”? (2015), www.cbpp.org

[5]Terry Kupers, “Prison Madness: The Mental Health Crisis Behind Bars and What We Must Do About It,” National Criminal Justice Reference Service.

[6]The National Center on Addiction and Substance Abuse (2010), http://www.casacolumbia.org/newsroom/press-releases/2010-behind-bars-II.

[7]CBS News (2012), “The Cost of a Nation of Incarceration, http://www.cbsnews.com/news/the-cost-of-a-nation-of-incarceration/3/.

[8]The National Center on Addiction and Substance Abuse (2010), http://www.casacolumbia.org/newsroom/press-releases/2010-behind-bars-II.

[9]U.S. Department of Justice, National Institute of Corrections, “Effective Prison Mental Health Services: Guidelines to Expand and Improve Treatment,” https://s3.amazonaws.com/static.nicic.gov/Library/018604.pdf.

[10]Anasseril Daniel (2007), “Care of the Mentally Ill in Prisons: Challenges and Solutions,” Journal of the American Academy of Psychiatry and the Law Online, http://www.jaapl.org/content/35/4/406.full.

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