Scientist spends nine months in max-security prison to learn how prisons manage mental illness in inmates

That is the title of this article I am writing about. “Case Western Reserve University mental health researcher Joseph Galanek spent a cumulative nine months in an Oregon maximum-security prison to learn first-hand how the prison manages inmates with mental illness. What he found, through 430 hours of prison observations and interviews, is that inmates were treated humanely and security was better managed when cell block officers were trained to identify symptoms of mental illness and how to respond to them. In the 150- year-old prison, he discovered officers used their authority with flexibility and discretion within the rigid prison structure to deal with mentally ill inmates.  Galenek’s observations and interviews with 23 staff members and 20 inmates with severe mental illness, are described in Medical Anthropology Quarterly article, ‘Correctional Officers and the Incarcerated Mentally Ill: Responses to Psychiatric Illness in Prison.’ The National Science Foundation and the National Institute of Mental Health supported his research. ‘With this research, I hope to establish that prisons, with appropriate policies and staff training, can address the mental health needs of prisoners with severe mental illness,’ said Galenek, PhD, MPH a medical anthropologist and research associate at the Jack, Joseph and Morton Mandel School of Applied Social Sciences’ Begun Center for Violence Education and Prevention Research at Case Western Reserve.” He looks like he has the skills necessary to find out how to best treat mentally ill prisoners.  I know that this is a prison and they are there to do time.  Although I was once one of them and there is nothing crueler than being mentally ill while you are locked up.
The article goes on to say: “ Additionally, he said, ‘I show that supporting the mental health needs of inmates with severe mental illness concurrently supports the safety and security of prisons, and that these two missions are not mutually exclusive.  With the number of prisoners with severe mental illness increasing, efforts need to be made by all prison staff to ensure that this segment of the prison population has appropriate mental health care and safety.’ Galanek saw how administrative policies and cultural values at the prison allowed positive relationships to develop between officers and prisoners diagnosed with severe mental illness, among the prison’s 2,000 inmates. In this maximum-security prison, left unidentified for the study to protect the confidentiality of officers and inmates officers received training to identify symptoms of mental illness, which, in turn, led to better security, safety and humane treatment of potentially volatile inmates.  But officers were also able to use their discretion in handling some situations. Galanek observed, for example, the following instances where an officer’s decision—rather than rigidly enforcing prison rules—helped mentally ill inmates and maintain order within the institution.” It is always better when you can work a situation for the better for both parties involved.  A person just wants to make life easier for themselves and all.  If no inmates get hurt in prison it would be all the better.
The article ends with: “Prisoners are required to work 40 hours at an assigned job.  But one inmate chose to remain in his cell instead of reporting to work—a prison offense.  The inmate told the officer he was experiencing auditory hallucinations.  Instead of sending the prisoner to a disciplinary unit, the officer allowed the prisoner to remain in his cell until the hallucinations passed.  A correctional officer confronted a violent prisoner, who was off his medication and began smashing a TV and mirror and threatened other prisoners.  Instead of disciplinary confinement, the officer conferred with mental health workers, who sent the prisoner to the inpatient psychiatric  unit to get him back on his medication.  Prisoners aren’t allowed to loiter or talk to other inmates outside their cells.  But a high-functioning inmate with a bipolar disorder worked a janitorial job that allowed him to talk to other mentally ill inmates.  Through those conversations, he was able to let officers know when inmates were exhibiting symptoms of their mental illness.  That information allowed officers to quickly address potential problems and decrease security risks.  Conversely, Galanek said, if these inmates were sent to the segregation unit (“the hole”) to sit isolated for hours their thoughts could lead to agitation and hallucinations that often bring on prison security problems.  Mentally ill prisoner’s work was important and meaningful because it acted as a coping mechanism to decrease the impact of psychiatric symptoms, he said.  To gain such access to prison culture is highly unusual.  In fact, such ethnographic studies have declined in past 30 years due to perceptions that researchers are seen as security risks within these highly controlled environments.  But as a mental health specialist in Oregon’s Department of Corrections from 1996-2003, Galanek was uniquely prepared to navigate the prison for his research. ‘They trusted me,’ he said. ‘I knew how to move, talk and interact with staff and inmates in the prison.

Are we Torturing the Mentally Ill

That is the title of this article about solitary confinement in prisons. I can only give my experience on the matter.  I was in prison in the nineteen eighties and it was a lot different back then it is now.  I was at Buena Vista prison and was on South wing and there is only one more wing to go to that is east wing where a person can wear street clothes and have more privileges.  I was happy in south wing as far as prisons go.  I had a gambling house and we watched the broncos and had burritos whenever the game was on.  So I was set in my ways and really did not want to go to east wing.

They made me go.  Also on south wing I had a partner with my gambling house.   He did not go to east wing just me.  I kept on gambling was having problems on the streets with my ex.  Finally one of the guards busted me for gambling.  I was angry and went to the hearing not understanding what was going on. They sentenced me to three days in the hole or solitary confinement.  I was very angry going to the hole.  I remember being locked in the cell and that is as far as I remember.  The next thing I knew I was in another cell not knowing what was going on and also insane. I know I was paranoid and not understanding what was going on. I could not comprehend what was going on.
I cut myself with a razor it did no damage but it got the guard attention and they put me in a cell with cameras so they could watch me and there is nothing worse than being watched all the time.  A doctor I knew came by and looked in at me.  The next morning they took me to Canon city where they had an infirmary and the psychiatrist asked me questions. He though I was just sleep deprived.  The two times I been in the hole this time I did not remember anything.  It is just a jail in a jail.  Although you do not see your friends also you eat in your cell so you do not get any company at all.  It can play with your mind.
After a while in canon after they started giving me sleeping pills I settled down and was not so paranoid the doctor asked where I would like to go and I said here in canon city.  I was not the same though.  I went back to the hospital one more time before I won my appeal and was freed. It wasn’t fun back then as it is not fun now to do time in the hole.  You have to be very strong to make it in the hole and come out sane.  It does play on your mind only seeing guards and not inmates while you are in the hole.  When I was doing time there were not that many inmates that were mentally ill at the time and in jail.
I hate the state hospital although it is a better solution when you are mentally ill than prison.  They can treat you and others like yourself are in there.  You cannot be in general population when you are mentally ill because your mind plays to many tricks on you and there are people who are going to do life in prison and they will not put up with someone who is mentally ill.  They really need to separate the two.  Here is an article on a new drug for schizophrenia that is successful in reversing schizophrenia.

Judges, Psychiatrists Confer on Handling Mental Illness in Justice System

That is the title of this article I am writing about today.  “Judges and psychiatrists are putting their heads together to devise ways to temper justice with mental health care for defendants and prisoners.  Psychiatrists and judges must learn more from each other to make headway together in dealing with the thousands of people with mental illness confined in U.S. jails and prisons, said speakers at the Judicial-Psychiatric Leadership Forum in Philadelphia last month.  Having doctors at the table is important, said Judge Ernie Glenn of San Antonio, Texas.  They understand far less about what we do than they should, and we understand far less than we should about what they do.  Jail should be the last place for people with serious mental illness, rather than the first, emphasized Miami-Dade County Judge Steven Leifman head of the Judge’s Criminal Justice/Mental Health Leadership Initiative (JLI) and a long-time champion of reform, addressing the 60 psychiatrists, judges, and court administrators at the forum. We have the leaders in this room to make a difference and change a horrific policy that has been an absolute, intolerable, unacceptable failure.”  I hope things change in the future because jail and prison is the last place a person should be with a mental illness.  My mental illness came about in prison in the late 80s and it was new than.  There was not that many with mental illness in the prisons or jail.  To be crazy in jail before I went to the State Hospital was not fun or like jail I had been to before.

The article goes on to say: “There needs to be a mutual recognition by judges and psychiatrists of the need to rehabilitate the prisoner and protect public safety, said Fred Osher, M.D. director of health systems and services policy at the Council of State Governments Justice Center in New York. I have optimism about the ways we can move forward.  The Judicial-Psychiatric Leadership Forum was cosponsored by the Justice Center, the JLI, and the American Psychiatric Foundation. Leifman is a member of the foundation’s board.  Judges have a great advantage when they want to get something done, said former Ohio Supreme Court Justice Evelyn Stratton. People listen to judges, and judges are used to being obeyed, Stratton noted.  Most of the judges in attendance were already part of the solution, working in mental health, drug, or veterans courts or other specialized dockets.  However, mental health training, perhaps in the form of continuing legal education, should also be expanded to reach judges in the system who do not have experience in specialty mental health courts, said Glenn.  Better yet, crossover education should start early in professional training, in law school and medical school.  I hate the state hospital but that is where people with a mental illness belong.  With others that have similar problems or mental illness.
The article also says: “The two professions could do more at both the beginning and end of a prisoners sojourn in the criminal justice system, since special mental health courts get only a small number of those with mental illness.  For example, judges could encourage police training to divert people with mental illness to hospitals for evaluation before they are arrested, because it’s much harder to get them out of the system once they’re inside.  More than 4,000 police officers in the Miami area have been trained to do just that, reducing arrests of people with mental health problems sufficiently to permit Miami-Dade County to close one of its jails, its Women’s Annex, earlier this year.  The average number of inmates fell from around 7,400 a year to just 4,800 at latest count, saving about $12 million a year.  There was also a 73% reduction in jail bed days.  Judges and psychiatrists are both interested in gathering information, noted Michael Champion, M.D. director of Champion Forensic Services in Santa Fe, N.M. Judges can do a good social history but don’t know how to turn that into a defined intervention strategy, and information is sometimes blocked on the psychiatrists’ side as well, because clinicians are not clear about what information will be used for.  Will it help or hurt the patient?” It is better to do something before a person goes to prison or jail.  Once you are in the system it is hard getting out.  It can take years of good behavior before you are released from all types of probation or parole services.
The last of the article says: “Both groups struggled with the problem of transitioning people out of the criminal system.  Clear release policies and procedures are needed for people with mental illness who are being treated in jail or prison, and then connections must be made with outside mental health providers.  One county found a simple solution: faxing or e-mailing a list of prisoners about to be released to local mental health agencies, said Judge Chad Schmucker, state court administrator for the Michigan Supreme Court.  The agencies frequently find the names of released inmates who were already on their client list and reconnect with them after their release.  We need to bring the criminal justice system into the continuity of care, agreed Debra Pinals. M.D., an associate professor of psychiatry and director of forensic education at the University of Massachusetts Medical School.  The dialogue between the two professions has to continue. Leifman and Osher maintained.  The want to see more, and larger, meetings like this one, to expand the interactions.  We need an army of you, Osher told attendees.  Let’s go back to our communities and work together on this issue.”  Let’s hope they all work together because being in jail I know for me was hardest time I ever did.  If they can rehabilitate so people stay out of jail and prisons and even the state hospital it would be great.

Stress

I wrote last week what happened when I had stress before my mental illness in this blog.  I will talk some more today about stress and how it affects me and others.  This article  gives some examples of stress and how to overcome it.  As I wrote last week I do not have all the answers to give someone when they are facing stress.  I can only be a sounding board.
What do you tell someone when they have no job, no money and they have kids to feed.  You can say it will get better.  That is all.  As I wrote in last week’s blog the biggest stress I ever had was facing twenty four years in prison.  It made me forget a person I knew well.   Today if I get stressed I usually will try and put it in the back of my mind and watch a movie or if I am really stressed it is music time.  That helps me forget and let the problem ruminate in the back of my mind it is where I do the best.
I know how problems in the subconscious will wake you up in the middle of the night and you will say why I am I awake.  Then the problem will come to light.  I just try and think of something else and get back to sleep.  It is not that easy for a lot of people.  Usually by morning I will feel better about the problem.  Sleep does wonders for me.  Everyone is different.  You would not be able to tell that I have a mental illness my Geodon works wonders for me.  I take it two or three hours before I want to sleep and I sleep.  I know when I do not take it because I cannot sleep and I will go look and make sure I took it.
I do not have the problem of stress with it like I had when I took moban.  Then when my turtle died it affected me and I could not sleep until early the next morning and had to take a PRN for that.  Now I do not have that problem.  I often wonder would I be tired if I did not have to take my medicine I will never try to find out because of bringing my mental illness back.  Although I see how family and friend react to loss of sleep and I do not have that problem.  I will yawn sometimes although that is with at least eight hours of sleep.
I wish there was some way that everyone with a mental illness did not have problems.  I mean negative problems.  If this illness did not happen when I was already twenty eight and happened earlier would I have went to college would I have done so well?  My mom is my sounding board when I went through college and even now.  I believe we all have to have someone to tell are problems to and the relief we have afterwards when we get it off our chest.  Then the answers will usually come to me after I got it off my chest.

Life in Recovery

It is hard to tell someone not doing well that things will get better.  When you do not have a job or a way to pay bills and you tell them hang in it will get better.  I’ve been on the down side of life before.  I know it is hard.  I was once facing twenty four years in prison.  I did not take a deal.  I was in trial and just before lunch the prosecutor said he was going to put a witness on the stand in a case that I had already did time for.  I went to a fast food restaurant for lunch but my mind was not on anything but my trial.  There was a server that told me hi and don’t I remember her.  I could not my mind was not there.  
When I was back in the car, I remembered who she was I knew her for years how did I not remember her in the restaurant.  I know now what worry can do to the mind.  Well I went back to court and we went in the judge’s chambers and my lawyers had worked during lunch.  The judge was not going to allow that witness to testify because we would have to retry the other case as well as this one.  Although she said she was not going to allow me to use the provocation law.  Of course I was acquitted on one count and found guilty on the other where she would not give me the law.
Maybe I smiled to fast when they said guilty, because I knew that on appeal I would win.  The judge would not give me an appeal bond and I did two years before I won my appeal.  That is where and when I had my first bout of mental illness I prison.  I have been down before.  It is not forever.  I knew in prison I would have to do some time although I also knew that once my case was heard I would be out.  I have always had hope.  That is a key to recovery that things will get better.
Another thing in recovery is time.  I know that this one is hard even for me.  People say I need a fast fix I do not have ten years to read positive books and wait for change.  What are you doing in those ten years?  Would it not be better to do something than nothing?  I know when I was in the state hospital; I did not want to hear it takes five years.  There are groups there and there is A.A. and you have to build a foundation that will not blow away like straw. I can say my medication works very well.  I read for some it does not and I feel for them people when I have it so easy.
I did the work in A.A. and I do not miss drinking or want it.  I can go into a bar and not want to drink I have done this and I did not want it.  I went once to a bar and it was my first time back in a bar and my last.  I had to do it to prove to myself that I would not drink again and that it would be my last time ever going to jail or anything because of alcohol.  I would not recommend this I just had to find out. In April I will have twenty three years of sobriety.  I would not for the life of me exchange it for a drink.
I know life can be hard although you have to look at what you have to be happy for.  My grandkid succeeding where I did not even though I was smart I took the wrong road.  I could have had a lot more material things by now if I would have went to high school or college.  Although I do not know if that would have prepared me for my breakdown or my eventual recovery that is where I can help my grandkids succeed in life through experiences when life gets tough.  Another key to recovery is you do not have to take everything a person says to recover.  If you take one thing from a lot of different people and can form your own recovery.  Everyone is different and not everything works for everyone.

Life before Schizophrenia

BEFORE I GET INTO The BLOG, I WOULD LIKE TO REMIND OUR READERS THAT The RECOVERY BLOG IS MOVING TO A NEW LOCACTION: OUR BLOG WILL CONTINUE FROM OUR NEW HOME:  http://www.mhcd.org/blog I turned something negative into something positive. That is paranoid schizophrenia that is what I am diagnosed with. I have said before that my life was not going good. Altogether I lost ten years of my life being locked up for crimes and for my mental illness. Every time I was locked up for a dui I would go to the county jail and ask to work in the laundry. That is what I knew how to do. No matter what I said that I was going to change my life for the better, I was soon locked up again. I did not see it as problem. There were a lot of people I knew that did time and a person would know the regulars.
You knew the people who would get locked up for the winter because it was too cold to be homeless at that time of year. It just seemed like bad luck was following me. Once I was walking through some apartment buildings where my friends lived and the police stopped me and told me to leave. I said O.K. and was cutting across a yard to get away and they locked me up for trespassing. That is the kind of luck I had. When I was locked up for the second time, facing prison time again I started looking at my life and knew I had to change it or I would be locked up for life.
Then what I thought should have been a misdemeanor or not locked up at all when I went to trial on a case. The Judge said it is the law but I am not giving the law to this person. I knew I would win in appeal court. Although I did not expect the Judge to not give me an appeal bond in a case that was wrong. I was back up doing time. I worked my way in Buena Vista to the south wing where I was the first time I was sent to prison. Then they wanted to move me to the east wing where you could wear street clothes. I did not want to go. No one was going to see me in street clothes in prison, so why wear them. I would still be locked up.
I also was running a gambling house with a friend. Things were going ok and I was just waiting for my appeal. When I reached east wing I had just finished an accounting class and receive a diploma for it. I started taking computer classes to learn basic programming. Things were not going good. I had everything you could have in prison because of my gambling. Then I did a stupid thing and raised the limits in my gambling. One of the guards I knew from the first time I was in prison was in east wing.
Then my ex-wife contacted me I knew that I should not be talking to her but life gets lonely in prison. She told me somebody was saying that I was snitching on people. I told one friend in jail what was going on and nobody else. All this was happening and I was doing well in the computer school. I had finished my studies and they made me an teaching assistant to teach what I had learned and to grade papers. Then the guard I knew from my prior lock up,wrote me up and they charged me with gambling. I was angry and all stress out with what was going on. They stuck me in the solitary confinement. I do not remember what happened after they locked me up in the hole.
I laid down on the bunk and do not remember anything after that. Then I woke up on another tier and was mentally ill. I did not know at the time I was mentally ill and tried to commit suicide with a razor I had it did not do no damage though. I told the guard what was happening and they sent me to the hospital in Canon City. I hardly talked to authority, although I did not know what was going on so I told the doctor what was happening. He thought at first I was mentally ill, then changed his mind and just ordered me sleeping pills. He asked where I would like to go back to Buena or where. I told him right there behind the walls. I could not go back and face my friends with something that happened that I did not understand. I stayed mentally ill in Canon City untill about a week later the nurses told me the doctor had ordered me sleeping pills. They were called halcyon. That brought me around and they moved me to population. Next week I will tell how I was released and the State Hospital. JUST A REMINDER THAT THE RECOVERY BLOG IS MOVING TO A NEW ADDRESS: OUR NEW HOME IS: http://mhcd.org/blog

Mentally ill in Prison

They have mentally ill prisoners in Supermax prison in Florence, Colorado. That is what this article says: “Inside the nation’s most locked-down federal prison, inmates shout, cry, talk to themselves and bang on their cell walls for hours at a time, according to a new lawsuit filed in Denver.” It is the most horrible thing to be locked up when you are mentally ill. I remember, I stayed in my cell and when they asked if I wanted to leave to go to population I would say yes. Then when it was time to move I would get paranoid and not leave.
In this prison they are locked up for twenty three hours a day. “They swallow razor blades, smear feces around their 12-foot-by-7-foot cells and mutilate themselves with sharpened chicken bones. One inmate amputated two of his fingers.” You are not right in the mind so of course they do those things to themselves. A sane person would go insane in the regular prison. I can understand why they would file a lawsuit to get out of there.
The suit says: “…alleges that Bureau of Prisons official are transferring prisoners with diagnosed mental illnesses to Supermax, in violation of the bureau’s policies against housing such inmates there. The suit claims that the prison then basically stops treating those inmates’ mental illnesses including sometimes taking the inmates off prescribed anti-psychotic drugs-making it difficult for the inmates to ever prove they can be transferred out of Supermax. The strict security often worsens the prisoners’ mental-health problems, the suit alleges. That was the worse when I was locked up, being off medication or not having any medication.
I can only hope they fix the problem even if the only way is a lawsuit. I was locked up in eighty nine. There was not that many mentally ill in prison at that time. I know it is worse by now. They would ask why I was not in population. I would never say because I did not understand myself. It is hard on the mentally ill and also on the other inmates.

Mental Illness

I came across this article on the web this week. It is titled “The beginnings of mental illness” it talks about what they believe causes mental illness such as schizophrenia. “Schizophrenia, for example, is often thought as a genetic disorder. But environmental factors can also boost risk-sometimes considerably.” It goes on to talk how stress is involved in mental illness. I believe it might have a lot to do with stress.
They go on and talk about why they think stress and inflammation caused by the stress has something to do with mental illness. “Inflammation is a key part of the stress response. It has also been linked to a variety of bodily ills, from diabetes and heart disease to depression and Alzheimer’s disease. I see inflammation as one of the chief evils in mammalian biology, Pace says.” It has so much to do with other diseases. It should be considered also in bringing about mental illness.
One of my triggers for mental illness is anger. That is what brought on my mental illness the first time. It was the angriest I had ever been. I thought at the time that the prison officials were doing be wrong. I just remember being taken to the hole in prison and I was just angry and they locked me in the hole and that is the last I remember until I woke up on another tier after my time in the hole was done. One of the guards that wrote me up for gambling in the first place said he did not write me up because of me. He said he did because he was scared I would get hurt.
At the time I did not understand I was just angry at the fact that I was going to the hole and going to have to start my time at the beginning of prison and work by way back all the way to the place I was at in the prison system there. I was at the top of the prison system where you could wear street clothes.
Later when I thought about the guard was right he knew me and everything else that was going on at that time made me make the wrong decisions that I did. I cannot change what happened. Although it was the right time to bring this mental illness on me or I would not have made the changes I did in my life if it would have happened at a later time in my life.
Stress brings on so much in our lives that is not good. I believe that this article for me explains a little of what havoc stress can play.

Mentally Ill

Last week I wrote about Andrew Steward’s Youtube video. Another thing that hit home on his talk was when he said he drove after leaving college for the day. He was driving on the interstate in California. I did not drive the time of my mental illness. Although, I do remember walking around Denver at night, I can remember all the cars and there seemed to be a lot. More than likely it was because I was mentally ill. I also had been recently released from prison. I also felt at the time as part of my delusion that the cars were circling and following me. When I am not mentally ill I do not pay that much attention to cars or people that are out and about. Although the times that I was ill, there always seemed to be more people, and cars than usual, if I was driving that night. I would probably have killed myself or wrecked a car. I could not dive in that condition. I do not know how he did it with all those delusions going through his head. It is a time I would rather forget. I can also remember hardly sleeping when I was mentally ill. That is also very hard on a person. Another part of my mental illness was hearing messages from the radio. I would play a cassette tape in my stereo and it seemed like it was talking to me. I would shut off the radio even though I like music. I thought at the time they were talking to me from Canon City the prison. That also is hard to understand. I know people who are going through it now are having a rough time. I am happy they did force medications on me. To stay that way for any longer would have been inhumane to be now that I am not ill.

Life Changes

Last week I wrote a blog about how I do not understand depression. I would like to clarify that statement. I know people have depression, although for me with all I have been through it is hard for me to get depressed. I have been told when I was at the State Hospital that I looked depressed some days. It did not last though because I had to always have known that someday that I would finally get out. It took forever though. I think what keeps me going though is hope and the knowledge that nothing last forever. I know that no matter what the situation is it will get better. I was once sentenced illegally to nine years in prison. I should have been allowed an appeal bond. That is where I first became mentally ill. I was thinking about that situation the other day. That Judge taught me a big lesson. I will not ever put myself in that situation again. I do not believe she meant for me to become mentally ill. After that I went to the State Hospital, because I was mentally ill. That was hard time and a very depressing place. The reason I say it was hard time is because you have a lot freedom that you would not have in prison. You wear street clothes, go for walks and you can even buy regular food from their restaurant. I would have rather did my time in prison. Because even though you had freedom you could not leave. Another reason it was so hard was when you did go for walks. You met people who would only be there for a week or a little longer. I had to stay a lot longer than that. I’ve been through so much that I know after a while it will change.