Seventeen Washingtonians have been murdered over the past 13 years by men whose violent psychiatric disorders were known to authorities before they committed the crimes.
Of the nine men who killed those people, the most recent and notorious is Maurice Clemmons, who shot four Lakewood police officers a year ago after being paroled despite a documented history of mental illness.
Before Clemmons' murder spree, in a scathing 2008 article headlined “State pays in blood for flawed mental health system,” the Seattle Post-Intelligencer described 11 of the “preventable tragedies.” Award-winning reporter Carol Smith (now a senior writer at Investigate West), wrote that state laws combined with an “overburdened, ineffective mental health care system” enabled the homicides.
Chad Lewis, a family services specialist with the state Department of Corrections (DOC), agrees. “The common thread in those cases is mental illness,” Lewis said, and marshaling resources to deal with mentally ill offenders is a top priority for DOC Secretary Eldon Vail: “We're not oblivious” to the need for improvement. “We're more than just aware.”
The Concerned Lifers Organization at Monroe Correctional Complex is equally concerned. The group is currently trying to improve mental health care inside prison walls, through a series of presentations to visitors including UW Medical School residents in psychiatry and others interested in ensuring better treatment of people with mental illnesses.
Earlier this fall a friend who has led CLO religion seminars for many years asked me to join a group of five people invited to attend one of these presentations. At the prison's front desk we turned our pockets inside out, gave officials our car keys, and filed through a metal detector. A woman who manages family services programs joined our group and led us through a series of locked doors and yards, where razor wire coiled atop fences between guard towers, into a room with a circle of chairs. Forty inmates straggled in, greeted each of us in turn, and sat down with us.
The CLO was founded at Monroe in 1978 by prisoners “doing ‘life without,’” as they aptly call serving their sentences of life without possibility of parole. Members mentor shorter-term convicts in life skills and values that could help keep them from re-offending after completing their sentences. They host visiting groups of at-risk teens and tell them about the life behind walls that looms ahead of lawbreakers. They sponsor religion classes, lead a book club, and raise funds to provide poor students in the surrounding community with college scholarships.
Last December, shocked by the Clemmons murders, the CLO wrote a collective letter of sympathy to relatives of the police officers who died. Through their labor at the prison rate of 42 cents per hour they raised enough to donate about $2,000 to the families.
Prisons like Monroe have become America’s de facto new asylums. It’s a truth so often repeated that the phrase has become a cliché. As rising numbers of Americans with chronic psychiatric disorders are incarcerated, the total share of prison inmates in the U.S. with serious mental illnesses has climbed to 16 percent. This is the most conservative estimate, according to "Confronting Confinement," a 2006 report of a national commission on safety and abuse in America’s prisons. Many estimates put the number closer to 36 percent, or even 54 percent when individuals with anxiety disorders such as PTSD are counted in.
The unintended and awkward medical role of prisons debuted with the steady release of patients from big mental hospitals, a shift that began half a century ago. By 1996 this “deinstitutionalization” had reduced hospital populations by 90 percent. During the Reagan years many state asylums were shut down entirely to save public funds, and few of the community clinics that were promised as replacements got built. Since then, despite the fact that most people with mental illness can recover and live productive lives if they receive proper care, public programs for treating psychiatric disorders have been chronically underfunded across the country and in Washington state.
The consequences are visible on our city sidewalks and in our parks. People with untreated mental illnesses wander around disoriented and incapable of insight into their actions. Most are harmless (statistically speaking, they’re far less dangerous to your health than a ride in a car), and street thugs prey on them. Some try to medicate their disturbing symptoms with alcohol or street drugs, and some break the law. A 2003 report from Human Rights Watch, "Ill-Equipped: U.S. Prisons and Offenders with Mental Illness," quotes a former lead psychiatrist at Washington’s McNeil Island Corrections Center as saying, “The severity of the mental illness of those coming in is increasing…. The prisoners often have no idea how they ended up here.”
Monroe superintendent Scott Frakes summed up today's situation: “Too often people get the help they need only because they step over the line, have a law enforcement encounter, go to prison, and get assessed.” Necessary medical treatment follows those assessments because, Frakes said, “There are two groups in the United States with a Constitutional right to health care: veterans and prisoners.”
So although Americans in general have no right to mental health care, some get it as a belated sort of fluke — dragged in hooked to punishments for helplessly irrational actions.
The night I visited Monroe, a panel of inmates summed up prison policies regarding the diagnosis and treatment of mental illness and questioned whether prison staff always follow recommended policy. They also spoke about the fears that lead prisoners to mask their symptoms.
For example, they’re afraid that staff use antipsychotic medications not for therapeutic purposes but to tranquilize and control, and that inmates who seek treatment will be branded as weaklings who “can’t handle their time” or as crazy “dings” (“dingalings”). Others fear losing their eligibility for conjugal visits, for opportunities to transfer to units with more privileges, or for Family Sunday, an event like a fair, which one panelist summed up as “for fathers, one of the best things going.”
One speaker told us how he came to be serving a life sentence under the Three Strikes statute. When he was 12 his two sisters were killed before his eyes in a bizarre attack. He started drinking to forget, but remained functional enough as an adult to hold a job as a union ironworker. “I married a woman who helped me stay drunk and out of trouble for years,” he said, but when the marriage ended he lost his job and committed robberies while intoxicated. He said that staff during his first two confinements failed to follow a Western State Hospital directive printed on the record he showed us: With proper treatment, it is unlikely [this man] would re-offend. He concluded, “The system could have fixed me 30 years ago but didn’t.”
A shy man in his 20s who committed a murder when he was 15 told the audience that counseling at Green Hill School juvenile center helped him develop some of the skills he needed to start managing terrors and antisocial impulses born of what he called “family issues.” But when he aged out of Green Hill, he said, a friend he made at Monroe who had paranoid schizophrenia hanged himself after staff stopped his prescription for antipsychotic medications. The young man said the suicide terrified him, but when he asked for psychiatric help, he was basically told to get over it. Now he’s “scared of asking” for therapy.
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