We are the surrogate mental hospitals now,” says Larry Chandler, warden at the Kentucky State Reformatory in La Grange, Ky. With the rising number of mentally ill, the reformatory was forced to rebuild a system that was designed for security. Never intended as mental health facility, treatment has quickly become one of their primary goals.
Unfortunately, this situation is not unique to Kentucky. The continuous withdrawal of mental health funding has turned jails and prisons across the US into the default mental health facilities.
A 2006 report by the U.S. Department of Justice shows that the number of Americans with mental illnesses incarcerated in the nation’s prisons and jails is disproportionately high. Almost 555,000 people with mental illness are incarcerated while fewer than 55,000 are being treated in designated mental health hospitals.
In Kentucky alone, it is estimated that almost 25 percent of all Kentucky prisoners are afflicted with a serious mental health problems such as schizophrenia and bipolar disorder.
The problem with the mental health system in our country did not spring up overnight.
“There was a shift in the way our society sees mental illness,” says psychologist Dr. Stephanie Roby. “We saw a fallout from the 60s when we were institutionalizing everyone. Society reacted by saying the community needs to be more responsible for these individuals.”
The goal was to reduce the number of mental health patients housed in government-operated institutions and to shift the care to local communities where programs would be created to handle their special needs.
“It was a great idea in theory,” says Dr. Roby. “Unfortunately, mentally ill people do a lot of inappropriate things, they are misunderstood, they commit crimes and then they end up in CPTU.”
Kentucky’s CPTU
To alleviate the strain in the state’s prisons and jails, the Kentucky Department of Corrections decided to concentrate its efforts in one location and created the Correctional Psychiatric Treatment Unit at the Kentucky State Reformatory in 1998.
What started out as a 13-bed special unit has grown to a 150-bed treatment unit for the state’s most severely mentally ill inmates. Staffed by licensed mental health professionals, the unit provides crisis intervention, stabilization and individual counseling.
“We are a mental hospital right here in prison and there is no difference other than the clients are incarcerated and they are called inmates,” says Kevin Pangburn, mental health director for the Kentucky Department of Corrections.
“As soon as you walk through the doors, you hear people screaming, kicking their doors and crying,” says Matthew Estepp, an inmate at Kentucky State Reformatory and an inmate watcher in CPTU. Although CPTU is located within a reformatory, “it’s like walking into a different world,” he says.
The goal in CPTU is “to stabilize people and get them in the least restrictive area as safely and as expediently as possible,” says Dr. Tanya Young, CPTU program director and psychologist.
The unit consists of three wings. The inmates placed in C wing are on 23-hour lockdown and evaluated for the purpose of stabilization and receive the most intense supervision. The other two wings in CPTU, A and B, are for those who have been stabilized in CPTU but the doctors believe need more monitoring and structure but don’t need to be locked down for 23-24 hours a day.
The hope is to move the inmate out of lockdown and isolation as quickly as possible and into A or B wings. Once they are stabilized in CPTU, the aim is to send them back into general population in the prison system or society depending on the length of their sentence.
“If they can’t mainstream in this population, surely they can’t exist outside of here when all of this support is pulled,” says the warden. To view more of more of Jenn's photos and videos click here:http://www.jennackerman.com/trapped/feature/
Julia Lish, a correctional officer, comforts an inmate during one his psychotic episodes. "Its going to be OK," she repeats as he cries and yells to the voices in his head. "They are rejects of society and warehousing them in prison isn't the way to go. Most of them don't have life sentences - they will get out some day." says psychologist Dr. Tanya Young. Locked down for 24 hours a day, many inmates spend their day staring out the window of their cell. "What do they do when they get out? There needs to be something else to absorb them or take them in," she adds. 