Nebraskas County Jails Neglect Mentally Disabled
by Gary Hunter
Nebraskas American Civil Liberties Union (ACLU) has revealed major problems in the state's county jails. Prisoners with physical handicaps, chronic illnesses and mental disabilities receive little or no healthcare in a state where 1-in-33 citizens are arrested each year.
According to ACLU investigators mentally impaired prisoners suffer most. Nebraska exceeds the national average for incarceration of the mentally ill with a figure of 17.5% compared to 16.3% nationally. Yet the states mentally ill patients have less access to services than any other disabled prisoners.
The study showed that most county jails lack any type of on-site health professionals. Consequently, most mentally ill county prisoners receive no treatment. Of those that are treated only 16% receive counseling -- a fact that is sometimes fatal.
Robert Patona was prescribed medication to control his anxiety disorder. When he was arrested and placed in Sarpy County Correctional Center jailers ignored his requests and refused to give him his medicine. On July 15, 2002 Patona hung himself in the jail.
Another man with a history of mental illness spent four weeks in a small northeastern Nebraska county jail without his psychotropic medication. Both the man and his wife alerted jail staff of the prisoner's need but nothing was done. The man soon began to experience visual and auditory hallucinations. Only after ACLU intervention was the man sent to a facility that could provide proper care.
The Nebraska ACLU has also had to assist prisoners in obtaining such basic needs as interpreters, heart medication and HIV tests.
One prisoner was doubly victimized when she was sexually assaulted in Nebraska's York penitentiary then was denied her anxiety medication when she went to the county jail to testify against her attacker. County jail officials claimed it was standard policy to deny new prisoners medication. This policy prevented prosecution of her attacker until the victim could be re-stabilized when her anxiety attacks reappeared. The prosecutor had to make special arrangements with the jail so that the victim could continue her medication during future court appearances. Again, ACLU intervention was required.
Five reasons have been identified by the ACLU for the gross inadequacies of Nebraska's jails. Insufficient funding, discontinued Medicaid, jail standards do not address mental health issues, inadequate jail facilities and inadequate oversight of county jail standards.
Although prisoners are entitled to continue receiving medication prescribed prior to their incarceration they seldom get it. Costs for some meds are prohibitive and simply not within the budgets of small county jails.
Families are not allowed to supply the drugs for fear that they might try to sneak in contraband. Most small county jails have no medical staff and would thus have to pay all the costs and medical fees incurred with taking prisoners to a hospital.
Medicaid assistance is also discontinued when a person is incarcerated. Consequently, the full cost of medical maintenance falls to the county jail. Some local health providers work with local jails to defray costs. Others do not. The Nebraska ACLU suggests that a balanced standard be implemented to equally accommodate all county jails. They also point out that discontinuation of Medicaid immediately upon incarceration results in a higher recidivism rate for affected prisoners.
The ACLU also points out that Title 81 of the Nebraska Rules and Regulations governing jail standards say nothing about how jails should address mental health issues. They suggest that this is a primary concern to be addressed by the Nebraska legislature. The Jail Standards Board has submitted several proposals on medical issues without success. Medical standards for the state have remained unchanged for over a decade.
Closure of regional health centers in 2004 has resulted in an inordinate incarceration of mentally ill citizens. Again the smaller counties are hardest hit because they lack community-based services. Even most Nebraska hospitals do not have psychiatric wards. Consequently, mentally ill citizens are jailed; their care disrupted, and then they are released from jail with no discharge planning. This is a cycle doomed to failure.
Neither do any state-wide standards exist for handling complaints.
Prisoners with problems are ignored for weeks and even months at a time. Neither is any satisfactory appeal process in place. Most of those in need have never even heard of the Jail Standards Board. Even so, the board has little power and limited ability to help. For those in need of immediate help there is literally no solution.
Source: BARRED FROM HOPE: A Study of Healthcare in Nebraskas County Jails ACLU Nebraska
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