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Mentally Ill Crowd Colorado Prisons

Like many states, Colorado has turned from state hospitals to prisons to provide care for the mentally ill. Since the mid-1970s, Colorado's mental hospitals have shriveled from 6,000 to 600 beds. Spending has dropped from 3.9 percent of the state budget in 1970 to 1.6 percent in 2005.

The Colorado Department of Corrections (CDOC) has taken up the slack. In 1991, the CDOC housed 239 seriously mentally ill prisoners. By 2003, that population mushroomed to 3,802, over 20 percent of the prison population. Mentally ill prisoners are far more expensive to house than other prisoners. The daily cost for the average prisoner was $71.91 in 2004. At the San Carlos Correctional Facility, the CDOC's 2S5-bed facility for the severely mentally ill, costs average $165.18 per prisoner per day.

The problem is rooted in the 1960s, when advances in medications allowed patients to be deinstitutionalized. Hospitals were replaced by out-patient community care. Recessionary budgets and state spending limits have since created wide cracks in the mental health care system. When the mentally ill fall through the cracks, they land in the criminal justice system, which is ill-equipped to treat them.

There are several paths to prison for the mentally ill. Some do not take their medications because of the side effects. Others self-medicate with drugs and alcohol. Many cannot maintain employment and end up homeless. If their behavior leads to contact with police, the police have few options other than jail.

Once jailed, a cycle of incarceration and release often results. While incarcerated, the mentally ill are often isolated, which may exacerbate their illness. They may be abused in the general population, also worsening' their condition. While they may be medicated while incarcerated, the CDOC releases prisoners with only a 30-day supply of meds. Those meds, furthermore, are usually older, less efficacious types with greater side effects.

When the meds run out, they have nowhere to turn. Pikes Peak Mental Health in Colorado Springs had funding for 2,741 uninsured patients in 2002. By 2005, funding had dropped to 470 patients. The same year, the CDOC released 100 mentally ill prisoners from San Carlos alone. San Carlos houses less than seven percent of the CDOC's mentally ill prisoners.

Budget cuts in 2003 forced the CDOC to slash its mental health treatment budget by 17 percent, or nearly $l million. In fiscal year 2005, only 0.8 percent of the CDOC's budget is directed to mental health treatment. As a result, 15 of the 26 vacant positions in the CDOC's Division of Clinical Services are for psychiatrists or psychologists. Doctors prefer not to work for the CDOC's low salaries.

The trends do not bode well for the future. Of the CDOC's new court commitments in 2004, 19.9 percent needed mental health programs, 82.3 percent needed substance abuse treatment, and 17.7 percent needed sex offender treatment. The Colorado Department of Human Services (CDHS) estimates that about 66,000 low income Coloradans have serious untreated mental illnesses or emotional disturbances.

Even though the CDHS noted that a mentally ill prisoner costs $60,000 per year while probation and community care costs only $7,000 per prisoner, it still requested funds to treat only one-third of the indigent mentally ill Coloradans. State lawmakers decided to revisit the issue in 2007. Colorado prisons, meanwhile, fill with the mentally ill.

Sources: The [Colorado Springs] Gazette, 8/28/2005; Rocky Mountain News, 12/14/05; CDOC FY2004 Statistical Report.

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