A rose by any other name, Shakespeare wrote, would still smell as sweet.
In California the question is, does referring to a cage as a “therapeutic module” make it any less inhumane, despite the fact that a human being is locked inside a space that the Society for the Prevention of Cruelty to Animals might condemn as “cruel” if a dog or monkey were kept inside instead?
The question arose when California prison officials responded to a federal court ruling which held (about a decade ago) that leaving mentally ill prisoners who were confined in segregation units locked in their cells all day without treatment amounted to cruel and unusual punishment. Now those prisoners are allowed out of their cells for group therapy.
They are led in handcuffs (which are later removed) to individual metal cages about the size of a phone booth.
A steel mesh and, typically, a plastic spit shield separate the patient-prisoners from the therapist. As the prisoners sit or stand in their cages, the therapist, wearing a stab-resistant vest, conducts the “therapy session” – sometimes in the middle of living quarters where other prisoners can observe, overhear and taunt.
“It’s bizarre,” said H. Steven Moffic, a psychiatry professor at the Medical College of Wisconsin, who has written about the possibilities and practices (not yet adopted in California) of treating patients in prison using less imposing restraints. Comparing California’s procedures to those depicted in the movie The Silence of the Lambs, Moffic observed that “it has a Hannibal Lecter quality to it.” He added, “I’m not quite sure what the clinicians think they [the patients] are going to get out of it.”
Others share Moffic’s view. Terry Kupers, a Berkeley psychiatrist who testified as an expert witness in Coleman v. Wilson, the case that forced California prison officials to upgrade the level of mental health care provided to prisoners, said, “Those cages are an abomination. They train people that they’re not human, that they’re animals.”
Jane Kahn, one of the attorneys representing the prisoners in the Coleman litigation, opined that it is difficult to foster the sense of confidentiality necessary for worthwhile therapy when there is no shield from the prying eyes and ears of other prisoners who are not involved in the mental health program. “You go down for therapy and there are guys screaming and yelling at you from every floor,” she noted.
For their part, California prison officials say they are trying to make the best of a difficult situation by making the court-ordered treatment available to all mentally ill prisoners, regardless of how dangerous they may be. As of 2009, some 36,000 prisoners – not quite a fifth of the total California prisoner population – were involved in the mental health program, with the overall cost of treatment estimated to be $358 million. About 3,500 of those prisoners (nearly a tenth) were confined in segregation units, most for disciplinary reasons and others for administrative reasons.
The state is considering alternatives to its “therapeutic modules.” Sharon Aungst, the California prison system’s Chief Deputy Secretary for Health Care, noted with seeming approval the use in New York state prisons of chairs with desks that come down over the prisoners’ legs, locking them in place. This not only leaves prisoners free to move their arms, but gives them a writing surface as well. Equally if not more importantly, at least from this writer’s perspective, by removing the cage a physical and emotional barrier to effective treatment is also removed.
The debate is heated. To Jeffrey Metzner, the Colorado psychiatrist who advised prison officials to refer to the cages as “therapeutic modules,” the terminology “is important, because if you call them cages, people inside might feel like animals and respond accordingly.”
To San Francisco psychiatrist Pablo Stewart, on the other hand, the situation is less nuanced and more reprehensible. “You’re not fooling anybody with some ridiculous euphemism,” said Stewart, an outspoken critic of the California prison system’s approach to mental health care delivery in general and the cages in particular. “This is one of the more horrendous examples of what goes on in the California Department of Corrections.”
Source: Los Angeles Times
As a digital subscriber to Prison Legal News, you can access full text and downloads for this and other premium content.
Already a subscriber? Login