PROBLEMS FACING MENTALLY ILL INMATES AT LOS ANGELES TWIN TOWERS

The following are problems affecting the mentally ill in the Los Angeles Twin Towers. There are inadequate mental health services/poor treatment of this population of male inmates which lead to increase in suicide rates. Please read the red marks and provide research on the comments. Please read it through first to understand this project and focus on the ADVOCATES/SUPPORTERS/LOBBYIST/ORGANIZATIONS part first. Then the specific interventions and elaborations.

ATMOSPHERE AND ENVIRONMENT

Problem #1:

-Overcrowded

-Vermin-Infested

-Dimly-Lit, Noisy

-Unsanitary

-Depressive

-Physical Safety hazards

* Briefly say a little bit more about each and indicate how each of these can impact suicidal tendencies

Interventions:

*What are short term, long term solutions to tackle EACH of the issues above? (Be specific for each one)…below are some examples of solutions to remedy the concerns above. Remember, each intervention needs to be specific.

-Perhaps enforcing daily clean-up routine for inmates? (tackling the unsanitary)

-Change some of the lighting in the cells. Make them appropriate (not too bright, not too dim) tackling the dimly lit issue

-getting rid of ventilation grates or light fixtures where an inmate could attach a noose – and institute a series of other suicide prevention measures. tackling the Physical Safety Hazards (What are other S prevention measures?)

-Cells will be treated with anti-bacterial liquids to keep inmates

-The state must also address the aging infrastructure and inadequate treatment space in several prisons that hinder the department’s ability to deliver care. This plan sets forth a health care facility improvement program that will provide upgrades in existing prisons to ensure adequate environment

*Please provide more interventions than the ones I have already listed. I am just giving these as examples.

Cost-Budget Analysis/ Resources and means needed to implement:

The Governor’s Budget proposes an additional $500 million on top of the $1.2 billion already budgeted for jail construction. This funding needs to be expanded a bit further to include construction of mental health treatment facilities and substance abuse treatment facilities to accommodate the increasing number. (This is not that clear because it is talking about jail construction not specifically budget for environmental/hazard issues.)

*I need to know how much some of the interventions listed above might costs. Where would this budget come from? What is the current budget or resources for these types of things (lighting, cleaning, etc.)

SOLITARY CONFINEMENT AND ISOLATION

Problem #2:

- Solitary confinement is the practice of isolating a prisoner in a cell for 22-24 hours per day, with extremely limited human contact; reduced (sometimes nonexistent) natural lighting; severe restrictions on reading material, televisions, radios, or other physical property that approximates contact with the outside world; restrictions or prohibitions on visitation; and denial of access to group activities, including group meals, religious

- Mentally ill prisoners are sent to their isolated units that is specifically designed to keep dangerous and difficult inmates

- Inmates diagnosed with mental illness are disproportionately represented in the isolation units to which prison officials send their more difficult inmates

-The harsh conditions of being held alone in a cell 23 hours or more a day with little or nothing to do, coupled with the paucity of mental health treatment characteristic of such units, can lead to an increase in symptoms, more episodes of psychosis, and further misconduct.

- Self-harm is, in some ways, the clearest illustration of the break from normal mental health that accompanies isolation

- the vast majority of prisoners subjected to solitary confinement are neither violent nor incorrigible

-Prisoners in solitary confinement hallucinate, they deliberately injure themselves, and they lose the ability to relate to other human beings. When these prisoners are eventually released from solitary confinement, they have difficulties integrating into the general prison population or (especially when they are released directly onto the streets) into life on the outside.

- Solitary confinement accomplishes one thing: it allows corrections officials and politicians to appear tough on crime.10 But, this appearance is purchased in lost safety (for the public and for those who live and work in prisons), lost funds (to pay for the operation costs that are twice as high as general population facilities), and the lost lives of prisoners who are driven to psychosis and suicide.

Interventions:

- reduction in the solitary population was accompanied by a greater use of alternative forms of punishment, such as loss of privileges and confinement to a cell in the general population area. And, the prison enacted an incentive system that allows prisoners to earn access to more recreation while in solitary and earlier release from solitary (Maine). Positive reinforcement

- End solitary confinement for persons with mental disabilities confined in jails and prisons

-Develop appropriate punishment/consequences for the mentally ill (you may suggest some)

-how about incentive system? Extra phone call? Research if such as thing exist already.

Cost-Budget Analysis/ Resources and means needed to Implement:

-Is it costing more money to solitary confine prisoners? If so, how much per solitary confined prisoner in Los Angeles Twin Towers?

-Perhaps, justify that it would cost less money to do away with solitary confining prisoners. This money can be used to provide better mental health care.

-Who is in charge of implementing this proposal? If we were to propose the extinguishment of solitary confinement, who would we need to address? Who is in charge of this rule?

SAFETY CHECKS AND MONITORING OF INMATES

Problem #3:

-The staff is under trained for psycho education and are limited in their ability to identify suicidal behavior/tendencies of inmates.

-The guards do not ensure appropriate safety conditions of the prison cells and does not carry out frequent safety checks because inmates outmatch the number of guards

-Please add more bullets regarding the inadequate safety checks of guards and how overlooking suicide ideation or behavior has increased suicide

Interventions:

-hire more guards

-mandatory training/psychoeducation among guards and other staff who have significant contact with inmates- make sure they are aware of how to identify suicidal tendencies

-more frequent safety checks how often are these safety checks happening?

- Approved inmates are monitored by Sentinel Monitoring Company, using an ankle bracelet and telephone receiver. Over sixteen hundred inmates are placed on EMP annually (please do more research on this monitoring company. I am unclear as to what they do/what does this bracelet do?)

Cost-Budget Analysis/ Resources and means needed to Implement:

-how much to hire one guard?

-Perhaps JMET can arrange for this training program (mandatory for current and newly hired staff)

-need more research and info

OVER-MEDICATION

Problem #4:

- The Los Angeles County Jail spends $10 million per year on psychiatric medications.

-Treatment is often limited to medication and typically does not include other effective therapeutic mental health interventions and psychiatric rehabilitation programs

-Inmate patients are given medications instead of counseling

-Provide more research on the over-medication of inmates. How is this a problem? Provide statistics on the disproportional number of prisoners who are medicated

Interventions:

- Newer medications improve the quality of life of offenders. More importantly, they help to reduce overall health care costs by reducing long-term hospitalization, emergency admissions to psychiatric units, and indirect costs associated with transportation of offenders to DMH facilities

-Counseling sessions should be initiated instead of carelessly mass distributing psychotropic drugs

-other interventions to remedy the problem?

Cost-Budget Analysis/ Resources and means needed to Implement:

-How much do medications cost? Replace medication with more therapeutic services (groups)

-Are there psychiatrist in these prisons? Is JMET handling this? (only psychiatrist can distribute psychotropic medication

-Other means required to meet the interventions?

QUALITY OF THERAPY/CASE MANAGERS/ASSESSMENTS

Problem #5:

-General statistics of inmates in need of mental health services

· about 20% of county jail inmates are classified as mentally ill

· lack of space - mentally ill inmates are being placed with general population

· justify: suicide watch (what are the signs inmates are showing that they are suicide?), safety of law enforcement from violent bipolar inmates

-Quality health care is not provided to all of them since, the figure is rising since the rate of mentally ill prisoners is increasing

-Group Counseling Topics need to be EBP; ensure that they are not outdated and that they are culturally sensitive

Interventions:

-Adequate initial evaluation (utilize updated screening tools) and identification of who will require mental health services

-Hiring Interns through an established volunteer program (FREE) to provide therapy (run groups) or case management services

-Have more groups as opposed to individual counseling to minimize costs

-Mandatory regularly scheduled counseling sessions (whether individual or group)

-UPDATE Group Counseling Material/Not Culturally Sensitive; Ensure that they are evidenced based to enhance quality of services

Cost-Budget Analysis/ Resources and means needed to Implement:

-Determine how much each individual counseling costs and compare to group counseling

-intern-volunteer outreach to different graduated school programs

HENCE,

LONG-TERM INTERVENTION

Problem Areas #1-5 all have one issue in common OVERCROWDING AND OVERPOPULATION

-too many people leads to oversight, less resources for more people

-Hence, long term solution and remedy is to build a new state of the art mental health facility which is designed to only house the mentally ill. This facility will tackle all of the problem areas…It will have appropriate environment, trained/psychoeducated clinicians and staff.

-provide more info about this new state of the art facility

-What is the budget for this? When is this expected to be built? Who are the advocates of this extension? Who are helping raise money for this extension? What will the new site feature?

- Los Angeles County Board of Supervisors is considering a proposal to spend as much as $2.3 billion on a massive jail expansion , with a significant portion of that money going to facilities for mentally ill inmates, who currently make up nearly 20% of the jail population.

FINALLY,

ADVOCATES/SUPPORTERS/LOBBYIST/ORGANIZATIONS

Who are the advocates, supporters, lobbyist and organizations in charged with this promoting and spreading awareness about the inadequate mental health services and resources in the LA Twin Towers? who will help find resources and help implement/advocate this injustice in the prison system?

-

*remember that all of the research needs to pertain particularly to Los Angeles Twin Towers

References

Los Angeles County Jail Plan. Retrieved from: http://bos.co.la.ca.us/LinkClick.aspx?fileticket=ix1E9LERBSE%3D&portalid=1

Metta World Peace Talks Mental Health . Retrieved from: http://ridley-thomas.lacounty.gov/humanservices/index.php/category/top-stories/page/3/

Program for mentally ill inmates at Twin Towers to be expanded under L.A. County budget proposal. Retrieved from: http://www.dailynews.com/social-affairs/20150414/program-for-mentally-ill-inmates-at-twin-towers-to-be-expanded-under-la-county-budget-proposal

Y Melamed. Mentally Ill Persons Who Commit Crimes: Punishment or Treatment?

Retrieved from: http://www.jaapl.org/content/38/1/100.full

Preventing suicides in jails and prisons. Retrieved from: http://www.who.int/mental_health/prevention/suicide/resource_jails_prisons.pdf