California Revises Policy on Mentally Ill Inmates


NY Times:

California Revises Policy on Mentally Ill Inmates

California’s Department of Corrections and Rehabilitation has introduced new policies for the use of force against mentally ill prisoners that are among the most detailed in the nation.The changes, which were introduced on Friday, were set in motion after videos showed corrections officers in state prisons dousing severely mentally ill inmates with pepper spray and forcibly removing them from their cells. The videos drew public outrage and were called “horrific” by a federal judge who ordered the footage made public last year.

The department said the revised policies, filed in Federal District Court on Friday in response to an order issued by Judge Lawrence K. Karlton in April, represented “a systemwide culture change” in how correctional staff members deal with mentally ill prisoners. The corrections department worked to revise the policies with a special master appointed by the court and consulted on the revisions with lawyers for the plaintiffs in a long-running lawsuit over the state’s treatment of mentally ill prisoners that led to the judge’s order.

The increasing number of mentally ill prisoners in prisons and jails across the country — in 2013, mentally ill prisoners made up just over 28 percent of California’s prison population — has raised questions about their treatment in corrections systems poorly equipped to deal with psychiatric symptoms. Mentally ill inmates, whose challenging behavior often leads to their placement in solitary confinement, are frequent targets for a cell extraction — the forcible removal of an inmate from a cell by a tactical team equipped with Tasers, pepper spray or other less-lethal weapons — or for other uses of force by guards.

Judge Karlton, in his April order, ruled that the use of force and lengthy solitary confinement of seriously mentally ill inmates was unconstitutional and ordered the department to revise its policies.
California’s new policy requires that before there can be any use of force, a mental health practitioner must conduct an evaluation of the “totality of circumstances involved,” including the inmate’s medical and mental status and ability to understand and comply with orders. A “cool-down period,” during which a mental health professional attempts to de-escalate the situation, is also required.


Some work that was done in Pennsylvania.


Whatever whatever whatever. These things will continue to happen. There will never be a “culture change” until there actually is a culture change. Maybe if we didn’t wait until people were totally suicidal or manic before mandating acute mental care then this wouldn’t be such an issue. PS: the likelihood that psychotic patients will hurt anyone is low. Personality disorder patients tend to be vastly more violent (although this is still low).

If there is one aspect of medicine in the US that should be socialized it is most definitely mental health, imho, even before assisting the poor and elderly… yet such a large percentage of poor also have mental health needs.

Mental health in the US is the furthest along the spectrum of all subsets of medicine from completely dead and broken to a shining example of radiant patient care. I think you know to which side. Plenty like to vilify psychiatrists as evil money-grabbers… not to mention the fact that psychiatrists are one of the lowest-paid specialists (hour for hour they are paid very well but most choose to work a sane balance).

Anyway, I obviously don’t know the specifics of this case, but I feel confident in saying that if anyone, professional or lay, is threatened, then he or she should be free to prevent such a situation, either by fleeing or subduing. I may want to be a psychiatrist one day and if I do it, I will want to have a weapon in my practice (not on me).


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