Thursday, September 17, 2009

Mentally ill prisoners, homeless the focus of media report but not national healthcare debate

Josh Rushing from Al Jazeera's English-language news has produced a quite well done, two-part video report on the mentally ill in US prisons, focusing particularly on Texas prisons and the Harris County jail (which is the largest mental institution in Texas, according to the report). See:
The two pieces run around 20 minutes all told and are well worth watching. Part one in particular contains some good interviews with staff and inmates at the Harris County Jail and hones on the relationship between homelessness and the criminalization of the mentally ill. Part two focuses more on the politics and history of how we reached this sorry state and also contains some interesting interviews with volunteers from our friends at Restorative Justice Ministries as they greeted prisoners fresh out of lockup in Huntsville.

An excellent point raised by Rushing is the near-complete lack of discussion about providing mental health services in the ongoing national healthcare debate. I'd also noticed that nobody in D.C. is talking about mental health and have wondered how the "individual mandate" for people to buy insurance will work with people who are homeless and mentally ill.

Kudos to the Harris County Sheriff for letting Rushing in the jail for interviews with inmates, medical staff, and front-line jail personnel. The state prison system refused, which I thought was bad form. Everybody knows we have a serious problem with warehousing the mentally ill in prisons and jails; there's no need to be close-lipped with the media about what's happening inside public institutions.

RELATED: From, see "Loathsome Prison Conditions for the Mentally Ill," covering a recent Congressional hearing on the topic.

Related Grits posts:


PirateFriedman said...

how the "individual mandate" for people to buy insurance will work with people who are homeless and mentally ill

I really hate this healthcare plan, but I can't really say your objection is a valid one. Most poor and mentally ill are covered by Medicaid. And the most recent plan calls for a significant expansion of medicaid. But we can still hope the plan fails...

Stan said...

Rothbard: Most ... mentally ill are covered by Medicaid.

No we're not actually. Most of us are working menial jobs and just about making it. The maze through which one must be escorted for state assistance is designed to be unnavigable. This autistic would be removed from the economy by so little as involvement in a traffic accident.

Suicide is be preferable to getting back into "the system". I lost many friends forced into that decision.

editor said...

Generally, the only indigent population eligible for Medicaid are children, pregnant women, and the severely disabled. Most poor and most mentally ill are NOT covered by Medicaid. Merely being poor does not make one eligible for Medicaid. To receive Medicaid for those with a disability (ie, severe mental illness) one has to receive SSI. To receive SSI, one has to prove that he or she can no longer earn SGA (just under $1000/month) as a result of that disability. That task often takes years.

Anonymous said...

My brother in law was hit head on in automobile by a bunch of kids throwing eggs at people's houses. the impact caused his small truck, which his wife was driving, had her turn signal on to turn left, was stopped, but yet the car hit them, rolled them,causing him to suffer a fracture C5-6 fracture.

This fracture left him a quadreplegic. My husband his brother had to work for over one year to get him on Medicaid and the next year year had to prove he was still a quad. This went on for 5 years. Finally, the State Medicaid got the picture, but the hell my husband went through each time and the mental stress on him, his brother and sister in law took a toll on all of them.

The Medicaid in Texas stinks!! There is not enough money, no one is in charge and once a quad, to my knowlege, and I do have a medical degree, one does not recover from that injury, it is permanent.

Imagine someone with a mental illness, put into prison, has no one to assist him trying to get help; virtually impossible.

The healthcare plan should be good for those who do not have good insurance. But to those of you who do enjoy those high deductibles and questions from the insurance company doubting your claim? I want a healthcare plan, one that gives options to healthcare even if it is run by private companies, you know the ones who make the big bucks and pay our legislators the money to fight the plans and make the fuss and cause confusion; it is time for our elected officials to get of their behinds and do something for the good of the people, I truly hope people are taking names of those who are making the fuss and those complainers loose their positions in the next election.

Go healthcare, it won't be perfect, but to those who have no insurance, it will be a God saving solution.

PirateFriedman said...

09:39:00, I'm really sorry that happened to you. I can understand your desire for healthcare.

While I am currently uninsured, I don't want any healthcare reform because I don't think its right for the rich and upper middle classes to be taxed to pay for my needs, any more than its right for me to get a handgun and rob them so I could afford to send my kids to private school.

Lynn said...

So Pirate, is it fair then if some major medical disaster should befall you (god forbid) and then you have to go to the emergency room and can't pay for it because you're not insured, and the exorbitant costs are passed on to the rest of society? I work in state government and county commissioners are always complaining that the rising costs of indigent healhhcare are eating up more and more of the county's budget each year (i.e. tax payer's money).

editor said...

Rothbard, when the indigent & uninsured show up at the county hospital emergency room with an exacerbated condition, let's say, pneumonia, that costs $5000 to treat, who do you think pays for it? The "rich." I am one of these so called, "rich," and I would rather donate my money to pay for the $10 preventative treatment (vaccination), then forced to pay the $5000 via an increase in doctor bills. Whether you are being taxed via the government or the hospital increasing their charges to cover those that don't pay, the "rich" are stilly paying for indigent healthcare. It just makes more sense (dollars and cents, too) to me to pay for preventative measures, instead of hiding behind the misguided idea that we are not paying for it now (at a higher rate)!

PirateFriedman said...

Lyn, of course I hate the fact that doctors are forced to treat people who come in, regardless of whether they can pay. If it were up to me, someone like that would just die waiting for a doctor.

But if socialism got us into this mess... is more socialism going to get us out?

By the way, the Baucus plan isn't really holding anyone accountable. Some lower middle class may be forced to buy insurance, but it will be significantly subsidized by the government. So instead of hospitals eating the costs, now the government will eat them. Is that really a solution?

PirateFriedman said...

Editor, you are mistaken to think prevention is always cheaper.

If the vaccine costs $10 and the ER care costs $5000, then the break even point is if more 1/500 people get sick. If less people get sick, prevention is more expensive.

Anonymous said...

The thing about prevention and treatment is that:

When the guy you run into in Wal-Mart has TB, he can give it to you.

When will people "get it" that preventive care benefits everyone, even folks who don't get the "preventive care".

Pirate Rothbard reminds me of a conversation where I listened to all that is wrong with the current system for 20 minutes. Then I asked, "Don't you think we should fix it?" The answer was "No, the Government can't fix anything".

I'm not sure the Government can fix all the problems with our healthcare system either. The difference is that I sincerely think they should fix everything they can and try to fix everything else.

Lynn said...

Pirate, you really hate the fact that a doctor would have to treat you in the emergency room without knowing if you can pay? So if you're in a terrible car wreck in critical condition, instead of treating you, they are going to need some ID first and then find out if you're insured, or what your bank account balance is, any income and assets etc. and if you die in the meantime - oh well. Yeah, this is a great way to run a society. And where shall we let all these people die? In the gutter in front of your house perhaps? You said you're not insured, so unless you're wealthy, chances are you couldn't foot the bill for a medical emergency, and therefore they should let you die too? Why don't you just put a sign around your neck saying "in case of emegency, please let me die in the hopes that some rich guy's taxes won't go up, because that would be the real tragedy". You're one sick puppy. You may want to google "peasant mentality" to diagnose yourself. Geez.

PirateFriedman said...

Lynn, I realize that the idea that stealing is wrong may seem quaint to you, but no need to resort to name calling to hide your ignorance.

Any moral laws apply to me too, so yes, let me die too if I can't afford treatment. Contrary to what you think, there won't be a huge avalance of people dying at once, so we can cart the bodies off ocasionally to pauper's grave's.

As far as your car accident scenario, I suspect incapaticitated people could have a card in their wallet showing the name of their insurance company, so they could prove their ability to pay.

editor said...

Are you saying you agree with social Darwinism?

PirateFriedman said...

Editor, you could call my views Social Darwinist, but I generally don't view them as such. Darwinism means survival of the fittest. I believe in personal liberty and property rights. I don't believe a doctor should be forced to treat anyone.

Anonymous said...

Pirate Rothbard, get a medical license, take the oath and then tell me you cannot treat anyone whether they have insurance or not.

I have a medical degree and the oath I took meant a great deal to me. I do not care whether someone has money, insurance or anything else, if that person is hurt, I am going to whatever I can do to help that person and it does not involve letting them die.

Anonymous said...

I don't think that it's just the mentally ill prisoners that are having a problem with homelessness.

This study lists mental illness as only one possible factor among prisoners in the issue of homelessness. The link, which I include below, is to a 2008 study from the Criminal Behavior and Mental Health Journal. The study concludes that

"Conclusions: Recent homelessness is far more common among ASFPIs than the general population. Prior incarceration, mental illness, substance abuse and disadvantageous socio-demographic characteristics were all found to be associated with homelessness among prison inmates, suggesting that there are several important factors in addition to efforts to survive with limited resources through criminal acts that influence the rates of homelessness among incarcerated individuals."

Other studies show that it's not just prisoners, but probationers and parolees that struggle with homelessness as well, totally apart from issues of mental health.

But just for fun, let's ask ourselves if it's homelessness that causes mental issues, or vice-versa??? (Or some combination in-between).

PirateFriedman said...

08:37:00, Good for you if you enjoy treating the indigent. If you’re really a doctor, perhaps you’re smart enough to read about free markets. There is a right way to dohealth care reform.

“Eliminate all licensing requirements for medical schools, hospitals, pharmacies, and medical doctors and other health care personnel. Their supply would almost instantly increase, prices would fall, and a greater variety of health care services would appear on the market”

Anonymous said...

Pirate, you've been reading far too much Ayn Rand.

Personally, I'd prefer that my Dr. has some credentials to indicate his education!

As for healthcare, you have no idea how lucky you are!

PirateFriedman said...

12:06:00, in a free market there would be private associations to issue credentials to doctors; you don't need the government for that.

It's an honor to be compared to Ms. Rand, but I'm not really familiar with her work. Being a believer in freedom doesn't require a prophet, it requires having the ability to analyze the consequences of the government action on society. And in health care, the consequences of government intervention are overwhelimingly negative.

Kyle Reynolds said...

Alot of the mentally ill are being placed in the prison system. And the psychopaths that need to be put in the jails are in the hospitals. Wow we still have a ways to come