Ryan Allison, the Utah State Prison (USP) inmate who died late last year after diving headfirst into the floor of his cell, was a Disability Law Center (DLC) client. Prison treatment notes and Mr. Allison’s conversations with us reveal near constant auditory and visual hallucinations. Misbehavior related to his mental illness led to punishment in solitary confinement, which in turn led to further deterioration, further misbehavior and additional time in solitary. From 2011 to 2013, he spent over 586 days in solitary confinement.
National estimates reveal that somewhere between a quarter to a half of all jail and prison inmates have a mental health diagnosis. USP administration reports that about 25 clinicians and therapists serve around 2,000 offenders with serious mental illness between the Draper and Gunnison sites. While the prison mental health staff does their best and deserves credit for taking on one of the most difficult jobs imaginable, they are hard-pressed to provide anything beyond “crisis management.”
As a first step in addressing the critical shortage, Gov. Gary Herbert’s budget recommends around $1 million to hire about nine additional medical and mental health clinical staff members. At a minimum, the prison mental health system must be funded at the level necessary to fulfill what is both a legal and moral duty.
Numbers like these are also why the DLC strongly endorses the governor’s $10.5 million request to implement the recommendations of the Justice Reinvestment Initiative (JRI). The JRI’s goal is to reform the criminal justice system in ways that reduce cost, reduce recidivism and keep people out of the system altogether. We especially support the effort to increase the availability of mental health and substance use disorder treatment in the community. Additionally, we hope the commitment to establish consistent standards and measures for community-based providers serving individuals involved in the criminal justice system who have substance use disorder or mental health needs will improve the quality of care available to their non-criminally involved clients as well.
On a related front, Department of Corrections (DOC) leadership has said that, whether the prison moves or is rebuilt, one of their objectives is to reduce reliance on solitary confinement as a response to behaviors resulting from serious mental illness. They are looking to accomplish this through changes in policies, procedures and practices. They also hope to design and build a facility dedicated to treating inmates with significant mental health needs. However, they think it would be difficult to retrofit the current site to realize this vision.
The DLC has no position on whether or where the prison is located. Rather, we want to make sure it is reasonably close to a pool of highly qualified staff and offers easy access for families, as well as approximately 1,200 volunteers who visit regularly. What we do care about is that Utah takes advantage of these once-in-a-lifetime opportunities to rethink the way the criminal justice system delivers treatment and support to offenders with significant mental health needs. If it does not, all of us had better be prepared to answer for more needless tragedy.
Andrew Riggle is the Disability Law Center’s public policy advocate. The DLC is the state’s designated protection and advocacy agency for Utahns with disabilities.