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Thursday, January 2nd, 2020

Marketing Psychiatric Drugs to Jailers and Judges

Author:     MAX BLAU
Source:     The Atlantic
Publication Date:     31 December 2019 | 12:00 PM ET
 Link: Marketing Psychiatric Drugs to Jailers and Judges
Stephan:   Since Nixon closed most of the government-supported mental facilities back in the 70s, the American gulag has become America's largest health system for psychiatric and psychological care. Today if you have a psychiatric issue and little money, and you act out in your illness, you are most likely to end up in prison. And in prison, as you can imagine, your care is, well, likely to be more like Bedlam than a modern hospital.  But Big Pharma has suddenly realized that mentally ill prisoners can be used as valves to further tap the public treasury, so we probably have a future in which over-medicated zombies will make up a large percentage of the prison population.

A prisoner visiting the prisoner nurse to get his daily medication. Credit: Pictures Ltd./Corbis/Getty

On a rainy Monday morning in April, more than a hundred sheriffs, doctors, nurses, and jail guards from around the country sat in a ballroom on the outskirts of Nashville, sipping on coffees and listening to Daniel Potenza, a psychiatrist from New Hampshire, describe one of their most vexing problems: treating schizophrenia.

The conference, on medical care inside America’s jails and prisons, had been put on by an organization that sets standards for treatment in correctional facilities. Potenza paced the stage, talking animatedly about a national mental-health epidemic that had burdened jails and prisons. He flipped to a presentation slide showing that nearly half of all inmates diagnosed with schizophrenia were “non-adherent,” meaning that they weren’t taking their daily medications as prescribed.

Then, Potenza suggested a solution: a single shot of long-acting antipsychotic medicine, whose effects last for as long as three months, administered to patients while they’re still incarcerated. To show how this might help, Potenza […]

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2 Comments

  1. David Center on Thursday, January 2, 2020 at 10:13 am

    If former President Nixon had anything to do with deinstitutionalization it was not major. Two Democrats were much more intimately involved:

    1963 – President John F. Kennedy signed the Community Mental Health Centers Construction Act. It provided federal funding to create community-based mental health facilities. They would provide prevention, early treatment, and ongoing care. The goal was to build one for every 125,000 to 250,000 people. That many centers would allow patients to remain close to their families and be integrated into society. But it ignored statistics that showed 75 percent of those in hospitals had no families.

    1965 – President Lyndon B. Johnson signed the Social Security Amendments of 1965. It created Medicaid to fund health care for low-income families. It did not pay for care in mental hospitals. As a result, states transferred those patients into nursing homes and hospitals to receive federal funding.

    The emphasis on community services resulted in a shift to services for persons with mild problems rather than serious mental illnesses, which was abetted by another Democrat, President Carter. Finally, any remaining hope for community treatment for serious mental health problems died at the hands of a Republican, President Regan. President Regain placed the funding for such programs into block grants going to the states and over which they had the discretion to allocate funding were they perceived the need was greatest.

    1977 – Only 650 community health centers had been built. That was less than half of what was needed. They served 1.9 million patients. They were designed to help those with less severe mental health disorders. As states closed hospitals, the centers became overwhelmed with those patients with more serious challenges.

    1980 – President Jimmy Carter signed the Mental Health Systems Act to fund more community health centers. But it focused on a broad range of a community’s mental health needs. That lessened the federal government’s focus on meeting the needs those with chronic mental illness.

    1981 – President Reagan repealed the Act through the Omnibus Budget Reconciliation Act of 1981. It shifted funding to the state through block grants. The grant process meant that community mental health centers competed with other public needs. Programs like housing, food banks, and economic development often won the federal funds instead.

    2004 – Studies suggest approximately 16 percent of prison and jail inmates or roughly 320,000 people were seriously mentally ill. That year, there were about 100,000 psychiatric beds in public and private hospitals. In other words, three times as many mentally ill people were in jail than in a hospital.

    https://www.thebalance.com/deinstitutionalization-3306067

    Clearly, some of the folks in prison need treatment. This is probably not the ideal or even the best way to get treatment to them. It could also be argued that many of them shouldn’t be in prison,especially if they aren’t responsible enough to be held accountable for their actions. However, that is a separate issue. If they are there and need psychiatric medication then so be. Hopefully, they won’t exercise their constitutional right to refuse treatment. As for the general prison population, they too have a constitutional right to refuse treatment, if the courts haven’t deemed incarceration to void such constitutional rights.