The Costs We Never Think About

Emotions spilled over as a mother testified before the Joint Audit Committee about her son, Jared, who had been in and out of jail. People thought Jared had drug and alcohol problems. But the real problem was mental illness.

Jared took medication to control his illness.  But while in jail, the dose of Jared’s medication was cut by three fourths and later completely taken away. It took three months to get the drug back.

Meanwhile Jared got in a fight and spent more time behind bars.

“I wish there were more, less expensive resources to help before we got to prison,” said his mom. The ‘we’ she used told me a lot about how Jared’s problems affected his whole family.

The cost of corrections is one of the hidden problems in our state budget. Few think about the cost to ‘lock someone up and throw away the key.”

Incarcerating someone with mental illness often costs the state $50,000 a year. A recent audit of the Department of Corrections (DOC) showed nearly one third of inmates are mentally ill.

Last week, I chaired a Joint Audit Committee hearing on the audit of inmate mental health care. During four hours of testimony I learned more about the high cost of keeping mentally ill prisoners. The evidence that mental illness is not well managed in prisons was striking.

Mentally ill inmates are responsible for eighty percent of assaults on corrections staff. Wisconsin’s inmate suicide rate is twice that of other states and 80% of suicides are committed by mentally ill inmates; 90% of those who injure themselves are mentally ill.

Medications are used to manage inmate mental illness. But too often these drugs are administered, not by nurses, but correctional officers with little or no training. In many cases, the officers do not even know an inmate has serious mental illness.

The psychotropic drugs used affect different people different ways and can have serious side effects; sometimes the side effects mimic ‘acting out’ behavior.

When inmates misbehave they end up in solitary confinement. This is a very expensive place to keep mentally ill inmates who act out because their drugs are not adequately monitored.

All neighboring states have nurses deliver inmate medications. For twenty-five years, correctional officers sought to change the practice in Wisconsin’s prisons. But DOC officials responded by saying the change would drastically increase costs.

These problems have now reached the court system.

A recent court injunction required nurses to administer medications at Taycheedah, the state’s only women’s prison. This legal action was just the latest in a long history of problems with the DOC and the courts.

Since 2003, eighteen cases related to inmates’ physical or mental health cost the state $6.2 million in settlement or litigation. The Governor added millions to this year’s proposed state budget to settle a federal Department of Justice complaint about inmate mental health at Taycheedah.

We must not ignore these problems until they result in costly court costs, large settlements, wasted lives and unsafe streets. I will be working with a few of my colleagues to create a ‘road map’ to be smarter about caring for those with mental illness in our correctional system and helping them successfully re-enter the community.

The hidden costs of mental illness in our corrections system is paid by all of us.

If proper medication and community mental health treatment could have kept Jared out of prison, it makes sense to take his mom’s advice and invest our dollars in critical community resources for those who struggle with mental illness.