Mental Health

Much was made of the tragic, self-inflicted gunshot death, of Sen. Creigh Deed’s son over Thanksgiving. It once again focused attention on Virginia’s broken mental system. I have written regularly about the large number of over-medicated inmates and their “thorazine” shuffle, how prison psychiatrists write prescriptions for “cocktails” of multiple anti-psychotic meds with little or no actual treatment being offered.

      And it is even worse. Forget the long-term health concerns from poorly managed anti-psychotics; there is the lack of coherent mental health care on site that is equally appalling.

      The prison employs three women in a “psychology” office. Problem is, none are psychologists. All three have BAs in psychology but nothing further. They serve as “gatekeepers” – they make “treatment” recommendations – for the D.O.C. psychiatrist who literally is a “Doc-in-the-box.” Medicated inmates speak to the psychiatrist via videoconference for less than 5 minutes every 90 days. There is no other medical treatment except blood work (these psychotropic drugs can cause liver damage).

            The “psychologists” are quick to offer diagnosis and place an inmate in a category: bi-polar disorder; schizophrenia; depression; there is a “top ten” list and men are neatly packaged into them. But, without meaningful one-on-one care all that is done is place the men in a drugged stupor. And these labels – so easy to attach – become self-fulfilling. These labeled men then tell you they can’t “help” their behavior. They have a “disorder.” And they use the disorder as a crutch; and they believe they are entitled to disability and release from prison without addressing why they did what they did. They are lied to repeatedly about their condition and then over-medicated and under treated. They go home and fall back into the same self-destructive lifestyle. And they return.

            That isn’t mental health. Many men here have significant psychological issues. However, the answer isn’t always high doses of mind-numbing chemicals and catch all diagnoses chosen from the newest DSM like one would order off a menu. Legitimate mental health education requires one-on-one treatment and regular assessment and control of prescription medication. That doesn’t happen in here.

            Like most things involving the Virginia Department of Corrections, mental health treatment exists only as words not as a real program. The cost – to provide actual in-patient treatment – would be staggering. Instead, the men are treated like cattle at a slaughterhouse. Each night forty to forty-five of the seventy-two men I reside with line up for pill call. And they have their pills placed in small Dixie cups – Seroquel, Prozac, trazadone, thorazine, the list (and the pill colors) are endless.

            They take their pills, numb their minds, and stagger back to their bunks. Some day they will be released; but what are the ramifications for DOC’s mental health failure? What indeed.