A Tie to Mental Illness in the Violence Behind Bars

By Dianne Frazee-Walker

Maj. Michael Gruver is all too familiar with the desperate howls and chilling sounds of clinking on steel bars as he makes his routine strolls down the halls of solitary confinement. Gruver, a correctional employee of the William P. Clements unit in the state of Texas oversees some of the men housed in isolation. Gruver admits working with a large mental health population can be grueling.  There are a lot of mentally ill inmates at the Clements Unit. 

Clements officers are qualified to deal with mentally ill inmates after completing a mere two and a half weeks of training. The main objective of the training is for equipping correctional officers to protect mentally ill inmates from harming themselves and others.

The Texas Tribune, a non-profit news organization has produced evidence from an extensive investigation of 99 Texas prisons that Texas prisons with high occurrences of violent behavior are linked to mental illness.

The research conducted for the six-year period of 2006-2012 indicates the prisons that reported the most significant numbers of violent related episodes within the walls of their facilities have significantly larger mentally ill populations.  Image courtesy vtdigger.org 

These troubling statistics worry Michele Deitch, prison expert at the University of Texas at Austin’s Lyndon B. Johnson School of Public Affairs. Deitch is questioning the competency of correctional administration to effectively address mentally ill inmates and maintain security.

Deitch claims the situation is too dire to overlook.

According to Texas Department of Criminal Justice data, out of the five facilities with the highest concentration of violence-related reports, three of them are psychiatric units. The William P. Clements Unit which houses 1,800 mentally ill inmates out of an inmate population of 3,500 is one of the five facilities in the category of high-violence.  The prison not only houses mentally ill inmates but it also has a wing dedicated to G-5 offenders, those considered the most dangerous. The prison has 448 cells for isolation; as of September 21, 2013, 435 of them were occupied.

Advocates of criminal justice reform and criminal justice officials have opposing views about the efficiency of handling mentally ill inmates within the prison system.  Supporters of revamping the criminal justice system believe the approach used to deal with mentally ill inmates is in need of serious improvement. Criminal justice administrators maintain mentally ill inmates are safely housed and provided with successful mental health programs.         

Barry Martin, senior warden at Clements, maintains the facility is doing an exceptional job of working with mentally ill inmates.

Despite Martin’s optimistic attitude about psychiatric prison programs, the numbers tell the true story. 

The most telling factor of how well Texas correctional facilities are taking care of  of mentally ill inmates is the perception of what constitutes a winning process for addressing mentally ill inmates.

Reports signify the Clements facility leads the way for violent episodes involving inmates and prison officials. The facility reported 6,600 confrontations involving assault, weapons, and disorderly conduct. Every year from 2006-2012, 25% of the inmates were involved in violent encounters.   

2011 and 2012 were busy years for violent episodes occurring at Clements. The facility leaped from fewer than 800 incidents in 2007 to 1,093 in 2011 and more than 900 in 2012.

The proof is in the pudding.

Smaller exclusively psychiatric institutions report the highest violence rates per capita. The average for 99 Texas prisons was less than 8 violent episodes per 100 inmates.  The Tribune’s investigation revealed that Lubbock based John Montford Psychiatric Unit  averaged 43 violent occurrences per 100 inmates from 2006 to 2012. Compare this data to the Beauford H. Jester IV Unit near Richmond, which houses some of the most violent mentally ill inmates in the system.  The Jester Unit reported 41 violent incidents per 100 inmates during the same time period.

Leaders at Clements and department administrators say the statistics do not reflect the hundreds of times when officers have prevented violence.

Deitch speculates, “Something is happening that’s causing inmates to act out in quite serious and dangerous ways, and staff do not have that situation under control.”

Cement’s method of inmate behavior control involves “major use of force” which is defined as officers forcing inmates to do something against their will. Major use of force was reported more than 3,400 times during the six-year study. The Montford unit, with a population less than one-third that of Clements, had more than 1,500 reports of major use of force during the same time period. Jester, with about 500 inmates, reported major use of force 900 times.

Is it possible for prison officials to prevent prisoner violence when officers use violent procedures to manage inmates? 

Supporters of prison reform believe changes in the way prisons handle mentally ill inmates are overdue because there is a significant nationwide trend transpiring in the criminal justice system. Current decades have witnessed the system being confronted with an increase in prisoners requiring psychiatric care.

The number of inmates treated for mental illness by the University of Texas Medical Branch, which provides most inmate care in Texas prisons, grew to nearly 17,900 in August 2012 from about 14,500 in August 2008. More than 15 percent of the 151,000 inmates have been given a diagnosis of some form of mental illness. (The University of Texas at Austin and the University of Texas Medical Branch are sponsors of The Texas Tribune.)

Ms. Deitch and other advocates of prison transformation agree there are solutions to problems related to prison violence and mentally ill inmates.  Reducing the prison population and adding more innovative training for prison employees handling mentally ill inmates are two of the suggested strategies for relieving the crisis.

Scott Medlock, director of the prisoners’ rights program at the Texas Civil Rights Project believes mentally ill inmates are entitled to accommodations that will help integrate them into the prison system and keep them safe. Medock’s suggestion is to consider structural changes including spreading mentally ill inmates among many facilities.  

Marion Williams, the medical director at Clements disagrees with Medock’s plan for separating mentally ill inmates into various facilities. Ms. Williams argues she can provide constancy of care when patients are contained in one unit. She contends treating mentally ill inmates behind bars is safer than working with them on the outside.        

The Clements Correctional facility is making an effort to address the needs of mentally ill inmates by incorporating voluntary and involuntary psychiatric programs into the system.

Health care providers from Texas Tech University Health Sciences Center run a voluntary Program for Aggressive Mentally Ill Offenders. 175 mentally ill inmates are participating in cognitive behavioral therapy. Those who complete the program by taking medication, attending therapy sessions and modifying their behavior receive a certificate that prison and parole officials consider when making decisions about housing conditions and potential release dates.

The involuntary program accommodates 200 critically mentally ill inmates with daily mental health care treatments.

Advocates of revolutionizing mental health care as a solution to prison violence and prison officials both agree there are many challenges tied to mental illness and prison violence, but they are not unsolvable.