Lawyers argue about prison mental health care


Lawyers representing the state say California is now providing a level of care to prison inmates that meets the requirements of the U.S. Constitution, while attorneys for inmates contend more improvement is needed.

California has spent more than $1 billion on construction of mental health facilities and increased salaries to hire more qualified mental health workers. The state now has more than 1,700 psychiatrists, psychologists, therapists, social workers and nurses to treat more than 32,000 mentally ill inmates.

That amounts to about one specialist for every 19 patients.

"California has invested tremendous amounts of money, resources and effort to transform its prison mental health care system into one of the best in the country," the state said in a court filing that attempts to show it is no longer deliberately indifferent to meeting the needs of mentally ill inmates.

Lawyers for inmates say more mental health facilities must be built and staffed. They also say more must be done to reduce a suicide rate that exceeds the national average for state and federal prisons and worsened last year.

California's prison suicide rate was 24 per 100,000 inmates in 2012. That compares to 16 per 100,000 inmates in other state prisons and the historical average of nine suicides per 100,000 inmates in federal prisons.

The state cites U.S. Department of Justice statistics for 2000-2010 that show California's average prison suicide rate of 20 per 100,000 inmates was lower than or equal to that of 20 other states.

U.S. District Judge Lawrence Karlton must rule on the request for renewed state control by early next month under the legal process Brown set in motion in January.

Ending the lawsuit is key to the Democratic governor's attempt to lift a separate court order over prison crowding that otherwise will force the state to reduce its inmate population by nearly 10,000 by year's end.

The order, upheld by the U.S. Supreme Court in 2011, prompted the state to enact Brown's so-called realignment law, which requires lower-level offenders to serve their sentences in county jails. Since then, the population of the state's 33 adult prisons has dropped by nearly 25,000 inmates to about 119,000.

So far, the legal battle has not gone well for Brown, although he has promised to appeal any adverse rulings back to the nation's high court.

Court-appointed experts and overseers have recently said California still provides substandard care to inmates with mental and physical illnesses, while federal judges have ruled against the state on virtually every motion they have filed.

The experts said they found the 13 prisons they visited last year all provided acceptable mental health care. Attorneys representing inmates said they were not notified of the visits and were not present when their mentally ill clients were interviewed, as required by ethical standards and a previous court order.

The state responded this week that one of the state's experts "mentioned it" to one of the inmates' attorneys, and that the court-appointed special master was told that visits were planned.

Complaints of continuing poor care for mentally ill inmates were supported by letters and a sworn declaration from staff psychiatrists at Salinas Valley State Prison that were filed in support of the inmates' case.

The psychiatrists work for the Department of State Hospitals, which runs the program that treats about 360 severely mentally ill inmates at the Salinas prison. One psychiatrist last week called for a federal investigation, saying all nine psychiatrists are leaving the program.

Department spokeswoman David O'Brien said in an email that the psychiatrists operate as part of a team that includes therapists, social workers, nurses and psychologists.

"It is inaccurate to judge the quality of care solely by the number of psychiatrists on staff as if they were the only providers of mental health care," he wrote. Nonetheless, he said the department is transferring or hiring more psychiatrists, and expects to have eight fulltime and five part-time psychiatrists working by the end of next week.

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