Fighting crime with health care at Shelby County Jail
Why should the public be concerned with the health care and health status of those behind bars? It is easy to regard prison health care as something insular. On the surface it seems like an issue that has little impact on most families in our community.
Often overlooked is the reality that the failure to properly care for those incarcerated provides a health and public safety threat to our community. Over 90 percent of our local prison population will be back on the streets one day and their health problems and needs will follow them.
In considering the high cost of incarceration, it is important to look more closely at how we are administering health care and mental health care to our prison population. Our failure to address drug addiction, mental illness, and communicable disease is something that will have a profound impact on Shelby County and our future.
The overcrowding of jails and close proximity of prisoners causes disease to spread more rapidly.
Hepatitis C is 9-10 times more prevalent among our jail population than in the general public. In recent years, there has been a dramatic increase in the number of severely mentally ill prisoners that far exceeds the rate of the overall population.
Indeed, a national study showed that the Shelby County Jail has more seriously mentally ill inmates than all state psychiatric hospitals in TennesOne see combined.
Are we addressing drug addiction and mental illness? Do we have the beds to treat chronic illnesses including Alzheimer and diabetes? How are we treating communicable diseases like Hepatitis C and Aids?
Those are all important questions that need to be asked in the selection of our jail’s medical provider -- a contract worth $18 million annually.
Government has a constitutional obligation to provide healthcare in our nation's corrections facilities, as mandated by the U.S. Supreme Court in 1976. The landmark decision Estelle vs. Gamble guaranteed prisoners medical treatment. To do otherwise, the high court ruled, would constitute cruel and unusual punishment under the Eighth Amendment.
So it is in Shelby County’s legal interest and financial well-being to make sure our prison and correction centers are being served by effective and quality healthcare providers. We set ourselves up for lawsuits and expensive legal repercussions when we provide negligent treatment.
For many inmates, their path to incarceration started in a childhood marked by trauma and poverty. Many witnessed violence, sexual abuse and unimaginable events at a young age and grew up in homes where the primary caregiver themselves were in and out of prison.
It’s a vicious cycle. As these victims grew up, their condition grew worse and often mirror the kinds of trauma faced by victims of war including anxiety, depression and PTSD. Jail is a particularly unwelcoming place for those with behavioral problems.
of the most pressing concerns is what happens when a person with mental illness enters the criminal justice system in Shelby County.
Mentally ill patients have waited up to 162 days before being transported to an inpatient setting; even in cases where a state court judge determined the inmate required treatment. In Tennessee, state funded beds are limited, creating a crisis that slows the judicial process and puts an unfair and unsafe burden on our jail personnel.
It is all of our responsibility in Shelby County government to ask important questions moving forward. Are we approaching prison healthcare in a way that will reduce recidivism? Does the company we contract with place prisoner’s lives above profits? Can we better address the epidemic of mental illness and drug addiction for the men and women incarcerated in Shelby County?
Over the next few weeks, the Shelby County Commission will be working with leaders in the mental health care field, the Shelby County Health Department, and the administrations of Mayor Luttrell and Sheriff Bill Oldham to answer these questions and find the best approach to addressing the current gaps in prison health care coverage.
We can turn crisis into opportunity by approaching this issue in a way that will best benefit the community as a whole. We can accept the way things are or rise to the challenge of the way things should be.
Reginald Milton is a Shelby County Commissioner and serves as chairman of the Shelby County Commission’s Hospital and Health Committee.