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Reports show ‘chronic mental illness’ in CT jails, says senator

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The state Department of Correction needs nearly $5 million to provide adequate health care in Connecticut prisons, where 80 percent of inmates suffer from mental health or substance abuse problems that require treatment, according to documents obtained by the Hearst Connecticut Media Group.

A state Sentencing Commission report to be released in March shows that nearly 80 percent of Connecticut inmates have a mental health or substance abuse problem that requires treatment.

According to a separate report that will be presented to lawmakers and Gov. Ned Lamont, the DOC needs nearly $5 million to hire more than 50 mental health and substance abuse clinicians, social workers and addiction counselors to provide appropriate treatment to Connecticut’s inmate population.

“They’re not getting the job done,” said state Sen. Cathy Osten, D-Sprague. “These reports clearly show that there is a problem with chronic mental illness in the state’s prisons.”

The same team of researchers who reviewed DOC inmates’ mental health and substance abuse diagnosis files for one day in January 2022 also concluded that 96 percent of inmates incarcerated that day have struggled with a mental health or substance abuse problem—or both – within their lifetime.

“Essentially, as a community and as Connecticut’s policymakers, we have decided that our correctional facilities are quasi-psychiatric institutions and that we will serve this population by incarcerating them,” Osten said during a forum on the issue in November.

The report, which is expected to be released to the full Sentencing Commission in March, is an in-depth extension of a similar study that Osten requested in 2019. The figures released in 2020 indicated that 80 percent of female inmates and 28 percent of male inmates suffered from some serious mental health problems that required treatment.

At the time, Osten believed the numbers were undercounted, since the DOC largely designates mental health status based on inmate self-reports.

As a former corrections officer, Osten told the panel in November that she witnessed how the closing of the state’s mental health facilities decades ago affected Connecticut’s prisons.

Osten last week introduced a bill to the Judiciary Committee seeking funding for the fiscal year ending June 30, 2024, to provide “adequate resources” to respond to the findings of the Sentencing Commission’s report.

“It’s important to recognize that we’ve made DOC accountable to people within the confines of their facilities,” Osten said. “We will need to address the medical, social, mental health and substance abuse of those in state custody.”

The authors of the Sentencing Commission report examined diagnostic information for people who were incarcerated on a specific day in January 2022. Based on the data, the research team reached roughly the same conclusions as the 2020 report based on inmate self-reports.

About a third of the inmates were classified as having an active mental disorder requiring treatment, and another 41 percent had a history of mental disorders not requiring active treatment, according to the study. More than 80 percent of incarcerated women had an active mental disorder that required treatment, compared with 28 percent of male inmates, the authors said.

The rate of active mental illness was higher for inmates age 25 and younger at 37.6 percent, including 41 youth ages 15 to 17, the report said. The most prevalent types of mental disorders were mood disorders, affecting about 24 percent of the incarcerated population, or 2,241 inmates, and post-traumatic stress disorder, at 12.65 percent, or 1,200 inmates, according to the data.

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The prevalence of diagnosed mood disorders in the general population is about 10 percent, the study concluded. About 8 percent of inmates had a psychotic disorder, compared to about 1 percent of the general population.

The report found that inmates who have pending cases or otherwise have not yet been sentenced had a “significantly higher” prevalence of mental disorders at 39.7 percent than the population of sentenced inmates, which was at 25.8 percent . The finding led the authors to question whether an inmate’s status could affect their mental health.

Nearly 90 percent of the inmate population was classified as having a history of or a current substance abuse problem, the study said. The DOC does not categorize inmates who have a substance abuse problem as having a mental disorder, even though the two are linked in the general population, said Dr. Reena Kapoor, associate professor of psychiatry at the Yale School of Medicine and one of the authors of the study.

“DOC is behind the rest of the world on that,” she said.

Nearly 81 percent of the incarcerated population on one day in January 2022 had either an active mental disorder or substance abuse condition requiring treatment, the authors concluded. Nearly 25 percent of the inmate population had both, the study found.

The findings may represent men’s reluctance to disclose relationships that would make them vulnerable, Kapoor said. “It may also represent the difference in access to mental health care,” Kapoor said.

Black and Hispanic men make up a large portion of the state’s prison population, but culturally it can be difficult to ask for help, she said.

The DOC was required by a 2022 law to submit a plan to the Legislature this year outlining the agency’s needs to handle inmate health care, including mental health and substance abuse treatment. In all, the agency needs about 250 more health care workers, including 114 licensed practical nurses and 61 registered nurses, to handle the roughly 15,000 inmates who pass through its doors annually, the document said.

The two biggest obstacles to hiring health care workers are the number of trained and licensed providers in the community available to work and the salaries the state offers, which the agency said in the document are not competitive.

Inmates are assessed as soon as possible so providers can create a treatment plan, DOC spokeswoman Ashley McCarthy said.

“We closely monitor the substance abuse and mental health requirements of the individuals in our care and remain aware of those in need of treatment,” McCarthy said in a statement.

But Osten questions whether the agency’s response is enough given the plan that was presented and the findings of the Sentencing Commission’s report.

“I think at first people didn’t believe what I said,” Osten said. “I want us to think about what the plan (submitted by the DOC) and the report from the sentencing commission say. Those are huge numbers. The question is, are we going to put money in the budget to address this?”