An asylum of last resort. That is what California's state prisons have become for the seriously mentally ill since the state began emptying its state psychiatric hospitals in the late 1960s.
And while conditions clearly have improved since the 1990s, U.S. District Judge Lawrence Karlton in Sacramento was scathing in his April 5 rejection of Gov. Jerry Brown's attempt to free the state prisons from federal oversight.
Though California still has a way to go in implementing the "remedial plan" that it agreed to in 2009, a spokesperson for the Department of Corrections and Rehabilitation was quick to say that the state would appeal the decision. Yet there's a smarter way forward.
Brown himself stated in March that the money the state is spending on court costs "could be spent on rehabilitation programs for inmates, where it's really needed." He should stop spending taxpayer funds on fruitless appeals -- remember the 2011 loss at the U.S. Supreme Court? -- and implement the recommendations that would return the prison system to the state.
Our prisons have a constitutional obligation to provide adequate mental health treatment that used to be the province of state hospitals. With the emptying of state hospitals, California's 33 state prisons now have 33,777 inmates who are seriously mentally ill -- nearly 30 percent of the prison population of 119,500.
New Secretary of Corrections and Rehabilitation Jeffrey Beard told The Sacramento Bee's editorial board that while he "would like to see more mental health options in the community," he "doesn't see the percentage of seriously mentally ill inmates in prison changing." Karlton acknowledges that the state has "made significant progress" in remedying "unconscionable delays in access to inpatient care." But many recommendations repeated periodically since 1999 still have not been implemented.
For example, the U.S. Supreme Court noted California's 2006 inmate suicide rate was "nearly 80 percent higher than the national average for prison populations." Today, inmate suicides are occurring at virtually the same rate. Last year's prison suicide rate was 23.72 per 100,000 inmates, a rate substantially higher than the national average of 16 per 100,000 inmates.
The judge noted that more than 70 percent of inmate suicides in California still involve significant inadequacies about which the state has known for years.
Not surprisingly, the judge found that mentally ill inmates placed in isolation units known as "administrative segregation," where they are locked up in a cell for 23 hours a day sometimes for longer than 90 days, don't get adequate treatment and show "statistical overrepresentation of completed suicides." It took more than a decade to get agreement on a remedial plan between state prison officials and the special master and his experts. That blueprint remains the guidepost for getting the mental health system in California prisons out of federal receivership. If the state would comply with that plan, federal oversight would no longer be needed.
Alternatively, the governor could have asked the judge to reconsider some of the elements of that plan. Since he did not, the state has an obligation to meet its provisions.
As the governor well knows, large-scale imprisonment of the mentally ill clearly has come at a cost in California. But trying to escape that cost by evasion will not pass constitutional muster.