The Committed

The state pours millions of dollars--and controversial social theory--into a prison for mentally ill felons.

It was decided early on that staffers would videotape the event, in part so they could use the film to train other officers in what are known inside the DOC as "cell extraction techniques."

On the tape, Summers emerges from his cell appearing relatively calm and cooperative. The struggle begins only after the guards try to give him a shower to rinse the food off his body.

Suddenly, Summers begins to buck and writhe, attempting to cast off the hands that hold his arms and legs captive. His voice rises in an unearthly shriek, his grunts and cries horrifying and unintelligible.

As Summers struggles and wails, the lead officer talks to him continually, trying to reach a part of the inmate's mind that might understand. "It's okay. Relax," the officer tells Summers. "Stop resisting. Calm down. You're okay. We're not trying to hurt you. Relax, partner."

But Summers is unreachable. Other staffers rush to the scene and place a helmet on Summers's head so he won't injure himself. They lay a towel over his genitals so he can't urinate on them, and another over his mouth so he can't spit in their faces.

Ultimately, it takes six people an hour and a half to subdue him.
"When they get like that," says Parmenter, watching the tape from a conference room down the hall from her office, "they are fearful and they will fight for their lives. When that happens, they're very dangerous."

Soon after the videotaped struggle, Summers was transferred to the state hospital, which serves as the prison's escape valve when it encounters inmates its staff can't control. It's a policy that speaks to a weakness in efforts to treat mentally ill inmates like patients: Because San Carlos is a prison and not a medical facility, the staff can't legally force prisoners to accept medication and treatment against their will. When inmates are on medication and their symptoms have eased, they are more amenable to treatment. But prisoners who refuse medication can quickly careen out of control. When, as in Summers's case, an unmedicated inmate becomes completely unmanageable, he or she is sent to the state hospital for evaluation. If doctors there determine that medication is necessary, they must petition a court and obtain a civil order for the right to provide treatment.

For that reason, San Carlos maintains twenty beds at the state hospital, some equipped with leather restraints. On any given day, most of those beds are filled.

Some experts believe that up to 20 percent of the more than 500,000 prison inmates in this country suffer some sort of mental disturbance. Colorado corrections officials estimate that 6 percent of the state's prison population are afflicted with a chronic mental illness.

Criminologists contend that the percentages of inmates with mental illnesses began increasing about twenty years ago, as the concept of "deinstitutionalization" took hold. Its roots were humanitarian (and in some cases, monetary) in nature, and it resulted in the release of untold numbers of people from state mental hospitals across the country. Colorado alone released thousands of patients during the 1960s and 1970s, says state hospital spokeswoman Nell Mitchell (many because the development of psychotropic drugs had made their illnesses easier to manage). The hospital's population eventually declined from a high of more than 6,000 patients to a recent count of 530.

Many of the mentally ill who'd been freed from state hospitals arrived in communities that had inadequate resources with which to help them. Some became homeless. Others turned to crime. And with the de-emphasis on hospitalization, incarceration seemed the only viable alternative for those who broke the law.

"There is a general consensus," says the DOC's Diamond, "that with deinstitutionalization, many of these people are ending up in county jails and/or prison. It's a problem nationwide. Somebody is going to end up with them. Unfortunately, many times it's us."

"We often find that we trade inmates with the state hospital all the time," Parmenter says. "A lot of our staff formerly worked at the hospital, and they see some of the same faces here that they saw there thirteen years ago."

The first stop for many of the mentally ill who land in prison is the office of the state public defender. "A lot of our clients, a lot suffer from mental illness," says Sharlene Reynolds, who heads the Denver branch of the public defender's office. "We're dealing with clients who have had abusive childhoods, who have been on the streets, who have a history of mental illness in their family.

"Oftentimes," Reynolds says, "I think the defense lawyers, the district attorneys, the judges--everybody in the justice system--gets so frustrated when they have to deal with the mentally ill defendant that they give up, and the defendant goes to prison. We throw up our hands and say, 'Nothing more can be done.' We don't know what to do with them."

But corrections personnel as a rule are equally unsure how to best deal with the mentally ill. "You throw in a schizophrenic who's actively hallucinating, and nobody knows what to do with them," observes Michael Steinert, a clinical manager with the Mental Health Corporation of Denver. "A lot of jails are not able to handle people like that."

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