Head Games

At least one out of every five Colorado prisoners is mentally ill -- some violent, some undetected or untreated. How did the Big House become the Bug House?

Many mentally ill offenders seem to be stuck, like Seibel, in a prolonged cycle of neglect and new charges. For every Troy Anderson buried deep inside the walls, there are dozens of non-violent parolees hitting the streets with substance-abuse problems and medication and treatment needs, and not enough programs to handle them.

Prisoners lose their Medicaid and Social Security disability benefits after as little as four weeks of incarceration; it can take months to get them reactivated. The Colorado Legislature passed a law two years ago that directed the DOC to get the paperwork processed sooner, before a prisoner is released, but the results have been spotty; the process is "tremendously complicated," the DOC's Michaud notes.

"Some of the biggest hurdles have to do with coming out with adequate medication and continuity of care," says Harriet Hall, a clinical psychologist who's president of the Jefferson Center for Mental Health and the current chair of the inter-agency task force studying the issue. "Housing, jobs, community acceptance -- they're all major issues. But they don't come out with enough medication to keep them stable until the community can feasibly get them medication, and there's not a funding stream to pay for it."

Troy, now 37, is serving a 75-year sentence for 
shootouts with police.
Troy, now 37, is serving a 75-year sentence for shootouts with police.

More than most lawmakers, the members of the task force know the compelling economic arguments in favor of community mental-health programs. A bed in San Carlos costs more than $60,000 a year; providing one person with mental-illness treatment in the community costs between $5,000 and $8,000 a year. A recent report by the National Institute on Drug Abuse shows that every dollar spent on addiction treatment results in a $4 to $7 reduction in costs associated with drug-related crimes. But during the lean budget years since 2001, lawmakers have tended to ignore arguments about long-term savings, focusing instead on what a particular program costs in the short run.

"Until the passage of Referendum C, the task force knew that anything that had a fiscal note attached to it wasn't going to get passed," Hall says. "Now we can start thinking about how we can best demonstrate the long-term benefits of spending a modest chunk of money now."

According to Michaud, the prison system has a crying need for increased resources as well. "There's no doubt that we need more special placement beds for people with mental illness," he says. "The budget cuts have really hurt us."

But a psychiatrist who's worked in many areas of the criminal-justice system says the most critical need is for diversion programs for the mentally ill before they end up behind bars. "Better mental-health care in prison is not the answer," insists the source, who asked to remain anonymous because of ongoing relationships with the state. "The mentally ill flat-out do poorly in a correctional setting. They start piling up charges. They're less likely to be granted parole. They just keep sinking further and further; it's like using a thimble to bail out a boat.

"If you want to see that system keep growing, just keep pouring money into it. The fact is that too many jails and prisons do no dispositional planning. They're not about treatment; they're about management. And the bureaucracy is deliberately sluggish about restarting people's disability benefits because it saves money. We need to keep mentally ill people out of that system in the first place."

There's no oversight of the current system, insists Mark Seibel. A few months ago he wrote to the state's Mental Health Occupations Grievance Board, complaining that the DOC had ignored his mental-health needs for more than a decade. "The Board is unable to intervene in the matter because it is not authorized to regulate correctional facility programs," program director Gayle Fidler responded. Fidler urged Seibel to take up the matter with the DOC -- a tricky business, since Seibel is now a parole violator.

"I'm not a punk," he says quietly. "I'm not going to lay down and let them do shit like this. I don't like being taken advantage of."

For now, he's getting his meds on the street, in the netherworld of speed freaks and meth maniacs that Troy Anderson used to inhabit. It's a small world; at the mention of Anderson's name, Seibel's eyes light up with recognition.

"You mean Evil?" he asks. "How's he doing?"

How Troy Anderson is doing depends on whom you believe. For the past five years, he's been in a strange stalemate with his keepers.

Shipped back to CSP from San Carlos, at first Anderson refused any mental-health treatment at all. He claimed that the meds he was being given caused his outburst at the hearing, so he stopped taking them. His psychiatric rating was downgraded to a point where he would no longer have routinely scheduled appointments with mental-health workers.

In early 2004, he changed his tune. Recognizing that he would have to be on medication to be considered for transfer from CSP, he began pushing for an appointment with a psychiatrist. The staffer dealing with him was suspicious of his request. He described Anderson as "addicted to his anger" and recommended a psychobabble course of action: "Confront thought distortions, encourage tolerance and gratitude attitudes."

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