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The Honolulu Advertiser
Posted on: Friday, January 19, 2007

Stop downward spiral in inmate health aid

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Advertiser Staff

The state's miserable track record in both its correctional facilities and in its delivery of mental health services is well established. So recent findings of a twin failure — shoddy treatment for mentally ill prison inmates — are sad, but unfortunately, not exactly shocking.

An investigation by Advertiser writer Rob Perez uncovered conditions that mental health professionals, including those working within the prisons, find disgraceful.

Overcrowding tops the list of prison facility shortcomings, compounding the difficulty of providing counseling and other health services that require adequate space. And the generally poor conditions contribute to the inmates' general poor health.

The state faces an enormous burden to correct the cumulative problems at its adult and youth correctional facilities. The most critical problems involve the O'ahu Community Correctional Center, target of a federal civil-rights investigation over its treatment of mentally ill patients.

It made progress, but has clearly lost ground. In 1999 the prison emerged from more than 10 years of court oversight because of the poor prison conditions, including the problems with mental health support. Only six years later, following reportedly deteriorating conditions, the civil rights probe was launched. Among the more unconscionable findings: Staffing and other resource shortages led prison officials to restrain some prisoners and order lockdowns instead of giving them the healthcare treatment they needed. In some cases, those actions made medical conditions worse.

The state has been working on improvements, admittedly: hiring staff, changing policies about the use of prison lockdowns as a coping strategy, seeing that treatment plans become the norm. But what's particularly disturbing is the failure of the system to maintain its progress, once federal judicial oversight was lifted.

The state ought to be able to make progress on its own without federal oversight. But shamefully, it seems Hawai'i officials need Uncle Sam at their backs to get things done. And as some experts have expressed concerns that inmates' constitutional rights are being abrogated, the prospect of further federal intervention looms.

Once again, it appears we're in crisis-management mode. The Justice Department has yet to issue its own findings based on the expert analysis, but it's critical that the state move swiftly to demonstrate the will to bring prison facilities up to minimum standards, at the very least.

No longer should inmates, or anyone under the state's purview, be subjected to inhumane treatment with medical conditions that are allowed to worsen. That's just plain wrong.