A new study finds there are more people with a mental illness in prison than in psychiatric clinics.

The report, prepared by Public Citizen and the Treatment Advocacy Center, stresses more must be done to expand mental health treatment options in the community, and suggests for some, treatment behind bars can be more effective than anywhere else.

Data collected by the Treatment Advocacy Center shows there are 1,543 beds available at state psychiatric hospitals in New Jersey, but according to Dr. Ralph Woodward, the managing physician for the state Department of Corrections, at least 3,000 prison inmates are being treated for an assortment of mental illnesses.

The department has a whole suite of services that parallel or exceed what you would find in the outside community, and treatment of mental illness for inmates begins very quickly.

“Inmates go through a brief examination done within four hours of arrival, just to make sure they don’t have any immediate problems such as medication needs or they’re in pain or they have mental health issues that might cause great anxiety or suicidal thinking, so we do that right as soon as they get off the bus,” he said. “Then within 72 hours they’ll sit down with a mental health professional who will go into a much deeper interview with them as for suicidality and their adjustment to the prison system.”

“If they’re on psychiatric medications they are at that time referred to a psychiatrist within our system and they are then placed in housing that is appropriate for their level of care.”

"We have in-house residential treatment units, we have transitional care units, and for our most acute patients we have stabilization units where they can be treated for acute psychiatric emergencies.”

He pointed out if there’s a problem with an inmate that cannot be addressed with these existing programs the individual will be transferred to the Anne Kline forensic hospital, a state-run psychiatric facility.

“There are so many resource that in many cases they do get better treatment when they’re incarcerated than on the outside,” he said.

Dr. Woodward stressed when an inmate with a mental health issue is due to be released, “we begin making contacts with providers in the community, and we do a warm handoff to these providers. They get a full electronic record, we communicate the patient’s medication needs, and the inmates leave our system with two weeks of medication in hand, with a prescription for an additional four weeks after that.”

He said the system is so effective that “we find many hidden mental health issues that may not have been disclosed previously. They get an exceptional level of services probably not matched in the community, it’s resource intensive, it’s quite expensive. We believe this is an important cornerstone of our healthcare program, to prepare them for release back into the community.”

John Snook, the executive director of the Treatment Advocacy Center said we should not be relying on prison systems to get people treatment for mental illness.

He agreed the severely mentally ill do frequently have difficulty getting voluntarily treatment, but “in a jail and prison often you’re able to provide that person care, regardless of their delusional thinking.

He said in some cases when inmates with mental illness are released, they don’t follow up to get treatment and
“that’s how you see people end up over and over again cycling in and out of the system, ending up in jails over and over again, and it’s simply because the person has, as a symptom of their illness, an inability to understand that they need care. It’s a problem with the mental health system, not the corrections system.”

He stressed, however, New Jersey is ahead of the curve and starting to become one of the leading lights to address this population.

“An outpatient commitment law was passed in 2014, and there is now a program in every county in New Jersey to make sure those who have resisted voluntary treatment in the past must receive it under a court order,” he said. “Those who do not participate the way they are required to may face involuntary placement in a hospital.

"It’s a program we’re just starting to see a number of states embrace, that’s been an exciting model to see rolled out.”

<i>Contact reporter David Matthau at <a href="mailto:dino.flammia@townsquaremedia.com">David.Matthau@townsquaremedia.com</a>