During a panel discussion on prison health care held last Thursday at the John Adams Courthouse in Pemberton Square, human rights advocates made a case for why improving the medical conditions for those who are incarcerated can also improve the health and well-being of those outside prison walls.
Nearly 2.3 million U.S. inmates must rely on their jailers for health care, and the 12 million people released from incarceration each year often return to their communities without sufficient resources — or, often, any resources — to maintain good health.
Those startling statistics were found in “The Health and Health Care of U.S. Prisoners: A Nationwide Survey,” a study released in January by Physicians for a National Health Program (PNHP), a Chicago-based organization comprising 15,000 American doctors.
The report goes on to say that 40 percent of inmates have a chronic medical condition, a far higher rate than non-incarcerated Americans in comparable age ranges. Roughly the same percentage of prisoners do not get treatment for illnesses while on the inside.
Dr. J. Wesley Boyd, a clinical instructor of psychiatry at Harvard Medical School and co-author of the study, said that ignoring the health of prisoners can have a detrimental effect on the larger population.
“If there was better community health and access to substance abuse treatment in prisons, there would be less crime and recidivism,” said Boyd, who also works as a psychiatrist at Harvard-affiliated Cambridge Health Alliance.
But as it is now, according to the advocates, the health care needs of inmates often go underreported or completely ignored, largely because many people are hesitant to appear to have sympathy for those that commit crimes.
There are approximately 25,000 inmates in Massachusetts, with about 12,000 in state prisons and the rest in jails. Leslie Walker, executive director of Massachusetts Correctional Legal Services Inc. (MCLS), said that while all state prisoners are required to have medical exams upon entering prison, it can be a struggle to make sure that inmates continue to get the necessary care during their sentences, due in part to variances in prison health standards among county jail systems.
“Sometimes, there has to be a lot of pushing from health advocates to get health care in the prisons, and sometimes that doesn’t help,” said Walker.
According to the PNHP study, 24 percent of state inmates with active medical problems stop taking medication after incarceration. Prison advocates are more highly concerned, however, about state inmates with severe mental health problems — 30 percent of whom were not taking medication for illnesses such as schizophrenia and bipolar disorder at the time of their arrest. Only 69 percent of state inmates are restarted on a psychiatric medication after incarceration, according to the study.
“We can’t afford to ignore mentally ill inmates,” said Joel Thompson, staff attorney at MCLS and co-chair of the organization’s Health Care Project. “Many of these inmates get out of prison and become a problem once they get back into the population.”
During his 34-year tenure as the head of the Hampden County Correctional Center in Ludlow, Mass., Sheriff Michael Ashe has gained a national reputation for being an innovator with an enlightened approach to treatment of prisoners. According to Ashe, to turn around prisons, which he said has become “reservoirs of illness,” inmates need to be given the resources to build toward leading law-abiding, productive lives once they are released.
“Our correctional facility is not a warehouse,” Ashe said. “Many prisoners come into our facility with a lot of baggage. We see our job as trying to lighten the baggage.”
Hampden County is the one of the first prison systems to use health providers from the surrounding community. For the last 10 years, Ashe has led a pioneering program, an acclaimed public health model in which the correctional center seeks out partnerships with community health centers.
Ashe said he believes that if prisoners regularly seek medical attention from these health providers, they are more likely to continue a relationship with providers after their release. With 97 percent of Massachusetts prisoners eventually released back into their communities, he added, the process is a win-win for both former inmates and society at large.
Since the initiation of the public health program, Ashe said, 56 percent of his former inmates who spent more than three years incarcerated do not return to prison.
“We apply a community standard of health, which is in the best interest of everyone,” he said.
