This is just a brief post to recommend a documentary for those who haven't seen it yet. It's a Frontline episode called The New Asylums. This is a vivid but balanced story about correctional mental health care and the needs of mentally ill inmates. You can watch it in streaming video at the Frontline web site. I will warn you that Part 2 has a scene of a very ill, out-of-control patient that could be shocking.
Here is an observation from the documentary that I could relate to:
"We release people with two weeks' worth of medication. Yet it appears that it's taking three months for people to actually get an appointment in the community to continue their services … and if they don't have the energy and/or the insight to do that, they're going to fall through the cracks and end up back in some kind of criminal activity," warns Debbie Nixon-Hughes, chief of the mental health bureau of the Ohio Department of Corrections.
Nothing will make you feel so helpless as a former patient who calls from free society to ask how he can pay for his medication. Or who says the clinic won't take him because he has no insurance. The part of the quote I disagree with is the part that says the patient is destined to fall back into criminal activity. I cringe a bit when I hear mental illness and criminality being inextricably linked and inevitable. There's nothing like worsening the stigma of our own patients.