State prison officials want to make major changes to help inmates with mental illness. The price tag for the first two years is $24 million.
The General Assembly might provide half of that.
The state House and Senate are in the final stages of budget negotiations, and neither chamber is anywhere close to the $24 million request, which the governor included in his budget proposal.
The House cut it to $12.1 million. The Senate went further and cut it to $6.4 million.
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Lawmakers said last week that the prison system’s plan isn’t getting full funding because of other budget constraints and priorities.
The prison system’s request is part of a long-term plan to overhaul the way North Carolina’s prisons operate. The $24 million would hire more staff to better diagnose and treat inmates with mental illnesses. A large portion would improve what happens when inmates enter prison, ensuring they are better placed in the right type of facility with proper treatment.
Money would go to fully open the new mental health treatment area and hospital at Central Prison in Raleigh, which offers programs in life skills, managing emotions, conflict resolution, reading, music and art.
The plan would also establish eight new “therapeutic treatment” housing units, with trained staff to work with mentally and behaviorally challenged inmates – an alternative to locking them in solitary confinement.
The prison system’s request comes amid calls for better treatment of mentally ill inmates. More attention has been placed nationally on solitary confinement and its effects on mental illness. President Barack Obama has spoke against the isolation cells.
Last week, advocacy groups in North Carolina urged a federal investigation into prison solitary confinement conditions, noting that one in five prisoners kept in isolation is mentally ill.
Last month, the state agreed to a $2.5 million settlement with the estate of a mentally ill inmate who died of dehydration last year after being kept in solitary confinement.
In the past 16 months, two inmates have committed suicide in Central Prison.
Currently, a number of individuals who should be receiving treatment are kept in Central Prison’s Unit One, a solitary confinement block. The CEO of the Central Prison Hospital said Unit One is where most inmates hurt themselves and it happens weekly.
Jeffrey Metzner, the psychiatrist who evaluated James Holmes, the defendant in the Colorado movie theater shooting case, has visited North Carolina twice and examined Unit One. In a 2012 report, he noted the same inmates would be transferred back and forth between Unit One and the mental health hospital at Central Prison.
In his 2014 report, he found the prison made almost none of his recommended changes to the unit, and that it “remained very problematic.” Metzner reported that about 60 inmates in the 192-bed unit were being treated for mental illness.
Prison officials acknowledge the problems. Director of Prisons George Solomon said the prison system needs alternatives for those with mental and behavioral challenges.
“So we can have an intervention available to us other than restrictive housing,” he said. “Restrictive housing is how we have had to manage all of our populations in the years past because we were growing at a pace where we were trying to grow prisons to maintain and keep up with the bed need. We are not at that point anymore.”
He said difficulties treating the mentally ill in communities affect the prisons.
“This is a national problem, a state problem, a prison and a jail problem about how we manage our mental health population,” he said.
Rep. Pat Hurley, a co-chairwoman of the Joint Oversight Committee on Justice and Public Safety, said she supports the smaller, $12 million funding. The system could seek additional funds later after proving a new approach is working.
She said the prisons “probably asked for more than they need.”
“But we have to do more for the mentally ill,” Hurley added. “They don’t have many people that can speak for them.”
Sen. Shirley Randleman, co-chairwoman of the Senate Appropriations on Justice and Public Safety Committee, expressed sympathy for inmates with untreated mental illness, but said the Senate is holding firm to a measured spending increase for the current budget year.
The Senate’s plan would target money to the requests it determined would have the greatest effect on mentally ill prisoners.
The Senate focused its dollars on diagnostic centers, which would screen for mental illness when a person is first admitted to prison. The prison system’s budget request indicates that current screenings miss about 5 percent of the inmate population that needs mental health treatment. Improvement would increase the mentally ill inmate population from about 4,500 daily to 6,500.
Tim Moose, deputy commissioner of the system’s adult division, said items in the budget request begin to address the most critical needs in the system – and are part of a larger, long-term plan.
“The challenge of effectively treating and working with folks diagnosed with mental health issues is a major problem in the community and has been transferred to our jails and prisons,” he said. “Previous administrations didn’t know or couldn’t predict what was coming. It’s not an excuse, but I think it’s just a fact that prisons were very unprepared to deal with the population that they now have.
“It’s a massive project to flip the prison dynamics that we have had in our state for the past 100 years.”