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Local

With budget cuts, prisons' mental health population soars

How, then, to deal with the influx?

Seventeen and a half laps around the wood floor of the indoor gym equals 1 mile.

Seventeen and a half laps, so says the sign hanging on the wall, clearly visible to anyone who enters this gym on the Dixon Correctional Center grounds – separated from the general population by a well-guarded gate.

Exercise is a prescription for health – one of many therapeutic devices used to treat the ever-expanding number of inmates at the prison who are classified as needing mental health care.

Dixon has more beds devoted to inmates with mental health care needs than any other prison in the Illinois Department of Corrections. Of the 2,400 inmates at Dixon, about 900 of them are receiving some type of mental health care. And of those, 300 are allowed to live in general population, while the 600 others are assigned to special housing units: the Special Treatment Center, which is medium-security and used to house inmates with higher-functioning disabilities, and the Dixon Psychiatric Unit, which people on the inside call “X House.”

From 2009 to 2012, states cut more than $1.6 billion for mental health services from their budgets, according to a report by the National Alliance on Mental Illness. Of that number, $187 million of the cuts happened in Illinois, which cut nearly a third of the funding for mental health services from its budget.

Those cuts have led to the closure of two of Illinois’ already small number of state-run mental health centers: Tinley Park and Singer.

Since 1997, Cheryl Price has worked full time with Dixon inmates who need special medical care. Before coming to the prison, she was executive director of Hospice of the Rock River Valley.

To her, the closures of Tinley Park and Singer have had a noticeable impact on the population at the Dixon prison.

“You see [the state-run mental health center] population going down and the prison population starting to rise, and we inherited that,” Price says. “We definitely can see the effects of that.

"We have men here who have the designation ‘seriously mentally ill,’ ... and then we have other people who are seen by a psychiatrist or a mental health person but who wouldn’t be considered 'seriously mentally ill.' The population that concerns us, of course, are those that are serious mentally ill, because there are so many barriers for them when they’re released from prison. Those are the people that we tend to see coming back and back and back.”

The four-winged Dixon Psychiatric Unit is a maximum security facility that houses about a fifth of all inmates assigned to Dixon’s special housing units. Inmates in the DPU are in need of a more constant level of care and a more structured program. The cells are single-person occupancy, and meals are taken in-house.

The Special Treatment Center is a little more relaxed. The 400 men housed within it are given more time outdoors and in the gym. The cells are double occupancy. Inmates are encouraged to interact with one another.

“We don’t want them to become reclusive or isolated,” Price says.

The 300 other men who receive psychiatric care are housed in the general population. Those men’s cases are less severe than what’s seen in the special housing units, whose residents see medical professionals rather frequently in the flesh. Patients in the general population are more likely to conference with their psychiatrist through a video screen.

It’s called telepsychiatry, Price explains, and it works a lot like normal video conferencing.

“[Dixon] is an ideal place to get your training, because we see such a wide variety of mental illnesses,” Price says. “Every mental illness that you can think of is represented here. The difficulty, then, of course, is, How do you provide services for that population?”

Another key issue is how to provide services for them once they leave the prison.

“There are so many barriers in the community for them with the cuts to mental health funding,” Price says. “How do they get their medication?”

That question is a harder one to answer, but at Dixon, at least attempts are being made.

The psychiatric staff there is working on ways to provide a better transition for inmates back into the community with gateways to community mental health centers. But with budget cuts slashing mental health funding, it’s proving to be a difficult task.

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