Friday, February 5, 2010

Healing the Prison Crisis

Transitions Clinic in San Francisco, an outpatient clinic serving the health needs of Californians on parole and probation, is a great example of one of my mantras, the solution to our penal crisis, won't come from anything penal. Enlightened penal policies, and the best kinds of criminological research that have traditionally shaped them, will follow, not lead the healing of the prison crisis. The clinic, spotlighted in an excellent article by April Dembosky in the Bay Area edition of the NYTimes, has focused like a beam on one of the deepest flaws in our penal state. The people we incarcerate, may or may not be the most dangerous people in the state, but they are clearly among the very sickest in the state. Years of chronic drug abuse, erratic medical care (both in and out of prisons), have left many prisoners decades older than their calendar age. Under its current policy of cycling parolees and probationers in and out of prison, California has put itself in the trap of both guaranteeing constitutionally adequate health care to this population (under the gun of the federal courts) and placing them in custody situations that make health care delivery fantastically expensive and administratively all consuming. Delivering good health care to people on parole and probation while they are out in the community can create a virtuous counter current where this chronically ill population receives care in a much cheaper and more effective manner resulting in lower costs when they do go back to prison and possibly, when integrated with the kind of additional services that Transitions strives to provide (like referrals to drug treatment and mental health agencies), keeping them from going back to prison at all.

Dembosky reports that clinics like this are spreading. This is good news. A solution to the prison crisis is likely to start outside the state, and outside of penology.

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