Wednesday, May 4, 2005

Corrected or Corrupted

Wacol prison in the morning mist

A psychiatrist from the prison Mental Health Team attached to Queensland Health made the comment that 25 per cent of inmates suffer from a diagnosed mental illness.

The General Manager of a prison on the outskirts of Brisbane raised this figure to 30 per cent.

Another professional described the Remand and Reception Centre at Wacol as the biggest mental health institution in the southern hemisphere.

First Impression

I often wondered what happened to that particular inmate. I remember him then as an old gentleman who kept himself to himself but who would smile at me whenever I chanced to pass him. Sometimes he would have a cat with him an he would gently scold it as it bounded playfully around his weeding fork.

Then just recently I heard where he was from another inmate. Now in his eighties and in a wheelchair after suffering several strokes, he was granted parole some months ago. "He is waiting to go to a nursing home but they've lost the paperwork, again!" I think I would have preferred to remember him tending the garden with his cat.

As the number of invitations to present programs increased so did our knowledge of the correctional system. I had to learn the jail jargon an soon I was able to converse about the 'screws', the 'dogs', 'having a shot', being on the nod' and 'fits' and 'gear'.

I learned the street names for most drugs and a basic understanding of the legal system. Sometimes I would ask what something meant and be told, "You don't need to know that", a comment I'd accept with good grace. But, more importantly, I leaned that to be trusted, I had to be trustworthy. I found in myself a compassion I didn't know I had and that made me feel good.

I began to ask questions of myself and of those in authority about efficacy of the rehabilitation offered and the nature of the follow-up to programs that were available.

I became concerned about the lack of support for inmates on release and observed the loss of basic skills and the anger that the correctional system engendered. As I began to understand the system more fully, I developed a sense of frustration when my questions and concerns remained unanswered.

Even now, I don't think I'm very popular with the hierarchy, One of my colleagues commented with amusement, after we had attended a meeting with the upper echelon of corrective services, that the lips of a certain management figure always got thin whenever I asked a question. I think I asked on that occasion, whether the programs which are so important to the parole boards, have ever been evaluated. Her answer was less than convincing. Nonetheless, thinking back, I believe that my involvement with the correctional system has been an experience that I classify as life changing and one which I value greatly.

The duty of care

The more times I visited prisons the more my frustration grew. Not being someone who waves banners and demonstrates in the streets. I have always tried to do things via the proper channels.

I have written numerous letters to people in authority, had interviews with members of parliament and taken every opportunity to talk to community groups. So far nothing much has changed but I'm not giving up. I remember one meeting with my local member, now not in office, where we could not agree about the basic concept of why people are sent to jail. I said it was ' as punishment' but he said it was 'for punishment'. Our interview did not last for long.

My understanding is that being deprived of liberty is the punishment and with incarceration goes the belief that there is a duty of care to maintain prisoner's well being.

Many times I have had to bite my tongue when I have listened to mothers telling me how relieved they are that their sons are finally in jail ' where they will be safe'. If inmates entertain this mistaken belief, it soon gets knocked out of them, probably on day one when another crim takes a fancy to their runners.

Inmates tell me, when I have asked them what advice I should give young offenders who are inevitably going to be intimidated for their personal belongings, that they should refuse to hand them over and fight back knowing that they will be hurt. Otherwise they will be seen as a soft touch for their entire sentence.

I believe that violence is never a way to solve problems but have been forced to pass on this information to first timers who know they are likely to end up inside. I am reminded of Len's description of his first time in jail and his chance meeting with someone he knew.

"As soon as we arrived in Pentridge, we were ordered out of the van and taken into another area where we were stripped, searched, showered. If you were sentenced you had to get your hair cut. We were also asked if we wanted Protection. Some fool did and got knocked straight out by one of the crims and what a good thing that turned out to be.

That drama meant no haircuts that day. After that we were then mustered into the holding yard and fed. That's when I ran into a friend from the outside and what a relief it was to see a familiar and friendly face! At last! There wasn't much time for conversation.

"Hey, Dave, I didn't know you were here." "Len, they're going to put you in F Dorm. Not a good go. They're sixty out in there and you won't get any sleep, every prick snoring and farting all night. Smash someone straight up, any one. You'll spend a night in 'one' cell but tomorrow you'll end up in D Division which are all single cells." "So without too much thought, I punched the person closest to me and just as Dave said, I was dragged out and spent the night in D Division.

This was the first piece of advice given to me in jail and it ended up being a good thing." That night, after being locked up at 3.30pm, I was alone still not knowing what was going to happen. The screaming and yelling all night was a bit much and I have to say I started to feel a little scared again, of the unknown I don't doubt.

The next day I was let out into the boy's yard of D Division and you reckon I wasn't happy about that. It was like an old school reunion. There were heaps of blokes I knew and I also saw other friends who were older in the other yards. When they saw me, they were quick to give me things I'd need like coffee and tobacco as well as advice. I was slipped some pot and that made things much better. My perception of jail changed dramatically. I have to say though, if it hadn't been so easy, I might have done it tough and never wanted to end up in jail again. Instead, it became an occupational hazard."

So Len's first experience of violence in prison was a positive one and it seems nothing much has changed. However I still like to think that, legally, the Department of Corrective Services has a 'duty of care', a responsibility to maintain the well-being of each inmate. Sometimes this means protection from other inmates or officers or making allowances for people with handicaps or special needs.

It also means medical care, hopefully of the same standard as that for people outside. Inmates who are sex offenders, child molesters or 'dogs' the tellers, automatically go on protection but there are others who are victims and just can't cope and ask to be segregated from mainstream. When I fist began to visit jails, the inmates used to joke about the possibility of their being more protection prisoners than mainstream. Now it's happened.

May 1999, saw the opening of Wolston Correctional Centre, a facility entirely for protection prisoners. Mainstream inmates fight against going on protection but some are not offered an option and are forced into it, for their own safety, mostly from other inmates but sometimes from the officers. Then it's a conflict for mainstream inmates when old friends end up on protection. The jail culture being what it is, they can't talk to them any more.

I have a client on the outside who refused to see me again when he found I was visiting the protection jail. When I explained that I am available for anyone who wants help, he was not convinced. He conceded that I was ' a nice lady' but gave me the impression that I was somehow contaminated by association with ' the bone-yard'.

Ironically, it was only his need for assistance when he went back inside that later made him contact me again. He's okay with me now so long as we never mention protection prisoners.

Correction centres have two main functions. custodial and correctional. The former they do very well as kilometres of razor wire and expensive perimeter vehicles testify. The later function is performed abysmally if the recidivism rate of more than 60 per cent is any indication.

As a personal observation, prisoners are released from detention more damaged than they enter and I'm only talking about those without special needs. Such inmates seem to me to get a raw deal. They include indigenous inmates, those with physical handicaps, with medical conditions or those exhibiting mental problems.

Recently I attended an interstate conference which was focusing on dual diagnosis in correction institutions, that is, situations where drug addiction and mental illness occur together. An eminent psychiatrist stated in his paper that anyone who allows his/her substance misuse to develop to an addiction stage must therefore have a mental instability.

This must cover almost the entire prison population and so jails must have become the biggest mental institutions in the country if that psychiatrist's views are to be believed, The incidence of mental problems associated with drug addiction appears to be increasing in prisons amongst my clients on the outside and is definitely rampant among the homeless.

It is difficult to manage this 'dual diagnosis' because it is not easy to discern whether psychotic behaviour is due to an existing mental illness or is drug induced.

It's difficult to get accurate statistics about the incidence of mental illness in the correctional system but what I have found appals me. A psychiatrist from the prison Mental Health Team attached to Queensland Health made the comment that 25 per cent of inmates suffer from a diagnosed mental illness. The General Manager of a prison on the outskirts of Brisbane raised this figure to 30 per cent.

Another professional described the Remand and Reception Centre at Wacol as the biggest mental health institution in the southern hemisphere.

I began to wonder what actually happens to prisoners with some kind of mental instability. I asked one of the drug and alcohol counsellors with whom I am on good terms how inmates who are exhibiting a dual diagnosis are treated. Knowing that prisons are not equipped to manage such inmates.

I was still appalled at the answer. They are, I was told, 'medicated to compliance' and presumably remain drugged on Largactil until their sentence is served.

Those prisoners who have experienced Largactil say that it kept them in a zombie-like state and scrambled their heads, no doubt making them more manageable, But, it seemed to me, not particularly helpful and just delaying the treatment for someone else to deal with.

People with dual diagnosis, in or out of prison, are the pariahs of society. My own experience has shown me, when trying to gain admission for some of my dual diagnosis clients, that mental health facilities take a dim view of addiction apparently believing that drug use is illegal and therefore the correct place for such a person is prison.

On the other hand some rehabilitation centres will not take people who are on anti-psychotics medications because they can be difficult to handle. A dilemma! The result is no treatment and living on the street. And then there are the inmates who hide their problems fearing that being a 'dipper' will not be helpful if appearing on their files when parole time comes around.

Indigenous prisoners are among those who might be called a ' special needs' group and they are grossly over represented in the system. The exercise yards in all the prisons are really like large covered cages with bare cement floors. When I see inmates walking up and down, up and down in these cages, I am always reminded of the lions I have seen doing the same thing in the older zoos. In my earlier years when I worked in a mental institution, I also observed the same behaviour in patients there.

I questioned then the therapeutic value of locking people up in cages, treating them like animals and then releasing them and expecting them not to bite their keepers. It must be much worse for aboriginals and islanders who are nomadic and do not function well in isolation! I suppose things have improved somewhat for them, now that there are Murri programs and Murri counsellors in some jails and Murri family days. And while I applaud this concession to indigenous culture, the downside is the resentment in the other inmateswho get no special programs and privileges.

At the same time, management doesn't handle with any expertise the racial problems that do arise. At one stage a while back, there was some trouble between the whites and blacks in one block in maximum security and the General Manager, in his wisdom, decided segregation was the solution. So all the indigenous inmates went to one unit and had their own visits, programs and oval times.

They were kept entirely separate from the other inmates who labelled it apartheid. The effect for both sides was to yell abuse at each other whenever the opportunity arose. Probably not the best way to encourage racial harmony!

While this disturbance was going on, I was presenting a Living Skills Program in the young offenders' unit which was opposite the unit where all the indigenous inmates were housed. Only about a third of the seventeen year olds were white and, as my assistant and I approached the unit, we were regularly treated to comments about 'white bitches'.

The older Murris' purpose appeared to be to get the younger inmates to do something stupid. The boys white or black, were all a volatile lot but fortunately nothing happened. The segregation stopped with a new General Manager but things could easily have got out of hand. As it is, there always seems to be a simmering racial problem in many of the jails.

Personally I have found there are some open-minded Murris and some very bigoted whites.

My frustration reached new heights when I had a deaf and dumb inmate participating in a Substance Abuse Program. I think his name was Neville. I was told he had a drug problem and that someone had said he should complete a drug program. At the start, one of the other inmates was able to do sign language for him and at least let him know what I was saying.

There was no opportunity for him to give feedback or for me to know whether he understood what I was trying to communicate. We muddled on for a while until the other inmate was transferred. Then Neville tried to manage by lip reading but he wasn't good at it.

The problem for me was that I had to keep looking at him which was hard because I try to make eye contact with as many of the group as possible while I am teaching. The whole thing became a farce because I would forget to look at him and turn my head away and the group would then chat in unison, "You're not looking at him, Miss."

They seemed to find this vastly amusing. I would get frustrated and Neville somehow contrived to look embarrassed. Finally, he just stopped coming and no doubt the parole board gave him a black mark for leaving the program.

Inmates with other physical handicaps suffer too, although the newer jails have wheelchair access. It's not easy, either, for those prisoners who don't speak English and unless someone looks after them they have no idea what's going on. The problem I'm told by other agencies is greater in the Women's Prison where non-English speaking women are being denied their rights.

Following the new Corrective Services Act, 2000, it is increasingly difficult to exit detention. The prison population is therefore ageing and with age comes more medical problems. It seems to me that this is one of the unanticipated side effects, and one which will further tax the existing but inadequate health care available.

When any one asks about the quality of health care available in correctional centres one is usually told that it is of the same standard as available in the community.

But I have heard enough stories and seen enough evidence to disagree. I can appreciate that nursing staff must be wary when inmates, most of whom have drug problems, ask for medication.

However, it seems that Panadol is the universal panacea for all illnesses, from headaches to broken limbs. I have seen for myself inmates in incredible pain from impacted wisdom teeth and heard them told that there is a two to three month waiting list for the dentist.

There are only certain days when an inmate can be ill and most of the doctors on call won't come out at night. Inmates have told me that if someone is showing signs of a heart attack, it's best t say it's an overdose because that gets help quicker. Death from natural causes doesn't usually make the newspaper. Good doctors who take time to listen or who are interested in proper treatment of drug addiction are few and far between and when they do come on the scene don't last, probably because the conditions are so bad.

This information comes from a doctor friend who does voluntary work in the system but iswell reinforced by the inmates.

A couple of years ago, Des got in a fight and had his arm broken. I was never told what caused the fight but Des did tell me sheepishly, "I think I must be getting rehabilitated because I didn't fight back much." He had several visits to hospital and after plaster on his arm for five weeks; an X-ray revealed that the bone wasn't healing.

The attending doctor suggested a plate would be needed and this would mean hospitalisation. Strangely, the prison wasn't so keen and it was decided that a further plaster might do the trick and the arm would probably heal in time anyway. Des, even to this day, remains unwilling to have anything to do with hospitals, agreed to wait. Significantly, Des was asked to sign a document agreeing never to sue Corrective Services.

In my view, somebody at the time must have doubted that treatment was inadequate. And indeed it was not. After Des was released he found a labouring job at the fruit and vegetable markets and after lugging bags of potatoes and pumpkins for hours at a time, he told me he suffered excruciating pain.

Eventually he was persuaded into seeing a doctor and I saw the X-rays myself. The break was still evident with the bones in his forearm not even touching each other. The cure, apparently, is to have his arm re-broken but that would mean hospital and Des will have none of that. In any case he fears he might lose his job and he needs that to survive.

-Rowena Solomon has qualifications in psychology and teaching. The early part of her professional life was spent as a tertiary lecturer in Human Development and in this context she co-authored a guide for parents about child-rearing in the early years.

While later working in a drug and alcohol agency, Rowena was responsible for welfare initiatives including counselling and the production of resources and education material for the Queensland Corrective Services Commission. It was in this role that she developed her interest in the correctional system; particularly in the care of prisoners post release

By Rowena Solomon posted 4 May 2005


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