For two years, Arizonaβs prison system has been under court order to improve health care for inmates.
The Arizona Department of Corrections has treated the order as optional.
Itβs been so bad that in October, U.S. magistrate judge David Duncan threatened to hold the department in contempt of court and fine it $1,000 for each time it broke the terms of the 2015 settlement. He described the state as having βpervasive and intractable failures to comply.β
Then came a bombshell KJZZ radio report on Dec. 18. It cited new cases, including that of an inmate who died of a treatable skin cancer that was allowed to penetrate his skull. A doctor who worked in the prisons for health-care contractor Corizon spoke to a reporter at the station about how the company was avoiding the monitors of the prison settlement.
In a hearing Dec. 20, Duncan stood and delivered a rebuke to the department and Corizon, questioning whether they are βcorrupt,β and saying βIβve used words like βshockedβ and βflabbergasted,β but I have run out of words.β
Coincidentally, in October I received a letter containing a paper written by Aaron Wamsley, an inmate from Tucson at the local prison complexβs Catalina Unit. He wrote it for a class heβs taking through Rio Salado College, about his treatment for bipolar disorder. Wamsley, 33, is serving a five-year sentence for methamphetamine-related crimes in Pima County.
His mother, Janet Wollerman, forwarded me the paper on Wamsleyβs behalf, and it seemed to bring up the kind of problems the judge is so upset about. Here, Iβm reprinting a slightly edited version thatβs broken into shorter paragraphs:
βAs it stands today, the mental health treatment provided in prison is counter-therapeutic, devoid of privacy and shows no signs of improvement on the horizon.
βArizona prison inmates with a serious mental illness have one chance every three months to converse with a doctor. Each meeting is likely to produce a doctor that the inmate is meeting for the first time. The doctors do not introduce themselves to, nor do they perform any psychological evaluations on the inmates.
βThe average appointment happens within three minutes. The doctor asks the inmate to describe their current symptoms, and then proceeds to stop, start, increase or decrease medications based on how they interpret those symptoms.
βBeing that a different doctor is used for each visit, the medications and treatment plans can be dramatically changed from visit to visit. There is no opportunity to build doctor-patient trust in this setting. There is also no way to establish or maintain doctor-patient rapport, which, in my opinion, is an essential component of meaningful therapy.
βImagine a private citizen seeking mental health treatment having to see a different doctor every time they had an appointment. Would a reasonable person feel comfortable discussing their most intimate problems with a total stranger? How about a room full of strangers?
βJust outside of the room where these doctor visits take place sit at least a dozen inmates waiting for their appointment. There is approximately ten feet of space between the front door of the medical building and the room used for doctor visits. All ten feet is used to cram inmates shoulder-to-shoulder as they wait to be seen by whichever doctor showed up that day.
βThese doctor visits are done over the Skype application, so no doctor is actually physically present. In the struggle to be heard as well as hear what is being said, the doctor visit becomes a very loud ordeal. So loud, in fact, that along with the prison inmates waiting by the door, everyone within the eight-hundred square foot medical building is privy to the conversation the doctor and inmate are having.
βAs for doctor-patient confidentiality, there isnβt any. These doctor visits are overtly scrutinized by multiple non-medical parties without the consent of the patient, but rather as a consequence of the environment in which the doctor visit occurs.
βSurely, the Department of Corrections would seek to improve upon this flawed process, wouldnβt they?
βFor the more than two years that I have been in the custody of the Arizona Department of Corrections, I have had ten doctor visits over Skype with eight different doctors. The crowd of inmates waiting outside of the doctor visits has only increased in size since my first appointment. More and more often these days, I hear other inmates jokingly discussing amongst themselves what they overheard during my doctor visit.
βHow then do I, or any inmate for that matter, expect to get any therapeutic benefit from attending these should-be-private doctor visits turned group therapy sessions?
βThe prison officials I posed that same question to merely reminded me that I was in prison. They also stated that I gave up the right to privacy when I broke the law. So, what does the future look like for mentally ill prison inmates in Arizona if the people responsible for administrating mental health treatment for the facility fail to view any of this as problematic?
βIf Arizona continues to direct more funding towards its Corrections budget than it does for treatment of the drug-addicted and mentally ill, the situation will grow increasingly worse. Currently, prison inmates who have issues that cannot be solved in their quarterly, three minute doctor visit are simply taken to suicide watch.
βOnce there, the inmate is stripped naked and thrown into a room, in which the only furnishing is a cold, hard cement floor. That is where they will stay also, until they are no longer having the psychological disturbances that brought them to suicide watch.
βOn more than one occasion, I was told by prison officials that I may need to go to suicide watch after I brought up some concerns I had about the mental health care provided in prison.
βSo in conclusion, the best step for an inmate to take is one towards silent acceptance of the circumstances they find themselves in. For example, I accept that during my next doctor visit I will be forced to Skype with a doctor I have never met before while a building full of strangers listens in.
βI accept that I am not a patient being seen by a doctor but rather a box needing to be checked by the state.
βI accept that I am being medicated by a doctor who has put zero effort into diagnosing my condition.
βI also accept and constantly remind myself that if I make too much of a fuss about what I am forced to accept, I may wind up naked in a dark room without windows for the rest of my sentence.
βSilent acceptance of the circumstances is a much better alternative. Still I wonder, if other inmates take this same approach and never raise these issues, are we making it possible for the Department of Corrections to provide mental health treatment that is counter-therapeutic and devoid of privacy?
βDoes our silence ensure that there will never be any improvement?β
