The New Asylums

Written, Produced & Directed by Miri Navasky & Karen O'Connor

ANNOUNCER: They are schizophrenic—

1st INMATE: Tried to kill myself about 17 times.

ANNOUNCER: —paranoid—

2nd INMATE: This is a plot by the government!

ANNOUNCER: —and psychotic.

JERRY THARP, Inmate: Thorazine me out, leave me for lost.

ANNOUNCER: But they are not in mental hospitals, they are in prison.

GARY BEVEN, M.D., Chief Forensic Psychiatrist: Prisons have become the new asylums, the new state mental hospital facilities.

ANNOUNCER: Tonight, FRONTLINE takes an unprecedented journey inside one of America's largest prison systems.

JAMES SCHMIDT, Corrections Officer: Once they get out of control, you do have to use force on them.

ANNOUNCER: And investigates the stark reality of locking thousands of the mentally ill behind bars.

REGINALD WILKINSON, Director, Ohio Dept. of Corrections: The attitude has been, "Lock people away. Then they're no longer a problem."

FRED COHEN, Prison Mental Health Consultant: Prison is simply not the place to provide mental health care.

ANNOUNCER: Why have America's prisons become The New Asylums?

[intervention team]

POLICE OFFICER: You know, I didn't get your name. My name's Alex. What's yours?

MAN: Jessie Parlet, from Corvala, on the other side, three courses, 450 degrees molecule, 3175 away from Luther.

POLICE OFFICER: OK. Are you giving me directions?

MAN: Yeah, I'm giving you fathoms.

POLICE OFFICER: OK.

EMT: Are you on medications that you're not— that you haven't taken today?

MAN: Yes.

EMT: Yes you did, or no—

MAN: No, I did not take them.

EMT: OK. Are you out of them? Are you out of them?

MAN: Yes, I am.

POLICE OFFICER: What apartment do you live in?

MAN: Apartment 18.

POLICE OFFICER: Apartment 18.

MAN: Yes, 1-8.

POLICE OFFICER: Very good.

EMT: Who do you live there with?

MAN: I stay there by myself.

POLICE OFFICER: OK. Do you have a phone at your house?

MAN: No.

POLICE OFFICER: OK. If something happened where you needed to get hold of family in an emergency—

MAN: Yes.

POLICE OFFICER: —who would you call?

MAN: I would call— nobody, really. I don't have any family right now.

POLICE OFFICER: Do you have a brother or a sister, a mother, a father—

MAN: No, I do not.

POLICE OFFICER: —an aunt or an uncle that may be able to help you today?

MAN: No.

POLICE OFFICER: OK.

EMT: Where are you from? What city?

MAN: I'm from— I don't know, really.

NARRATOR: Scenes like this have become all too familiar throughout America. As the nation's psychiatric hospitals shut down, police departments everywhere were left to handle the growing number of mentally ill on the streets.

1st POLICE OFFICER: Watch your head. Watch your head.

WOMAN: Her husband's coming up here, saying, "Open the door." "I can't let you in, you guys are going to kill me," and all that.' She thought we was going to kill her.

1st POLICE OFFICER: Why'd she think that?

WOMAN: You know, she's crazy.

2nd POLICE OFFICER: Husband was telling us she's just off her meds.

3rd POLICE OFFICER: So you guys just going to do a voluntary thing?

2nd POLICE OFFICER: Yep. She's set to go. She wants to go.

FRED COHEN, Prison Mental Health Consultant: Once you had hundreds of thousands of people leaving the mental hospitals, they suddenly, obviously, didn't become mentally healthy. They went to the streets, they became homeless, and then they eventually began to cycle into the system that cannot say no.

[www.pbs.org: What happened to mental hospitals?]

INTAKE CLERK: Have you ever considered or attempted suicide?

NEW INMATE: No.

INTAKE CLERK: Do you plan to harm yourself now or while you're incarcerated?

NEW INMATE: No.

MARK BARRETT, Chief Deputy, Franklin Cty. Jail, Ohio: Well, most of them are non-violent crimes. They're crimes against property, the petty theft out of the local 7-Eleven store, or even a criminal trespass. A person with a mental issue goes in there to try and get shelter from the elements outside, and they start acting up. And the property owner, you know, calls the police. And then as soon as the police step in, they end up bringing them to jail, and here we go.

NARRATOR: Today, there are nearly 500,000 mentally ill being held in jails and prisons throughout America. That's 10 times the 50,000 that remain in psychiatric hospitals.

[county jail]

INMATE: I want to see the doctor to get my meds. Get out of my face, you filthy bitch!

MENTAL HEALTH COUNSELOR: All right. All right.

NARRATOR: This massive incarceration of inmates with severe mental illness has created enormous problems for prisons across the country.

REGINALD WILKINSON, Director, Ohio Dept. of Corrections: There was a failure in society. There was no safety net for all these persons who were no longer being treated by mental health agencies. And as a result, many of those persons who would have been in state hospitals are now in state prisons. So in addition to being the director of the Department of Corrections, I became a de facto director of a major mental health system.

NARRATOR: Ohio corrections officials agreed to give FRONTLINE unprecedented access to their prison system to see first-hand the difficulties of coping with the thousands of mentally ill inmates in their custody.

[group therapy]

1st INMATE: I just feel like I'm suffering, man. I feel like I'm suffering every day. I just feel like I'm suffering. I feel like I'm just— I'm just in a— in a— in a locked— a real small locked room. And no matter how much I kick on the door, no matter how much I scream, man, don't nobody hear me, man.

COUNSELOR: What about you, Mr. Simmons?

2nd INMATE: They said I'm a paranoid schizophrenic.

COUNSELOR: Are you on forced medication?

2nd INMATE: Yeah.

COUNSELOR: What medications are you on right now?

NARRATOR: This is group therapy at the maximum security prison in Lucasville, Ohio.

3rd INMATE: Didn't like a lot of things I seen in my childhood, a lot of things I seen in my household. Start having hate inside of me.

COUNSELOR: Come here, man. Let me see your arms. Bring them here. I haven't even got to see them. [examining wounds] What's new, all these?

4th INMATE: All of them.

COUNSELOR: These? How about this? This new?

4th INMATE: Yeah.

COUNSELOR: What drove you to this point, man? Last time I seen you, you was doing good.

4th INMATE: I just— the bottom dropped out, and I just couldn't think of nothing else.

REGINALD WILKINSON: Sixteen percent of our prison population in the state of Ohio — which reflects, basically, a national average — are persons who've been diagnosed with a mental illness, which means that they require an awful lot of attention. Many of them require hospitalization. They require, you know, major regimens of psychiatric medications. And they are a population that would be at risk not only in the institutions, but when they leave the confines of our correctional facilities.

NARRATOR: Ohio spent the last decade reforming their system and is now considered a model for providing mental health care behind bars.

INMATE: I said, A-ha! Can we get a witness? Can we hear the Bible verse up there, Reverend Jack Black?

JAMES SCHMIDT, Corrections Officer: We've had inmates bang his head on the wall, scream, shout, yell, kicking the doors, kicking the bars. That'd go on forever. Throwing human waste on the range, that's something that happens regular. And somebody new that would come in here and experience something like that, they'd probably want to turn right back around and leave, say, "I don't want to come back in this place." But you get used to it after a while.

NARRATOR: In Ohio, mentally ill inmates are separated from the prisons' general population and housed in mental health units where they can be treated.

ERIC NEFF, Corrections Officer: You have to have a little more patience here. You have to have a lot more patience here, not a little, because it gets pretty frustrating at times to have to tell somebody to do something three, four, five, six times before they do it. A lot of them simply don't understand the rules. If they're paranoid about something, you know, they think somebody's out to get them. It's just a different world in here than it is in the rest of the prison. This is another world inside a world.

BRIDGET BENETIS, Mental Health Administrator: You have this population of seriously mentally ill, and simply keeping them locked up isn't going to do any good for the inmates themselves, or for the prison. So you bring the treatment part of it into it, and maybe this is the first time some of these guys have received treatment. We have medication here. We have the psychiatrists here. We have nurses here 24 hours a day. And some of the guys here probably have not had that level of care, maybe not ever in their lives.

COUNSELOR: Now, you haven't heard voices?

INMATE: No.

COUNSELOR: But you do have some special abilities, right?

INMATE: Yeah, mental telepathy.

COUNSELOR: Yeah, which is different than voices.

INMATE: Yeah, it's a lot different. A lot more friendlier.

COUNSELOR: Yeah. And who's the main person that you have telepathy with?

INMATE: The main one is Ms. Hillary Clinton now, and then the next one is George Bush. Then I talk to Ms. Oprah Winfrey sometimes.

COUNSELOR: How is she friendly to you?

INMATE: She's the power builder of my all well-being.

DEBBIE NIXON-HUGHES, Chief, Bureau of Mental Health, ODRC: We've projected about 25 or 30 percent of those individuals that have a chronic mental illness will always need someone making sure that they take their medication, having somebody mediate in terms of interpersonal relationships that they might have with staff, as well as have with other inmates, having a population or an environment where people understand that illness and yet keep in mind what the security needs are.

INMATE: And I say, what the [deleted]! I want out of my [deleted] mouth to any one of you bitch [deleted], and I'll rape all you bitches, [deleted], every one of you? [unintelligible] I'll rape— I rape all these bitches! And you talk about raping Julie Riley, you [deleted]

GUARD: You want your light on?

INMATE: What?

GUARD: You want your light on?

INMATE: Yeah, I want it on, bitch! You better not [deleted] with it, you faggot!

COUNSELOR: Is this what you wanted me to have? OK. And this is what we've been talking about on numerous occasions. You want PC because you don't feel safe.

BENNIE ANTHONY, Inmate: Yeah.

NARRATOR: Bennie Anthony, a paranoid schizophrenic, spent much of his life in and out of psychiatric hospitals. In 1987, within weeks of being released, he had a paranoid episode and set his girlfriend's house on fire.

BENNIE ANTHONY: Protective— protective custody— I will feel comfortable.

COUNSELOR: But you're kind of like in protective custody. Remember? We discussed this, Mr. Anthony.

BENNIE ANTHONY: But I want protective custody.

COUNSELOR: You're in your own cell.

BENNIE ANTHONY: I want protective custody.

COUNSELOR: All right.

BENNIE ANTHONY: I want protective custody because I'm scared.

COUNSELOR: OK. And what are you afraid of?

NARRATOR: Anthony has believed for years that people are trying to kill him.

BENNIE ANTHONY: They was from Texas. They was coming out of Texas. Some of them have syringes of poison, electric— electric, battery-powered, volts on them, where they can pierce your heart or your stomach. And some of them have wooden— wooden bats, like. And guns.

[mental health team meeting]

CHIEF: OK, Eric, what have you got?

ERIC WIDDOWSON, Psychiatric Nurse: Looks like a busy weekend. Starting Friday, inmate Taylor down in J4 tried to hang himself. They put him upstairs on a watch.

NARRATOR: Each morning, the mental health staff meets to discuss inmates who are in crisis.

ERIC WIDDOWSON: Inmate Waller was placed on observation status for possible psychosis. He has not been med-compliant with his Risperdal all weekend.

CHIEF: OK, anything else on any of these folks?

COUNSELOR: There are at least two others that are on their way here that have put toothbrushes up under the skin in their arm. The difference is that Taylor had two toothbrushes up his arm, and they were only able to retrieve one. The other one started to scoot up out of sight, so they— they're just monitoring that at the present time.

NARRATOR: When inmates need acute care, they're brought here to the prison infirmary.

1st INMATE: Brought me up here on constant watch because they was afraid I was going to do something, and they thought I was either going to try to kill myself or seriously hurt myself again,

2nd INMATE: I don't know. I think my meds need to be changed.

COUNSELOR: They've already decided to do that. It might take a few more days for that to take effect for you. So we'll talk to you some more later on, see how it's progressing for you.

GARY BEVEN, M.D., Chief Forensic Psychiatrist: Hey, Waller, you seem kind of upset. I'd be willing to talk to you, and maybe we can resolve all this.

3rd INMATE: Resolve what? I was doing fine working in the kitchen, this and that, and I go see this— whoever the hell this psych doctor is and—

Dr. GARY BEVEN: Have you not been taking your medication? Is that true?

3rd INMATE: I don't feel I need it.

Dr. GARY BEVEN: Providing effective psychiatric care in a maximum-security prison is extraordinarily difficult. Many patients decompensate and become extremely depressed, hopeless, suicidal. Many turn to severe self-mutilation or acts of self-injury. And many inmates that also suffer from severe mental illness become delusional and hallucinate.

GUARD: Bankston, can you hear me?

ROBERT BANKSTON, Inmate: No! No!

NARRATOR: Robert Bankston, a paranoid schizophrenic, was brought to the infirmary when he became psychotic and started banging his head against the wall.

1st GUARD: Roll him over.

2nd GUARD: Inmate Bankston, 40151686. The nurse states that he's having a psychotic episode. Medication has been administered. At this time, I have officers restraining this inmate on the gurney because it's become necessary to do so. He'll be placed in cell 18 D-1 infirmary. He'll be placed in restraints.

ERIC WIDDOWSON, Psychiatric Nurse: I've dealt with Bankston in crisis a couple of times, and I think the biggest problem that we had with him was complying with the medicine that we were trying to provide for him. He would just take it whenever he felt like it. Sometimes he wouldn't. Then perhaps, when he became sicker is when he decided to not take it anymore, which seems to be the normal course for a lot of mentally ill people. They start getting sicker, and they think it's the medicine that's making them sicker and they quit taking the medicine. And if they're not on mandated medicine, then they continue to decompensate further.

NARRATOR: The medical staff decided to keep Bankston in the crisis unit on constant watch. But he continued to refuse all the officers' orders to "cuff up," so the prison's special response team was called in.

GUARD: Bankston, I gave you a direct order to step up here and turn around so handcuffs can be applied.

ERIC WIDDOWSON: He was also given emergency medication to help with possible psychosis. At approximately 7:10, I went down to check inmate's file to ensure that chemical agent can be used on him. I'll be here to monitor use of force.

GARY BEVEN, M.D., Chief Forensic Psychiatrist: I think the first thing that people should realize is that prison doesn't exist to provide mental health treatment, the prison exists to provide security and safety to the community. And so you have to be realistic. If there's an inmate, even though he's sick, refuses to come out of his cell, refuses to allow officers to inspect the property, refuses to comply with orders and stands fast to that, eventually, that inmate is going to do what they're told, whether they want to or not.

ROBERT BANKSTON: [screams]

GUARD: I'm giving you another direct order to step up here, Bankston. You guys ready?

ROBERT BANKSTON: [screams] Please, sir! Please, sir! Please, please, please, please! [screams] Ow! Ow! Ow! Ow!

NARRATOR: Soon after this crisis, Bankston was placed on mandated meds and forced to take his medication until his condition stabilized.

ROBERT BANKSTON: I snatched a purse back in 1989. If I'd have knew I was going to have to go through all this, boy, I wouldn't have— believe me, I wouldn't have never snatched no purse. But yeah, this is classified as a robbery.

NARRATOR: Because of his long history of psychotic and aggressive behavior, Robert Bankston has served much of his time at the maximum security prison.

Dr. GARY BEVEN: Many severely mentally ill inmates have come into prison either on minor violations of the law or parole violations. And they were previously at a minimum or a medium security prison, and because those prisons have their own strict rules and guidelines and expectations of compliance with security protocols, those inmates with serious mental illness just can't follow the rules appropriately. They're frightened. They're scared. They're paranoid. They're anxious. They're pacing. They're restless. They don't take their medications. And then they filter down to a prison like this, which is kind of like the basement for the severely mentally ill in Ohio.

NARRATOR: Concerned that too many mentally ill inmates were ending up at its maximum security prison, Ohio began to take mental illness into account in their disciplinary process.

REGINALD WILKINSON: The biggest change that we started to pay attention to, when we looked at certain kinds of behaviors prisoners were demonstrating, that may have been psychiatric but that may not have been, we wanted to understand the theory — and I'm not trying to be crass here — the difference between mad and bad. You know, we wanted to know if behavior that resembled deviant behavior was related to just criminal kinds of activities or if it was induced by some mental illness.

GUARD: You're in trouble. You might have to wait a few minutes, all right?

NARRATOR: Michael Shreves, in prison for aggravated robbery, was diagnosed with bipolar disorder. He was recently charged with spitting on an officer. Before his disciplinary hearing, Shreves is meeting with a mental health counselor. If mental illness is found to play a significant role in his misconduct, the charges can be dropped.

COUNSELOR: So the big issue is about— the officer is accusing you of spitting on him.

MICHAEL SHREVES: See, what it was, was I'm watching myself, he grabs the back of my jumpsuit, throws me on the ground. I was trying to— get off me. I didn't do nothing.

COUNSELOR: While you disagree with what he said, you do remember the incident, right?

MICHAEL SHREVES: Yeah, but not spitting on him.

COUNSELOR: Right. But you do remember the incident.

MICHAEL SHREVES: Yeah, because he said to me, "Do you spit?" I said, "I don't spit."

PRISON OFFICER: Kahn?

MICHAEL KAHN, Inmate: Yeah?

OFFICER: Come on in here.

MICHAEL KAHN: You know, they started the lunch already.

OFFICER: Shut the door and have a seat.

MICHAEL KAHN: OK.

NARRATOR: Michael Kahn, in prison for rape, began to yell when he couldn't reach his parents on the telephone. He threw his glasses on the ground and emptied his shampoo bottle all over his cell.

OFFICER: Case number is 20040368. State your name and number for record.

MICHAEL KAHN: Michael David Kahn, 234609.

OFFICER: Kahn, how do you plead to a rule 18?

MICHAEL KAHN: Guilty.

OFFICER: Kahn, at this time, the committee's going to allow you to make a statement.

MICHAEL KAHN: Dr. Martin— Dr. Martin was going to keep me on level 2 for one year or so and get special permission from Steve Dillon to have my TV, as well as my fan trimmers in my cell, while being on level 2, until I showed some improvement. What happened, I ignored the fact, but a Mr— or not realizing the fact—

OFFICER: Kahn, what does that have to do with this conduct report? What I want to know is what took place during the time of this conduct report. I don't want to know what happened when you was talking to Dr. Martin.

NARRATOR: Michael Kahn was found guilty of creating a disturbance and destroying state property. Although he could have been sent to segregation, his only punishment was to have his phone privileges revoked. And Michael Shreves was also found guilty. It was his 18th rule violation this year, and he was sent to segregation.

MICHAEL KAHN: And I see the parole board in March of 2005 and—

FRED COHEN, Prison Mental Health Consultant: If an inmate spits or refuses to hand back his food tray or curses an officer or doesn't cuff up, when the officer says, "Put your hands out, cuff up"— if that person was in a hospital setting, that would be considered acting out or symptomatic of the illness. In a prison system, that's considered, "I'm telling you to cuff up or I'm going to write you up." They write them up. They go before a tribunal, a disciplinary tribunal. They're found guilty, and they're sent to segregation. Probably the worst thing that could happen to them and to the system, but that's what happens. That's what happens.

ERIC NEFF, Corrections Officer: It gets to the point where there's no— there's nothing else can be done. You're going to have to lock them up in segregation. They have to be locked up and removed from the area, or it's going to cause— just going to escalate. It's going to cause a bigger problem on the block. And then you kind of lose control of everything in the block.

JAMES SCHMIDT, Corrections Officer: A lot of the mentally ill inmates that are in here, you got to use more— I mean, you do have to use force on them. Just— it just seems that way. To me it does, anyway, because once they get out, and then they get out and once they reach that level, they're out of control, you know, then they need to— they need to be secured.

[www.pbs.org: More from the officers' perspective]

GUARD: Come on Donny.

DONALD HALL: No!

GUARD: Donny, this is your last chance.

DONALD HALL, Inmate: Don't want to go with them!

GUARD: Donny—

DONALD HALL: To go with him! I ain't going to fight. I'll walk, OK?

NARRATOR: Since entering prison in 1981, Donny Hall, convicted of rape, has had a terrible record of misconduct that has sent him to segregation nearly a hundred times. He has cut himself, spit on officers, thrown urine and feces and flooded his cell.

When the staff at Lucasville can no longer handle his behavior, their final option is to send him to the prison psychiatric hospital. Oakwood Correctional Facility was built on the grounds of one of Ohio's abandoned state asylums. Here inmates are treated more like patients than prisoners. This is the 18th time Donny Hall has been sent to Oakwood.

DONALD HALL: These people down here know how to help me, know how to give me the right medication. I don't have to be locked down all day, can go to the gym, be in the day room all day, go down to the dining room to eat. Got more freedom. I feel a whole lot calmer, more better. Don't feel upset no more. And I'm doing a whole lot better, a whole lot better.

DEBBIE NIXON-HUGHES, Chief, Bureau of Mental Health, ODRC: Every aspect of your life, from eating your meal to recreation to treatment, is all centered around attempting to stabilize the mental illness. It's a 24-hour treatment environment, like any other hospital in the community.

[card game]

SIGMON CLARK, Inmate: Uno!

DONALD HALL: Shuffle up, Clark. Shuffle up.

SIGMON CLARK: These all mine?

DONALD HALL: Yeah. Shuffle up, like this.

NARRATOR: Sigmon Clark, convicted of robbery, has been in and out of prison for nearly 20 years and has been hospitalized at Oakwood many times.

DONALD HALL: Cut your cards. Cut.

NARRATOR: He became so delusional that he was convinced officers were trying to kill him. And to rid himself of the poison, he started drinking water from his cell toilet.

SIGMON CLARK: The colors go down the same way?

DONALD HALL: Yeah, yeah. The same colors, the same way.

SIGMON CLARK: I went to, like 7, 8 institutions, in some of them 12 years, to a point behavior will go up and down. They will change my security level. And it will go up and down, and I would do better. Sometime I had to go to a higher security, if I done worse. Sometime I had to go to a lower security, if I done better. But I still had this disease, mental illness, regardless of what is happening to me.

NARRATOR: Although Clark's behavior has improved significantly while at Oakwood, he cannot stay indefinitely.

FRED COHEN, Prison Mental Health Consultant: It's just not intended to be anything other than a turn-around hospital, get you back to your environment. And it has a mission, short-term acute care— stabilize. We're not saying you're better, we're saying you're stabilized, and you go back.

[Oakwood discharge meeting]

SIGMON CLARK: Good morning, ladies and gentlemen.

1st PHYSICIAN: We were discussing you before you came in, Mr. Clark, and we think you've done wonderful in here. So we are thinking of sending you back to Lucasville. What is your idea?

SIGMON CLARK: The question is, is that in my best behalf at this time?

1st PHYSICIAN: We think so, yes.

2nd PHYSICIAN: You have adjusted beautifully well to the level of medication. There's been absolutely no side effects whatsoever. Quite frankly, you've been an exemplary patient. People don't go to the hospital to stay forever, they stay as long as they need to be there. Clinically, we feel that you have improved to the point that you can now start functioning in a manner that's OK for you back in your system. Your delusions are way down. You're not hallucinating. You go to group. You have goal-directed conversations. In other words, you're doing real well.

SIGMON CLARK: In this setting. Do I do well in another setting?

2nd PHYSICIAN: And I see no reason why you can't.

NURSE: A lot of it's up to you.

1st PHYSICIAN: Don't you want parole with better options?

SIGMON CLARK: I want a better day every 24 hours.

1st PHYSICIAN: True.

NARRATOR: After 90 days at Oakwood, Sigmon Clark was sent back to the maximum security prison in Lucasville.

SIGMON CLARK: Good afternoon, ladies and gentlemen. Neff, you done lost weight. You on days now?

ERIC NEFF, Corrections Officer: Yep, back on days.

NARRATOR: Each time he is returned to the prison's mental health unit, Clark's condition has deteriorated and he's ended up back in the prison infirmary.

SIGMON CLARK: It was gloomy because I know I'm coming down the road of isolation now. You're just stuck in a cell with all kind of thoughts going through your head.

Neff, I need a pillow and some toilet paper.

ERIC NEFF: I'll get you. One second.

SIGMON CLARK: I always try to stick it out by one— taking it one day at a time, doing the best each day and hoping that the next day is brighter.

ERIC NEFF: I think, basically, this is home to him. It gets to the point where the treatment that everyone receives in prison is pretty much all that's left. It's pretty ironic that they have to be locked in prison, probably, to get better mental health treatment than they could get if they were free.

NARRATOR: At Lucasville, the mental health staff struggled for nearly four years to manage and treat Jakuba Lewis's schizophrenia.

Dr. GARY BEVEN: If you had seen Jakuba Lewis several years ago, when he was incessantly hallucinating and really struggling, one would think, "There's really no hope for this person." But thankfully, even though we're here, we've been able to treat him very effectively, and his behavior stabilized to the point where he was able to be conduct-report-free, I believe, for over a year, which is really remarkable in a real strict environment where you're expected to follow the rules essentially irrespective of what your limitations are.

NARRATOR: Jakuba Lewis was transferred out of the maximum security prison to a lower security prison in Orient, Ohio.

REGINALD WILKINSON, Director, Ohio Dept. of Corrections: Unfortunately, I do believe that some of the mental health treatment that we provide in prisons is better than what one might get in the community. I've actually had a judge mention to me before, that, you know, "We hate to do this, but we know the person will get treated if we send this person to prison." When you know that the courts are more apt to send a person to prison because they're going to get treated, then there's something disconcerting about that.

[www.pbs.org: Read Wilkinson's extended interview]

JAKUBA LEWIS, Inmate: How're you doing? I'm doing fine.

NARRATOR: Lewis is meeting with his new mental health team to discuss his ongoing treatment.

COUNSELOR: Does your mental illness have something to do with your crime?

JAKUBA LEWIS: Yes

COUNSELOR: Can you share how?

JAKUBA LEWIS: Because when I was on the street, right before I caught my case, I was real, like— you ever heard how somebody say a dark cloud come over their head? Strange things was happening, but I really didn't know what it was. People was talking to me in telekinesis. Somebody was saying something to me, but they're really not. But back then, I couldn't tell the truth because I didn't know what schizophrenia was. I didn't even know I had a— I didn't know nothing about it. I thought it was real.

COUNSELOR: Well, do you feel comfortable telling me what the crime was?

JAKUBA LEWIS: Oh, I was down for— I had— I had murdered— I had killed two people.

COUNSELOR: And at that point in time, you thought that they were the enemy or—

JAKUBA LEWIS: Yes, I thought they were trying to kill me because of the way the whole day was going. Last four years, I've been learning more about it, so I know how to handle them a little better. But I'm still not to the point where I can control it. But I haven't had a psychotic episode in a long time.

NARRATOR: While Jakuba Lewis believes the treatment he received in prison has made him better, other inmates believe that prison has made them worse.

CARL McEACHRON, Inmate: Being locked up in prison, it does affect your mental well-being. It's just like these environmental factors, which must be— which— I— I continually say must be considered before one is— is given some diagnosis, some misdiagnosis or— or some drug, you know what I'm saying, that's supposed to be a cure-all. I'm saying, let's find out what's really going on first. And being in prison, that's one problem.

NARRATOR: Convicted initially for burglary, Carl McEachron returned to prison in 1988 when he violated his parole by stealing a bicycle. For nearly a decade, McEachron's disciplinary problems led him to spiral down through the Ohio prison system from medium security to maximum security and eventually to the supermax.

Dr. GARY BEVEN: He was the type of individual who was very difficult to work with because, in the past, he had been very aggressive towards staff, including, I believe, by spitting on staff members and throwing body waste. And so there wasn't a lot of empathy for him. There wasn't a lot of people going to bat for him, and people weren't saying, "We really need to help this person."

The tendency would be, for somebody like that, is just, "Let's lock him away." You know, "If this person's going to behave like that, let's just not have anything to do with him." Before we had the system in place that we do now, that type of individual would still be in segregation, and they would probably never get out of segregation.

[www.pbs.org: More on segregation]

CARL McEACHRON: Being— being involved in a solitary situation, being placed in a solitary situation, is— is like being placed in a prison's prison. And that's— that's worse than simply being taken from society and placed in prison.

FRED COHEN: If you're mentally ill when you go into segregation, you're going to become worse, invariably. If you're not mentally ill, the risk of becoming mentally ill is very high from isolation. Some people dispute that, but in my experience, the people who are so unsocialized and so psychologically fragile to begin with are deprived of any kind of social support, any kind of psychological stimulus, and they just— they just fall apart.

NARRATOR: McEachron spent years in solitary confinement, and eventually, his psychological problems became obvious. He didn't speak for nearly a year. He began crawling down the cellblock on his hands and knees. He told officers that there were cameras in his eyes.

CARL McEACHRON: It seemed like a hopeless situation because I was just— I was just going down, falling into this— this abyss or— how would you pronounce it?

INTERVIEWER: Abyss.

CARL McEACHRON: Abyss? OK. And it's like you're— you're— that's it. It's, like, "Oh, is anybody there," you know what I'm saying? "Help," you know what I'm saying? And it's— it's— it's really hopeless.

NARRATOR: Carl McEachron has been in prison for over 16 years. Because of his disciplinary problems, he never became eligible for parole and has been held 13 years beyond the sentencing guidelines for his crime.

CARL McEACHRON: I see the parole board next month. And it's— there is some hope there, that I hope they actually do release me. I hope this is— I hope they do, I really do, because this is my last year of really feeling— really having this hope. I'm not going to go off or anything like that, but I just hope they— they do really consider what's going on.

1st INMATE: And they killed my goddamn mother! All of them, every [deleted] goddamn [deleted] one of these bitches murdered my [deleted] goddamn mother! [unintelligible] And Julie Riley is my goddamn wife!

2nd INMATE: No, I'm not playing Jesus anymore. I showed you Jesus. I wasn't bothering the man about that. I got the two pillows in my room.

NARRATOR: For mentally ill inmates, obtaining parole is almost always difficult.

BENNIE ANTHONY: I got a parole board date next month. I'm hoping they'll let me go. I'd just tell them that I've been incarcerated for 16 years and have all remorse for things I've done. And I know I'm mental, but I'm not incompetent. And I know that— I know that I could really function on the outside. And I wish and hope that they would give me a parole, you know? Yeah.

NARRATOR: While most inmates hope to be released, Jerry Tharp, who was granted parole after a 10-year sentence for robbery, doesn't want to leave prison.

JERRY THARP, Inmate: You know, I'm trying to— you know, my release is coming quicker, and I'm trying to stop that because it'll help us all.

COUNSELOR: Well, I know you said you had some concerns in treatment team.

JERRY THARP: Yeah, and I've said that about every treatment team that I've went to, and still nothing's become of it.

COUNSELOR: Do you have other plans when you get out, then?

JERRY THARP: Yeah, I have other plans. And you know, the sane mind that I'm in now and the sanity that I still have says that's not, you know, right to go through with those plans. And innocent people will be hurt and murdered, and you know, also people will be hurt and murdered. So go ahead and stop the parole, you know, work with the system of things, which I've learned, and you know, well understood insightfully, so now—

I've been locked up, you know, for so long that, you know, I have a fear of going directly to society because, you know, in here in prison, life's a lot simpler and everything is on a tight schedule. And I've learned that out in society, the— you know, the world— well, society, it's— it's a lot bigger and more complicated, a little bit more scarier. And I'm trying to stop my release from, you know, prison to go to society.

INTERVIEWER: So what would you do with you?

JERRY THARP: Put me off in some government state hospital and take a— you know, a lobotomy, I think is what they call it. And I don't know. I think, in some states, it's still legal here. You know, Thorazine me out. And what I mean by that is, overmedicate me with Thorazine and just leave me in a room to sleep my life away. Just, you know, leave me— leave me for lost.

NARRATOR: Although he wants to live out his life in a psychiatric institution, there are so few mental hospitals left that long-term commitment has become almost impossible. Jerry Tharp was released to a half-way house.

REGINALD WILKINSON: I think a lot of the attitude has been over the years, "Out of sight, out of mind. You lock people away, then they're no longer a problem. Well, guess what? Ninety-eight percent of everybody who goes to the prison gets out. And it behooves us all to pay close attention to it when we can and not to sweep it under the rug.

NARRATOR: It's been over a year since Robert Bankston had to be restrained in the prison infirmary. In and out of prison for 16 years on his purse-snatching conviction, Bankston recently became eligible for parole.

ROBERT BANKSTON: That's a long time, I mean, for snatching a purse. And I've been down here paying ever since. I don't know. I hope they pay me. I hope they give me a parole, is all I will say, you know?

[parole hearing]

1st HEARING OFFICER: Mr. Bankston?

ROBERT BANKSTON: Yes?

1st HEARING OFFICER: We're ready to see you.

2nd HEARING OFFICER: Hello, Mr. Bankston.

ROBERT BANKSTON: Hi.

2nd HEARING OFFICER: Hi.

ROBERT BANKSTON: Hi.

2nd HEARING OFFICER: You've come a long way. Your behavior has improved significantly, hasn't it.

ROBERT BANKSTON: Yes'm.

2nd HEARING OFFICER: You haven't had a conduct violation since—

ROBERT BANKSTON: It's been a while. Since, I think, 2003.

1st HEARING OFFICER: Since 2003.

2nd HEARING OFFICER: I do notice that you tend to get in more trouble when you're not doing the meds right, or what?

ROBERT BANKSTON: Yes. I tend— I tend to get paranoid. Usually, that's what— that's when some— something take place. They wind up sending me to D-1 at Lucasville for refusal.

2nd HEARING OFFICER: Is that what's happened on the rest of these?

ROBERT BANKSTON: Yes.

2nd HEARING OFFICER: Is that what happens out on the street, too?

ROBERT BANKSTON: Yes, pretty much. My— my P.O., when I was out last time, he made sure I stayed on the medication.

1st HEARING OFFICER: Do you have contact with your family? Do you have a rapport still with your family?

ROBERT BANKSTON: Well, I talked to my aunt a week ago. That was— that was about the last person I talked to. My grandmother died since I've been locked up.

1st HEARING OFFICER: OK.

ROBERT BANKSTON: Not really. No, not really.

1st HEARING OFFICER: In terms of a place to reside, do you have a place?

ROBERT BANKSTON: With my mother. That's about it.

1st HEARING OFFICER: Well, you haven't talked to her, so you wouldn't know if you could reside there or not, right?

ROBERT BANKSTON: Right.

NARRATOR: Robert Bankston was granted parole on the condition that he continue his mental health treatment and meet regularly with his parole officer.

ROBERT BANKSTON: They gave me the parole, man.

MICHAEL TOWNSEND, Inmate: That's got to be the greatest feeling in the world.

ROBERT BANKSTON: Yeah, it's cool. Yeah, it is.

MICHAEL TOWNSEND: All you got to do is get out there and maintain, man.

ROBERT BANKSTON: Yeah. Hey, I didn't even know if I was going to get the parole or not, man.

MICHAEL TOWNSEND: Come on, man.

1st HEARING OFFICER: Michael Townsend?

MICHAEL TOWNSEND: Yeah. Put in my time, man.

NARRATOR: This is Robert Bankston's fourth parole. Each time he's been released in the past, he stopped taking his medication and ended up homeless, violated his parole and was sent back to prison.

Another inmate, Keith Williams, is about to leave the maximum security prison. He served his full two-year sentence for burglary and is being released to St. Paul's, a homeless shelter in Toledo.

INTERVIEWER: Is your family there?

KEITH WILLIAMS, Inmate: No, I'm not close with my family anymore, been away too long. I just— you know, St. Paul's, and then after that, somewhere else with my people.

INTERVIEWER: Who are your people?

KEITH WILLIAMS: Mommies, angels and cats.

INTERVIEWER: And where are they living?

KEITH WILLIAMS: They live all over the world, if I'm not mistaken. They live all over the world, all over the world.

DEBBIE NIXON-HUGHES, Chief, Bureau of Mental Health, ODRC: We release people with two weeks' worth of medication, yet it appears that it's taking three months for people to actually get an appointment in the community to continue their services. We have a fairly solid correctional mental health services that we have supported people with. And when they go out, they're going to have to be assertive, if not aggressive, to try to get the services that they need. And if they don't have the energy and/or the insight to do that, they're going to, what we say, fall through the cracks and end up back in some kind of criminal activity that ends up with them going back to jail and possibly coming back to prison.

OFFICER: We give you $75 gate money to go home on. So it's going to be a total of $81.16. There's 16 cents, and there's $81. OK? And good luck to you.

COUNSELOR: Mr. Williams— this is a two-week supply, so you'll need to get in to see the doctor before these run out to get a new prescription. The Risperdal is the green tablet and the Cogentin is the white tablet. If you miss a dose, then take it again at the next opportunity, but don't double up on the doses.

JAMES SCHMIDT, Corrections Officer: From working here, the 15 years I've been here, I've learned that a lot of the mentally ill inmates that are in here, you can't just lock them up and tell them to do 10, 20 years, and then soon as that time's up, send him back out on the street. It's not going to work. It's— it's not— definitely not going to work.

NARRATOR: Today, there are over two million people in U.S. jails and prisons, and nearly 500,000 of them are mentally ill. Although Ohio's prison mental health care system is considered one of the best, in much of the country, vast numbers of mentally ill inmates continue to receive little or no treatment.

REGINALD WILKINSON: I started in this work in 1973. We had 7,000 prisoners. Today we have over 44,000. And nationally, those numbers parallel what we experienced here in Ohio. But also in 1973, the number of persons in mental health and retardation facilities was a lot greater than what existed in state and federal correctional institutions.

FRED COHEN: Prison is simply not the place of first choice in which to provide mental health care. And with a certain irony, I would say we shouldn't devote ourselves to raising— continually raising the level of mental health care in prisons because the better you make an institution that shouldn't be used for the purpose you're improving, the more you're ensuring its use.

COUNSELOR: Are you in the community service project? See, if you can get in the community service project, he can hook you up with a lot more stuff.

REGINALD WILKINSON: We are the gatekeepers of a lot of persons who are mentally ill, and that's not something we relish. We don't like that idea. We don't like the idea that we're being charged with fixing a lot of the woes of our communities. But I don't think that we've developed the system of alternatives that need to be in place in order to prevent the kind of problems that we're dealing with now in prisons and jails across this country.

NARRATOR: Less than a month after being released from prison, Keith Williams stopped taking his medication and assaulted a counselor at the homeless shelter. He has been back to jail twice.

Jerry Tharp was out of prison for only two months when he robbed a pharmacy. Arrested hours later, Tharp told police he committed the crime because he wanted to go back to prison.

Carl McEachron, in prison for 16 years, was finally paroled. But before he could be freed, McEachron, who had come to the u.s. from Jamaica as a child, was detained by U.S. Immigration and deported.

After Robert Bankston was paroled, he stopped taking his medication and was asked to leave his homeless shelter. He hasn't reported to his parole officer in weeks, and if he fails to show up within the month, a warrant will be issued for his arrest.

And Bennie Anthony, who was in prison for 11 years, was also paroled. He is now enrolled in a special program for mentally ill inmates and is reportedly doing well.

THE NEW ASYLUMS

WRITTEN, PRODUCED & DIRECTED BY
Miri Navasky & Karen O'Connor

EDITOR
Daisy Wright

ASSOCIATE PRODUCER
Laura Minnear

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Olaf Bertram-Nothnagel
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ARCHIVAL MATERIALS
Ohio Department of Rehabilitation and Correction

SPECIAL THANKS
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Southern Ohio Correctional Facility
Correctional Reception Center
Oakwood Correctional Facility
Franklin County Jail

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ANNOUNCER: There's more on this story at FRONTLINE's Web site, including answer to frequently asked questions about the mentally ill in prison and about the making of this film, a state-by-state map, where you can learn about the situation in your state for imprisoned mentally ill people, the organizations that are helping them reenter society and the legislation pending in states and in Congress, plus interviews with experts and additional reports, and the chance to watch this program again on line. Then join the discussion at pbs.org.

Next time on FRONTLINE/World: In Lebanon, a former prime minister's assassination has sparked a revolution. Reporter Kate Seelye looks at the chance for democracy in a country with so many different factions. And in Liberia, a peacekeeper with a difficult mission to disarm tens of thousands of rebels.

— Are you going to hand in your weapons?

— No! No!

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