After being released from Tomoka Correctional Facility, AIDS patient Keith Carter revealed the deficient health care he received while incarcerated. “It’s a terrible, terrible feeling to be powerless over your own life. The judge gave me ten years. He didn’t sentence me to death”. Carter’s poignant comment tells a lot about the health care available to prisoners in this country. Terry Kupers’ studies of mental health care in prisons as well as articles from Prison Nation reveal that although prisoners are the only Americans with a constitutional right to health care, ironically, the care they receive is often the most inadequate.
Terry Kupers is a leading authority on the treatment of the mentally ill in prison. Prisons and jails have become the largest mental asylums and providers of psychiatric care in the United States. The deinstitutionalization of public mental health care providers in addition to harsher laws in taking mental illness into account in regards to sentencing has put a large number of people with psychiatric illnesses behind bars. In fact, more individuals with mental illnesses are in prison than in non-correctional psychiatric facilities. The needs of mentally ill inmates are often ignored by prison guards, whose main concern is security, not the emotional and medical needs of those they are guarding. Prisoners who are mentally ill not only receive inadequate psychiatric care but also suffer on account of increasingly harsh prison conditions. The “mass warehousing” of criminals creates a hostile environment that increases the likelihood that these people will resort to violent or antisocial behaviors while in jail or upon their release. This applies to all inmates, but especially psychotic ones. Sensory deprivation, social isolation, and total idleness induce intense rage and disorientation in anyone, especially those already prone to mental breakdowns. Mentally ill prisoners have a hard time following the prison code, which says that only the tough, intimidating bullies survive. They also don’t understand the code against snitching, and are often victimized by other felons. With regards to rehabilitation, it is even more difficult for these inmates to be acclimated back into society upon their release because their mental health conditions are severely worsened while in prison. Kupers points out that this poses a danger to public safety. Based on his observations of the mentally ill in prison, Kupers calls for a more humane approach to crime and justice.
The articles from Prison Nation point out the inadequacies of other aspects of health care within prison systems in the United States. Medical care in prison is sub-par – nurses often use the same needles on patients, the ill are left unattended, there are excessively long lines to see the doctor, and inmates are often victimized by emotional and sexual abuse. The nation’s prison population now boasts the highest concentrations of hepatitis C in the country. Prisoners with HIV or AIDS are being denied proper treatment. Many prisoners are believed to be “faking”, and are denied the medical attention they need. A key factor is the low-caliber doctors found in prisons. Doctors found incompetent to practice in any other jurisdiction are sought after by prison systems. “Prisons get first-rate deals on third-rate physicians”, report Sherwood and Posey.
The problem with the health care available to prisoners poses a philosophical debate. At what point in a human’s existence do we consider their life no longer worth living? Based on the current heath care system in prisons, this devaluing of life occurs after an individual has acted in a manner termed deviant based on social norms and the law. In no other jurisdiction would this deficient medical care be acceptable. The lives of these “marked” individuals do not matter to us anymore, since they have left the productive ranks of society. This attitude is in conjunction with the shift in focus from rehabilitation to punishment. What we must keep in mind is that most prisoners will be released from jail eventually. Because inmates are not receiving the medical attention they deserve while incarcerated, it will be more difficult for them to live outside of prison upon their release. Jackie Walker of the ACLU sums it up nicely with her observation: “Prisoners are going in expecting to do 10-15 years, and they’re ending up with a death sentence…They’re not getting the (medical) treatment that they deserve to receive”.
 Anne Marie Cusac, “The Judge Gave Me Ten Years. He Didn’t Sentence Me to Death,” Prison Nation, ed. Tara Herivel and Paul Wright (New York: Routledge, 2003), 199.
 Mark Sherwood and Bob Posey, “FDOC Hazardous to Prisoners’ Health,” Prison Nation, ed. Tara Herivel and Paul Wright (New York: Routledge, 2003), 204.
 Silja J. A. Talvi, “Hepatitis C: A ‘Silent Epidemic’ Strikes U.S. Prisons,” Prison Nation, ed. Tara Herivel and Paul Wright (New York: Routledge, 2003), 186.