WE'RE ALL PRISONERS OF OUR INCARCERATION POLICIES

Everybody knows we've been sweeping something under the rug. The lump is too
big not to notice, but until recently few people have had any inclination to
clean house. Terry Kupers thinks that is changing.

Kupers, a psychiatrist, says that for too long, mentally ill people have
been disappearing into prisons while the rest of us looked the other way.

"We live in a very cruel time," he told me recently. "There is not a lot of
sympathy for the poor or for immigrants. There is harshness toward the
underdog." So it is not surprising, he said, that most people have not cared
about the fate of people who suffer from mental illnesses.

But he thinks the pendulum has swung as far in the direction of cruelty as
it can go.

The wrong antidote

Kupers has written a book that gives his diagnosis and prescription for our
penchant for hiding people with whom we do not want to be bothered. "Prison
Madness" arrives in book stores this month with anecdotes, statistics and a
very large pill: Stop using police and prisons to treat social ills.

We've been fooled (willingly) into believing our biggest problem is crime,
so that while we focus on locking up as many people as we can, the real
problems - joblessness, homelessness, inadequate education, drug abuse,
inequality - go unaddressed and keep churning out new people for us to
imprison.

Kupers practices in Oakland, where he is president of the East Bay
Psychiatric Association and a fellow of the American Psychiatric
Association. He has been a consultant to the Civil Rights Division of the
U.S. Department of Justice and to Human Rights Watch and is the author of
several books on mental-health issues.

He doesn't oppose locking up people who pose a danger to others, but he says
most of the people sent to prison each year in this country are sent there
for nonviolent crimes. A significant number of those people are mentally
ill.

Even as we approach a new millennium, our attitudes toward mental illness
remain stuck in the very distant past. In our own state, mental-health
funding is woefully inadequate, and across the country insurance companies
refuse to treat mental illness as seriously as they treat physical illness.
If it doesn't bleed, it can't be real.

Jails and prisons, which see more than their share of people with mental
problems, are even less accommodating.

In his book, Kupers argues that many people who commit crimes because they
are mentally ill become victims of more violent criminals in prison. Some of
them learn to be violent themselves, as do other nonviolent inmates.

More violent people come out of prison than go in.

Kupers also says the conditions in most prisons are likely to drive some
previously sane or borderline inmates across the line into psychosis.
Prisons are often crowded, noisy places where people are deprived of privacy
and constantly fearful of being preyed upon.

He describes beatings and rapes, feces fights and other behavior so common
in prison that it's a wonder anyone there remains sane.

The capacity of most prisons to deal with mental illness is limited.
Sometimes there are resources only for treating the most dangerous
psychotics without offering care to the large numbers of other prisoners who
might need it.

Controlling, not healing

Even when there is care, it often is aimed at controlling rather than
healing people. Health-care workers with the best intentions become
overwhelmed and many times burn out.

In the course of studying many prisons, Kupers came to this conclusion: "Our
prisons are designed to fail." If the prison system curbed crime, the system
would begin to shrink, but if it contributes to crime, it grows and
prospers.

"We know that prison overcrowding causes increased rates of violence,
psychiatric breakdown and suicide, yet we keep pouring more people into our
prisons," he writes.

"We know that well-designed rehabilitation programs help prisoners prepare
for `going straight' whereas idleness leads to violence and emotional
disability, yet we keep on dismantling prison rehabilitation programs."

He cites Washington as one of the states where serious efforts are being
made toward reform, but even here there are a multitude of obstacles.

In the end the burden of change rests with us. We have to make it clear,
with our votes and our voices, that we want less madness in and out of
prison.

You can reach Jerry Large c/o The Times, P.O. Box 70, Seattle, WA 98111.
Phone: 206-464-3346. Fax: 206-464-2261. E-mail: jlarge@seattletimes.com.