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Frontline: "The New Asylums"

Miri Navasky
Frontline Producer
Wednesday, May 11, 2005 11:00 AM

There are nearly half a million mentally ill people serving time in America's prisons and jails. As sheriffs and prison wardens become the unexpected and ill-equipped gatekeepers of this burgeoning population, they raise a troubling new concern: Are jails and prisons America's new asylums? With exclusive and unprecedented access to prison therapy sessions, mental health treatment meetings, crisis wards, and prison disciplinary tribunals, Frontline goes deep inside Ohio's state prison system to present a searing exploration of the complex and growing topic of mental health behind bars and a moving portrait of the individuals at the center of this issue.

Learn more about the special: The New Asylums.

Frontline producer Miri Navasky on was online to discuss their film "The New Asylums."

A transcript follows.

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Columbus, Ohio: This "film" should have been called "the new asylums as seen through rose colored blinders." You might have mentioned that all your inmate contacts as well as staff contacts were under the watchful eye of the department watchdogs. What you "produced" was the state of Ohio's "party line" misrepresented, redefined and short on reality.

Miri Navasky: I am not sure what exactly you feel was "rose colored" about the documentary. However, there were actually no conditions placed on what we could film and nothing was off-limits to our cameras. And honestly, we felt it was a very gutsy thing for the Director to allow us to do, as most prison systems across the country remain pretty closed.

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Rutherford, N.J.: It is 9:30PM and I just saw this advertisement. I wish I would have known earlier. I am going to see if the show is still on. Meantime I wanted to let you know that I have a son with a mental illness who is currently incarcerated. I have not been able to obtain any information on him and I am nervous and scared for his safety. He is 20 1/2 and is bi-polar(manic depressant) and ADHD. I don't believe that the court knows this. He self medicates with drugs as usually happens. When he reached 18 the government dropped his insurance and any help he was getting. He became homeless and started getting into a lot of trouble. This is a terrible situation. The U.S. has to do more. I phoned the court last time he was incarcerated for driving a mini motor scooter without a license. They said that they would take into consideration what I told them about his mental illness but nothing was done. There truly is nowhere to turn but letting them go to jail and hope that they receive treatment. How horrible for a mother to have to see this happen because she's not rich and has no means of obtaining proper treatment for her son. Is there anyway someone can help me please. I just want the court and jail to know that I am here for him and ready to give them any info they may need. They will not release any info to me. Thank you for your time. Thank you.

Miri Navasky: Very Heartbreaking and tragic. We heard many stories like this in our research, unfortunately. From what we saw, just continue to do what you're doing, be at every court hearing and let them know your child has family that cares. So much good luck to you.

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Kailua, Hawaii: Excellent film!! I am deeply moved to share the information with my legislators.

What was your budget? Who funded the film? How long did it take to make?

Miri Navasky: We were fully funded from the start by FRONTLINE,but then during production FRONTLINE received a production grant from The MacArthur Foundation and then the Open Society Institute gave Frontline additional funds to expand the web site.

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New York, N.Y.: I'm writing from Filmmakers Library in New York City. We watched your film last night and thought it was terrific. We distribute fine documentaries to the educational market; are there other films you have done that are available for this market? Thank you.

Miri Navasky: Karen O'Connor and I have been co-producing films together for the past 5 years. We have done two other films that are available through Frontline. "The Killer at Thurston High" a documentary about a school shooting in Oregon and "A Crime of Insanity" which looked at how our court system handles mental illness.

Thanks so much for watching!

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Newport News, Va.: We are contacting you from our AP Psychology class. We just watched the Frontline special. Here are a few of our questions: Is there a psychological evaluation of all prisoners when they enter prison? Is there a way to make sure they are taking their medications in prison? What programs are available to help the paroled inmates? Can't they do house arrest (ankle device)for the paroled inmates?

Miri Navasky: Yes, in Ohio, they now screen every inmate as they enter the system. However, I believe many states are still struggling with that issue and many mentally inmates get overlooked.

Yes, in Ohio they have the ability to hold a due process hearing and mandate inmates to take medication for a certain period of time.

Unfortunately there are not a lot of programs to help paroled inmates. In Ohio they have a few pilot programs (see our web site) but they still need more funding. And as you could see from our film, many inmates end up returning quickly to jail or prison.

Thanks for your questions.

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Chapel Hill, N.C.: We may have to accept the fact that our state prison system will replace the state mental institutions of the past. Legislatures will have an easier time appropriating money for prisons than for mental health institutions. If a decent amount of those appropriations can be siphoned off for mental health care, then this is probably a good development. The correlation between mental illness and crime is fairly high, so maybe it is appropriate that serious mental illnesses be treated in the prison system. Finally, some mental health patients have a difficult time keeping to their medication regimen, so a system such as the prison system, that requires absolute conformance to expected behaviors, may be the best approach to achieving medication compliance. Your comments?

Miri Navasky: To us, after spending months inside the Ohio prison system, that seems like a pretty big failure to us. Although you are correct that there are cases in which inmates are both mentally ill and violent, we also saw many cases in which more petty, non-violent crimes were leading mentally ill people to be incarcerated for very long stretches of time. I also believe that if there was better care in the community, many of the inmates we saw would have been able to be paroled and stay on their medication. for example, at least to date, Bennie Anthony, who was one of the inmates that went into a pilot program for mentally ill in transition....has been monitored and has been able to stay on his medication and, we are told, is doing quite well.

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Ann Arbor, Mich.: I submitted an earlier question asking about institutional and social factors other than deinstitutionalization that contribute to this crisis. Perhaps I should reframe the question to ask what challenges a filmmaker faces in addressing structural and institutional factors, in addition to conveying the personal impact these factors have in terms of people's "stories." Does a filmmaker sacrifice depth of institutional analysis and critique in favor of dramatizing personal stories?

Miri Navasky: This was a big struggle for us, especially in a one hour documentary. We did end up cutting out a lot of the back story in Ohio (deinstitutionalization, tougher measures on crime, lawsuits and etc...) in order to be able to have more time inside the prison. We felt that much of the back story was more familiar to people and what we really wanted to be able to achieve was to bring viewers into a world that they rarely have the ability to see. But yes, the struggle between the personal and the larger historical issues are always difficult. Thanks.

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Columbia, Md.: I noticed that the majority of the inmates interviewed were African American. Was that reflective of the general prison population or does mental illness and the lack of proper care seem to have a more dramatic effect on the African American community? Thank you for your response and as always thanks to Frontline for producing great features.

Miri Navasky: In the mental health units, the prison population and race statistics are constantly changing as inmates move in and out. But in Ohio, as in states across the country, African Americans are over-represented in general in our criminal justice system. And particularly in the Maximum Security Prison. But honestly, as filmmakers, we just followed stories that we felt were important.

Thanks for your question!

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New Albany, Ind.: I happened on your program last night totally by accident. My son died in prison on March 15, 2001. He was diagnosed with paranoid schizophrenia after stabbing his best friend without provocation the weekend after Thanksgiving 1998. After 1 1/2 years in jail, he was sentenced to 15 years in prison. He lasted approximately 2 months in general population before attempting an "escape" over the fence just a few feet from guards. He was sentenced to 1 year in the SHU despite our pleas for leniency and understanding of his situation. He entered the SHU in November and in the early hours of March 15 was "found unresponsive" in his cell during a check. My son was only in the presence of guards--obviously, his plight (I now know )was almost hopeless.

Miri Navasky: We are so sorry to hear about your loss. Absolutely heartbreaking. If there is anything else you'd like to hear about our film, just write in...and there might be some useful additional information on the web site. We did another film, which you might be interested in, on a young man named Ralph Tortorici ("A Crime of Insanity"), who was a paranoid schizophrenic, who hung himself in prison. It might be too difficult for you to watch, but you can get a copy through the frontline web site if you are interested. Again, all of my heart goes out to you. Thanks for watching and writing.

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Chicago, Ill.: What about the privacy (HIPPA) issues for the patients? Were they able to consent to being photographed when psychotic? Was it hard to get the prison system to agree to show this very painful part of life?

Miri Navasky: We talk extensively about these issues on our web site, but essentially we had to have a psychiatrist evaluate each inmate and we did not interview inmates who were too psychotic to really consent. The prison system, as you could see, really allowed us full access and although at times it was difficult, I believe the Ohio System really wanted to show what was going on inside the prison walls.

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Washington, D.C.: A question and a comment:

After the show, I went to the PBS web site were they tracked statistics about the number of people in mental institutions from the mid-1950s on showed the dramatic drop. It is implied that there was some sort of consensus on letting people out, but wasn't that really due to court decisions that said the states could no longer hold them if they were not deemed a threat to society?

My comment is it is all fine and well to talk about more services for the mentally ill. However, making mental health services more available is going to make many more people eligible than just those who are currently in prisons. Outpatient mental health services and medications make some differences but it is often hit or miss. If we followed the suggested path we would be spending a WHOLE lot more on mental health services but I'm not sure we would necessarily end up with many fewer people in prisons. Shouldn't we be really talking about going back a institutionalization, if perhaps a new and improved form of it?

Miri Navasky: Yes. I think you have hit on something important. And many of the experts we talked with felt that maybe we have just gone too far with complete deinstitutionalization....I know in our research there were a lot of people who on a gut level you just felt didn't belong in prison, but also there was no place else for them to go....

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Miami, Fla.: I missed the film last evening. Will it be re-run and if so, when? I have 2 mentally ill sons, but neither has been in trouble with the law up to this point.

Miri Navasky: Check your local listings. I'm sure it will be rerun, otherwise it will be available to be streamed on the internet soon...

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Wheaton, Md.: Who is actually representing these mentally ill people in prisons and making sure their civil rights are protected?

Miri Navasky: In Ohio, Alphonse Gerhardstein is a civil rights attorney, who has opened a prison reform advocacy center that deals with prisoners grievances. It is one of the few places that consistently has been fighting on behalf of the mentally ill in Ohio. I believe similar organizations are cropping up in states across the country, But in Ohio, he has been an advocate for the mentally ill for over two decades and in fact, it was a class-action lawsuit, that he filed that began all the reform in Ohio.

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Philadelphia, Pa.: You mentioned that you also produced "A Crime of Insanity." I'm a criminal defense attorney in Philadelphia. How can one obtain a copy of that documentary?

Miri Navasky: I believe you can purchase a copy through the frontline web site. It aired in October of 2001 I believe. And it is actually a great film (and should be required viewing) for any criminal defense attorney presenting an insanity defense.

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Washington, D.C.: Curious if you researched the issue of mental illness in juvenile facilities. At a Justice Department program several years ago, one researcher into the issue referred to juvenile detention centers as "mental health care for the poor." Two-thirds of kids there had mental disorders as diagnosed by DSM standards, many had co-occurring problems (a.k.a., PTSD as well as bipolar disorder). Essentially, if a child acts out and is from the middle class, they're "troubled" and are sent for counseling. Poor and minority kids are labeled as bad seeds and send to juvie.

Once again, I have to wonder how the U.S. gets off calling itself the greatest country in the world.

Miri Navasky: We did not research this, but are very interested in the topic.

Thanks.

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Arlington, Va.: Sorry I missed your program. Did you mention Foucault in your background material, particularly his theory that the criminalization of "madness," which he traces back to the 18th century, was one of the founding milestones of bourgeois society.

Miri Navasky: We did not mention it, but did read the book in our research.

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Riverdale, Md.: Do you know what became of the mentally ill inmate that was deported to Jamaica? Have you followed up on his condition in Jamaica? I think it is cruel to deport someone who has been here in the U.S. since childhood, especially someone who is mentally ill.

Miri Navasky: We have not yet tracked him down, but we are hoping to. As you could guess, the U.S. Immigration department was not particularly cooperative. But I agree he was returning to a place where he knew no-one.

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Arlington, Va.: Hi. I was really moved by the program last night. This is a problem that has bothered me for a long time, and watching your show once again motivated me to think about whether there is a way I could volunteer in a useful capacity. Beyond trying to be proactive about encouraging governments and legislators to better deal with this problem, what can I do? Where I could help ex-prisoners, particularly mentally ill ones, better transition into society? Also, a number of times, I've wondered about how I might be able to volunteer or correspond with individuals in prison, but the only programs I found were religious ones or very informal arrangements that seemed to require giving up a little too much personal safety (for a 28-yr old female, living alone). Recommendations?

Miri Navasky: I know there are many "pen-pal" organizations across the country. You might want to contact some of the advocacy legal groups that should be listed on our web site. And I'm sure there are many opportunities to volunteer but you would have to do some research on the topic.

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Minneapolis, Minn.: Could you give some background on the political climate that lead to the dismantling of the state mental institutions? For instance, was this primarily viewed as a cost saving measure, a "personal freedom" issue, a rejection of state institutions in general, or something else entirely?

Miri Navasky: I think this was one of those rare instances, according to experts we spoke with, where the left and the right agreed, obviously though for different reasons. I think, on one hand, the right believed that shutting down big old psychiatric hospitals would be a cost-saving measure and on the other hand, the left felt that they needed to ensure individual freedom, as you mentioned, because so many people were remaining locked up for decades. But either way, the community funding never came into place when it was supposed to. Thanks for your question.

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Charlottesville, Va.: My observation from having been married to a bi-polar man with a schizophrenic-affective disorder is that there is too little incarceration, or housing if you prefer, rather than too much. I don't say this from animosity, but from compassion. My ex, the father of our children, is continually held in wards until just barely stabilized and then sent back onto the streets where he invariably starves, commits a crime or is brutalized. We've seen and heard tales of others that are the same. Mainstreaming these folks seems to lead to homelessness, crime and dangers. What should be done in policy and practice to balance individual and societal needs illness management?

Miri Navasky: I am not sure how to answer this, I think though that incarceration is not always the answer but that you are right, more housing, easier hospitalization, and access to care is very necessary. We heard many similar stories of people out of crisis wards after days without any continually assistance at all. Thanks for your interest and good luck.

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Sacramento, Calif.: We both know, it boils down to money. What do you suggest that I do to effectuate change as a California Parole Agent? The legislature and people of California won't vote monetary funding for the proper facilities to care for what CDC (California Dept. of Corrections) terms MDO'S (Mentally Disturbed Offenders).

Miri Navasky: I'm not sure, you have one of the harder jobs in the country. I do think you need to a community that wants to take better care of this population in order to make changes happen.

But, I suppose, maybe on an individual level you are making a lot of difference to inmates that are being released. Thanks.

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New York, N.Y.: Comment&Question...

Great film! The question is, have you heard from the prison staff in Ohio? How have they responded to the film?

Miri Navasky: Not yet...but we look forward to speaking with them.

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