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Mail February 13-19, 2008

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On Mental Lockups

I am writing in regard to Peter Wollheim's recent article, "Do Iron Bars A Mental Hospital Make?" (BW, Feature, Jan. 23, 2008). I respectfully request that you take note of the following corrections and clarifications.

The first paragraph says that Gov. C.L. "Butch" Otter wants to turn a state prison warehouse into a 300-bed facility to house people the state deems too dangerous to themselves or society to be free. That is incorrect.

It is true that the Idaho Department of Correction wants to convert the warehouse at Idaho Correctional Center into a housing unit at an estimated cost of $6.5 million. The dormitory-style facility would provide housing for 304 inmates. Separately, the Idaho Department of Correction wants to build a 300-bed secure mental health facility at a location that has not been determined at an estimated cost of $70 million. Your writer has mistakenly combined two separate proposals and presented them as a single initiative.

The article contains other errors that confuse readers and further the stigma associated with mental illness.

The article says, "the plan will involve a 300-bed facility, with 260 of these set aside for violent mentally ill inmates." Admission to the facility for inmates would be based strictly on the presence of a major mental illness and the need for enhanced treatment services. Violence is not a factor in placement as many inmates suffering from mental illness are non-violent. The only segment of the population that would be, by definition, "dangerously and mentally ill" would be those civilly committed under statute 66-1305.

The article also misrepresents my views. The article says, "As it stands now, she says, those with civil commitments don't get a lot of time out of their cells." The article fails to make clear I was referring only to patients at Idaho Maximum Security Institution and not at state hospitals.

The article quotes me as saying, "We definitely need something different from a state hospital, which tends to be contraindicated for people with major, major mental illness and is not well-equipped to meet their needs." I was referring to the current situation of placing people with major mental illness who have been civilly committed as "dangerous and mentally ill" in a maximum security prison that provides primarily security with limited access to treatment opportunities. I was not referring to the quality of care offered by state hospitals.

In addition to what was said, I ask you to please take note of what was not said. The article fails to give adequate attention to the fact that the proposed secure mental health facility would be just one element in the continuum of mental health care for the people of Idaho. Instead, the article frames the discussion as a question of "highly centralized and institutionalized treatment" versus "a more proactive and localized approach." In doing so, the article fails to acknowledge an important facet of this debate and the significant need for such a facility, especially for people committed to the care and custody of the Department of Correction who require treatment for major mental illness.

—Mary Perrien, Ph.D., Chief, Division of Education and Treatment, Idaho Department of Correction

Wollheim Responds

1. While the first paragraph of the story does use the term "warehouse," the section of the article on the proposed conversion of the Idaho State School in Nampa makes it clear that this is a different facility and that the conversion is an interim step.

2. I respectfully disagree with Dr. Perrien that the quote concerning civil commitments refers only to the Maximum Security Institution.

3. My notes indicate that Dr. Perrien was referring to how state hospitals are ill-equipped to deal with populations for which they were not designed or staffed.

4. The comments concerning "highly centralized and institutionalized treatment" versus "a more proactive and localized approach" are made in the context of attacks by Kathy Garrett and other mental health advocates on the proposed plan. The point is that these critics fear that the new facility will not provide the "continuum of care" which Dr. Perrien and others would like to see. Instead, it will serve as a poor substitute.

—Peter Wollheim

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