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Published: Friday, 3/19/2010

More mentally ill Ohio inmates refuse post-prison help

COLUMBUS, Ohio — More mentally ill inmates are refusing help in making the transition from prison to the free world even as advocates are suing Ohio to force the state to do more for them, state records show.

Nearly one in four mentally ill inmates either declined post-release services or never showed up for their prison appointment in the state fiscal year ending in June 2009, according to a review of Department of Mental Health records by The Associated Press. That's up from fewer than one in five in previous years.

The challenge for helping such inmates increases once they're released: mentally ill inmates typically have a 50 percent no-show rate for clinic appointments after they're out of prison, about the same rate as the rest of the population.

"Our staff work very hard to ensure that there is continuity between persons leaving prison and persons moving into the public mental health system," said Debbie Nixon-Hughes, program and policy deputy director at the Ohio Department of Mental Health. "We realize that it's a critical piece."

State records obtained by the AP show other problems with the delivery of services.

Outside clinics serving newly released inmates complained that information about the inmates sometimes arrives late, appointments aren't always set up ahead of time and offenders often arrive out of medicine and in crisis, according to a 2007 survey of service providers.

Contacting social workers involved in helping the inmates "is very difficult and often delays approval or acceptance of cases," one community provider said in the survey released to the AP.

Other providers said the program, dubbed Community Linkage, works fine.

Nine inmates represented by a prisoners' advocacy group are suing to force Ohio to improve life after prison for mentally ill offenders.

Similar lawsuits have been filed in recent years involving state prisons and jails in New Mexico, New York and Chicago.

As many as 16 percent of people jailed or in prison nationally have some kind of mental illness.

One of the Ohio ex-inmates, Robert Wickham, bounced in and out of jails and prison before serving a seven-month prison sentence for forgery in 2008.

Since his release, he spends his days scrounging food from soup kitchens, brokering drug deals to feed his heroin habit and waiting on long-promised government disability.

Wickham, 37, pays a crack addict $50 a week to live in his apartment and tries to manage the pain from a crane accident that crushed four discs in his back. He suffers from depression, bipolar disorder and severe anxiety.

Wickham says the state didn't provide him enough medicine or help find him a place to live after he left prison in 2008. The result, he says, is a kind of instant handicap.

"I mean, let me break your legs and see you swim. It's not going to happen," Wickham said. "If you're not thinking right, how are you supposed to make the right decisions? It doesn't make sense."

The federal lawsuit filed last month alleges the state is making it harder for mentally ill inmates to meet the conditions of their release by not adequately helping them obtain housing, food stamps, Medicaid, disability benefits and other assistance. The state has until April to respond.

Social workers meet with mentally ill inmates in prison before their release to schedule appointments and help with the transition, under the so-called community linkage program operated by the Ohio prison and mental health departments.

An attorney leading the lawsuit says those in-prison meetings must be mandatory.

"That meeting with a community linkage social worker should be a requirement of the discharge planning policies that they have in place," said Bess Okum, staff attorney for the Ohio Justice and Policy Center. "That piece is not an option or should not be a choice."



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