SACRAMENTO — California’s prison mental health system has been spending far more on anti-psychotic drugs than other states with large prison systems, raising questions about whether patients are receiving proper treatment.
While the amount has been decreasing in recent years, anti-psychotics still account for nearly $1 of every $5 spent on pharmaceuticals purchased for the state prison system, according to figures compiled by The Associated Press.
Questions about the spending have been raised by the state budget analyst and by the court-appointed authority in charge of buying prison pharmaceuticals, who concluded that California’s inmate mental health professionals appear to overmedicate their patients. Even a former top prison mental health administrator acknowledged that fear of lawsuits often drove the decisions about inmates’ treatment.
Nearly 20 percent of the $144.5 million California spent on all prison pharmaceuticals last year went for anti-psychotic drugs, according to the AP’s figures, which were obtained through requests under the state Public Records Act.
“Why are all these people on meds? A lot of it, I think, we overprescribe on mental health. Anybody who comes in on mental health (referrals), we put on a psychotropic,” said J. Clark Kelso, the federal court-appointed receiver who controls prison medical care.
His office buys psychiatric drugs for the prison system, but he is not in charge of prison mental health care and thus has no say over how often the pharmaceuticals are used.
A separate court-appointed authority, Rhode Island attorney Matthew Lopes Jr., oversees the treatment of mentally ill inmates. He did not return repeated telephone messages for this story.
Kelso, the medical receiver, raised an alarm with prison mental health officials internally three years ago when he identified what he thought was an extraordinary use of anti-psychotics, which in 2008 accounted for 34 percent of all prison pharmaceuticals spending. Spending on anti-psychotics has since fallen from about 26 percent of all prescription spending in 2009-2011 to 19 percent last year.
When he raised concerns, Kelso said he was told that “we have a substantial reliance on drug treatment programs, more so than in other states around the country.”
The comparatively high use of the drugs in California is feeding a debate between doctors and the attorneys representing inmates over whether mentally ill prisoners receive too much medication or not enough. California’s poor treatment of inmates with mental health problems prompted a federal court takeover of that operation and persuaded federal judges to order the prison population sharply reduced to improve prisoner care.
Gov. Jerry Brown’s administration faces a Thursday deadline to tell the court what steps it will take to further ease prison overcrowding by year’s end.
A federal judge recently decided to maintain court oversight of the mental health system, finding that the state continues to violate constitutional standards.
