Cross-posted from Beyond VSH: 

A new reported shows that the Vermont Department of Corrections may administer antipsychotic drugs to more of its prisoners than any other state. A study done by the Associated Press shows that 46% of all prisoners held by the Department of Corrections were prescribed antipsychotics.
 Even the Department seems to admit that these drugs are overused. For instance, Dr. Susan Wehry, the medical director for the Department of Corrections, admitted that some powerful drugs, such as Seroquel, are given to help prisoners sleep, and that sometimes doctors prescribe antipsychotics for prisoners who request them rather than have to deal with a grievance from a prisoner who wants them. “Quite frankly, I think docs get worn down,” she told AP.”

Given that the incidence of schizophrenia worldwide is estimated at 1%, the adminstration of antipsychotics to 46% of Vermont prisoners seems very difficult to justify.

Aside from whether all this use of antispychotics is justified, it is important to consider the impact of this news on the VSH Futures effort. As you know, this has been going on for years in an effort to design a replacement for the Vermont State Hospital. Naturally, one of the big questions has been the size of any new facility, which, of course, entails an understanding of the need. For years, mental health advocates have been arguing that the State has sytematically understated the number of Corrections inmates with severe mental illnesses, and for just as long the State has been reporting laughably small numbers for these prisoners.

Here's an excerpt from the minutes of one meeting earlier this year:
Hospital Futures Plan from February 4, 2005, that the VDH/Division of Mental Health
prepared for then Secretary
of AHS Charles Smith. She distributed excerpts of the plan.
Discussion of the group’s charge stimulated discussion around several issues:
o Given a number of different populations currently served at VSH, should we
create multiple inpatient programs to address each population?
o How do we meet the needs of people in Department of Corrections custody?
o How would we estimate the inpatient capacity needed for Corrections?
The
February 2005 Futures Plan reported the Department of Corrections’
estimate of four to ten persons in DOC custody needing psychiatric
hospitalization for whom no appropriate inpatient service site was
available.
The
inpatient mental health needs of Corrections is required for capacity
planning for the Futures project.

So tell me: if the mental health needs of DoC prisoners are so high that almost half of them need antipsychotics, what should we be doing to plan for their mental health needs in the future?

( – promoted by odum)

<><>Has anyone by chance seen the article about the Dyncorp merc in Free Press (I can't get the weblink to function, but it on the front page of the website)?   It is appalling that the paper treats the guy like a human interest story and fails to raise a single point about the implications of what this guy was up to. 

<>A few years back (shortly after 9/11) a friend was working on her thesis for her grad degree.  She was, at the time, the CFO of one of the largest private security firms in the world – Group 4/Falck.  Her thesis was on the privatization of military and intel capablity and its negative implications for US foreign policy and civil liberties (quite a stand given where she was sitting at the time – no wonder she was later fired).  At the time, I thought she raised an interesting point, but a bit overblown.

<>I didn't realize how prescient she was until a few years later I was sitting at Dubai airport waiting to catch a rickety Ariana 727 for Kabul.  Instead of the usual NGO – humanitarian types waiting at the gate, most of the passengers were clearly ex-military.  Past their prime, but still sporting tight white wall hair cuts, tucked in polo shirts and Wrangler jeans.  On the flight to Kabul I struck up a conversation with one of these guys and he told me a story very similar to the Freep article.

<>When I got to Kabul, I was stunned at the omnipresence of the private security firms.  The US embassy is not guarded by Marines, but by contractors – consisting primarily of Nepalese Ghurkas and South African supervisors.    Even most of the NGOs  operating there are forced to hire these firms.  While I was in Kabul, the Dyncorp office was blown up by a warlord (whose kid was ran over by a Dyncorp convoy, so I suppose he had a beef).  

Anyway, I digress.  The point I am trying to make is that one of the greatest worries I have about the Bush era is the privatization of military force and intel capability because it will be very hard to ween these companies off of their fat contracts.  Unlike the traditional defense contractors (Boeing, Lockheed Martin) which can thrive in peacetime (provided there is a threat justifying huge expenditures) – these guys need active conflicts to make money.  Do we expect Dyncorp and Blackwater to simply give up their contracts and go home when the war in Iraq ends?  How do we turn these swords to plowshares?