Stan Lee

Can effective mental health treatment exist in a criminal justice system driven by profit?

J

osh Gravens, now 27, was sen­tenced to the Bill Clayton De­tention Center in Littlefield, Texas when he was 13. He was told to expect a jail stay of nine months, but he spent 42 months under the supervision of the Texas Juvenile Justice Department. He was not fully re­leased until he was 21, having been de­tained for years without cause, he says. "I never even had a write-up," he says. "Behavior was never the issue. Grades were never an issue. We engaged will­ingly and aggressively."

In Texas, the state contracts corporate prisons to jail juvenile offenders. Com­pensation per prisoner escalates by level of care. However, these facilities aren't guaranteed children at specific compen­sation levels, so it's often in a corpora­tion's best interest to keep profitable offenders for as long as possible. This isn't what correctional supervision is supposed to accomplish, and it seems to be enabled by psychologists who falsify treatment records to extend incarcera­tion times. Texas's juvenile sentencing system works by assigning indeterminate terms to offenders, with release possible only after a vague set of treatment pro­grams has been fulfilled.

Melvin Tomison, a case manager at Clayton during the time of Gravens's

sentence, spent two hours a day discuss­ing personal problems with the children while providing life-skills instruction. He says 10 case managers had come and gone in the 11 months prior to his ar­rival. "There were no problems with my reports on these kids for the first five or six months," he says. "But when a new supervisor came along, every report I filed was wrong. He would edit them to change the meaning of my observations." In one instance, a 10-year-old's report of abuse at the hands of his stepbrother was deleted from his file. "That was some­thing that would have made a profound difference in how anyone would view his behavior and psychological state," Tomison says. "My supervisor wanted to get rid of me," he concludes, "because I was the only one getting kids out."

T

he legal precedent that allows psychologists to testify about the presence of mental disor­ders is found in the 1962 U.S. Court of Appeals decision Jen­kins v. U.S. Use of psychologists as expert witnesses has increased since, but recent investigations have revealed that their tes­timony is often little more than propagan­da. A 2011 study in Virginia found that the state attorney general's office relies on a small stable of experts in court arguments. These experts side in favor of prosecutors 80 percent of the time. Similar practices are used in 20 states and federal trials.

When a group of unscrupulous psychol­ogists lobbied to add a slew of sexual dis­orders to last year's DSM-5—the definitive mental health manual—they revealed the toxic relationship between psychology and prosecution. If paraphiliac coercive disor­der, hypersexuality and other suspect men­tal illnesses had been allowed to be listed, they would have become available for use in trial. "The civil commitment industry

and the psychologists it employs lobbied for these disorders so they could use them in testimony instead of shady 'unspecified' diagnoses," says Karen Franklin, a foren­sic psychologist in California. Assigning a defendant an "unspecified" diagnosis is a practice employed by co-opted psycholo­gists to justify detention of offenders with-

out legitimate mental illnesses. Having

the disorders they proposed officially recognized in the DSM would pro­vide even firmer ground for such

convictions, but the disorders are not recognized by the broader medical com­munity and "didn't even end up becom­ing 'conditions for further study,'" Frank-

lin says, evidence of their tenuous scientific standing. When psychologists lobby for diagnoses as shady as these to be listed in the definitive mental health manual of our age, one can be sure their intentions are far from honest.

Twenty thousand sex of­fenders are released from our prisons every year. No­where has psychology be-

come more removed from its fundamental principles than in the post-incarceration treatment of these offenders. The vast majority are required to undergo mental health treatment, and while community safety can and should be held as these pro­grams' utmost goal, psychology is corrupt­ed by law-enforcement aims. This means little is done to address the roots of criminal behavior or to protect communities. 'Judg­es and citizens mistake these treatments for psychotherapy," says Phil Taylor, who spent 20 years as a licensed treatment provider. "It is not treatment. It is police work."

Post-release law-enforcement supervi­sion masquerades as therapy in the "con­tainment model," whereby therapists and polygraphers share information about

patients with officers. It is often provided by companies that exist solely to fulfill treatment contracts, which is obviously a perverse financial incentive. Confidenti­ality is signed away, refusal to cooperate is a jailable offense, and patients are sub­jected to treatment that would never be tolerated in private practice.

"When states certify practitioners, and definitions and prescriptions come under the control of politically be­holden agencies," says Taylor, "there is an inexorable drift toward treatment as punishment and treatment as post-adjudication inquisition."

It is akin to assuming anyone convicted

ot then: is recidivist and worthy of the same mode of rehabilitation. The con­tainment model lumps together a diverse popula­tion of convicts and fails to rehabilitate them. Long­standing evidence-based treatment models could bring real help to these pa­tients, but they are failed by an overzealous state.

With 7 million Ameri-

cans under law-enforcement supervision,

the demand for mental health services has

never been greater. But professional objec­

tivity and the goals of psychology have been

abandoned in pursuit of lucrative contracts.

These compromises set dangerous

precedents for the future of mental health

policy. They fail to reduce recidivism, fail

to promote public safety and fail to allevi­

ate incarceration rates. To promote true

public safety, they must be addressed

across disciplines and through broader

cultural conversations. Until then, the

lowest bidder wins. ¦

Galen Baughman was convicted in 2004 of a sex offense with a minor at the age of 19 and served nine years in prison. He is now an advocate against the civil commitment model and co-founder of the Center for Sexual Jus­tice with psychotherapist Andrew Extein.

"There is an

inexorable

drift toward

treatment as

punishment."