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Monday, October 16, 2017

Nancy Reagan’s recent death was a reminder of the shallow moralizing of the Just Say No anti-drug campaign she once championed.

Thankfully, attitudes have changed. We’re more attuned to the fact that untreated mental health issues are often a precursor to drug use. Nancy’s slogan to fight peer pressure won’t help much there.

Most people realize that the War on Drugs, begun under Nixon, has failed.

And there’s growing public awareness that we’ve let our jails and prisons become warehouses for people who need treatment — and who needed it long before they took a criminal turn.

Mandatory sentencing guidelines have been changed, and the days of presidential administrations following the whims of a drug czar are over.

Incarceration rates are dropping. To most, this is good news. But it’s not if your business model revolves around keeping people locked up.

The for-profit prison industry has kept one step ahead of the trend. They got wise quick, sensing the winds shifting away from mass incarceration and toward the need to address mental health issues within the nation’s prisons and jails.

For those familiar with the term “prison-industrial complex,” meet its offspring — the “treatment-industrial complex.”

A report released in February by Grassroots Leadership, a civil and human rights organization, rings some warning bells. The report, “Incorrect Care: A Prison Profiteer Turns Care into Confinement,” is part of a series of reports that has focused on reducing the nation’s dysfunctional criminal justice system.

This latest installment takes an in-depth look at the privatization efforts in Texas, Florida and South Carolina. In particular, it goes after the shifting business models of for-profit prison operators Corrections Corporation of America and the GEO Group, as well as spinoff rehabilitation companies like Correct Care Solutions.

The charge is that just as prisons are often not about rehabilitation, these new for-profit treatment places are not about helping people regain their mental stability and, therefore, their release. The report also challenges the quality of care being offered, citing cases of violence and patient deaths.

One startling figure from the report: 50 percent of people in correctional facilities suffer from mental health and substance abuse disorders. This compares to estimated rates of only 1 percent to 3 percent within the U.S. population. Prisoners represent a huge market for mental health care. If the prison operator also has a side business in mental health care, a conflict of interest presents itself.

Under normal circumstances, a person can get out of prison after serving his sentence. In fact, 90 percent of people who are sentenced do just that. But inmates can be placed by a judge into a for-profit mental health program in a prison — say, under civil commitment laws now on the books in about 20 states — and be detained there past the end of the sentence. The operator has a clear incentive to keep a person there indefinitely, to increase the return on its investment.

The Grassroots Leadership report points out that these private operators offer cost savings to a state when the facility is full: Thus the cost per head goes down. Assigning inmates to these facilities can be very appealing to lawmakers trying to balance tight budgets. Potentially, it becomes even more alluring when a lobbyist with the industry is making a hefty donation to a re-election campaign.

A basic set of circumstances and decisions has set the stage in many states. Legislatures have cut public mental health budgets, resulting in understaffing and poor conditions in state-run facilities. Community-based mental health programs are also being shorted. That leads to more untreated people who act out and then find themselves in a criminal justice system.

By virtue of their mental state, many of these people are not in a position to self-advocate for better care. Locked up, they are easily forgotten. One question must continuously be asked by legislators, advocates and the taxpayers whose dollars are being spent: In a for-profit model — in which more inmates equals more revenue — what possible incentive does a rehabilitation company have to help people regain stability and rejoin society? If such an incentive doesn’t exist and outweigh the profit motive, it’s hard to see how private-sector rehab programs won’t make matters worse.

(Mary Sanchez is an opinion-page columnist for The Kansas City Star. Readers may write to her at: Kansas City Star, 1729 Grand Blvd., Kansas City, Mo. 64108-1413, or via e-mail at msanchez@kcstar.com.)

(c) 2016, THE KANSAS CITY STAR. DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC

Photo: U.S. President Barack Obama speaks to reporters during his visit to the El Reno Federal Correctional Institution outside Oklahoma City in this July 16, 2015 file photo.  REUTERS/Kevin Lamarque/Files

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