“The former chief medical officer of New York City jails has just published a remarkable new book about the health risks of incarceration. Dr. Homer Venters offers unprecedented insight into what happens inside prison walls to create new health risks for incarcerated people, including neglect, blocked access to care, physical and sexual violence, and brutality by corrections officers.”
Excerpts from a Q&A session with Homer Venter and a representative from Physicians for Human Rights June 19, 2017
In the prison system, I used this approach to advocate against solitary confinement; by analyzing 250,000 jail admissions, we showed that people who had been in solitary confinement had an eight times greater risk of self-harm than other prisoners.
I also want to introduce dual loyalty trainings through health care professional organizations; I’m doing one for the American Psychological Association in November with the goal of reaching up to 5,000 American psychologists. And we could scale up this type of engagement through the hundreds of doctors in our Asylum Network who have a special insight into health issues in immigrant and other detention facilities – an area that promises to present significant human rights challenges going forward.
Venters writes that, on Rikers, the “most dramatic and tortured aspect of dual loyalty” involves the role that medical staff play in sending people to solitary confinement. Jail managers who wanted to lock an individual in solitary first had to obtain “clearance” from a mental-health worker—assurance that the inmate would not harm himself if isolated for twenty-three hours a day. Venters is a fierce critic of the process. “Health clearance for solitary is not based on any reliable science and violates basic medical ethics because, of course, that patient is supposed to suffer,” he writes. “It’s punishment, after all.”
Mythbusting solitary confinement
Published on February 4, 2016
Health, Human Rights and Epidemiology
- Solitary isn’t linked to real health outcomes. Our data (250k jail admissions) show patients exposed to solitary have odds ratios of 6.9 and 6.6 for self-harm and potentially fatal self-harm. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3953781/
- Solitary is evenly applied across race and age. Our data (50k 1st time jail admissions) show African American and Hispanic patients more likely than white patients to enter into solitary (odds ratios 2.5 and 1.6), even after adjustment for length of stay. These disparities also seen in younger patients and exists in the mental health service. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539829/
- Solitary is a necessary tool. Together with NYC DOC, we have created ‘Clinical Alternatives to Punitive Segregation’ units. Seriously mentally ill patients who previously went into solitary now go into treatment settings, designed and run by teams of health and security staff, with improved outcomes. These units are an important alternative to solitary, but their cost should prompt discussion about the need to divert patients into clinical treatment before they arrive in jail. http://www.mdpi.com/1660-4601/13/2/182
Community Oriented Correctional Health Services (COCHS) is a non-profit organization that works to build partnerships between jails and community health care providers. Our goal is to establish medical homes for offenders in their communities.
Our objectives include:
- Support changes in public policy and practice that promote access to health preventive and treatment services both in jail and in partner community institutions
- Ensure that local health care systems are in place to treat jail-involved populations
- Improve the ability of jails to connect offenders with health care
- Develop health care delivery systems that are financially viable and sustainable
On a national level, we convene policy discussions of major stakeholders in the health and health care of vulnerable populations that interact with the criminal justice system to determine how we can make the system work better for these populations. Many of these conversations focus on the challenges and opportunities created by Medicaid expansion under national health reform…. Connectivity between jails and community health care providers is our guiding principle. There are a variety of strategies for achieving connectivity, but the goal is always the same: to ensure that people involved with the criminal justice system can get the health care services they need, regardless of their criminal justice status and regardless of whether they are in jail or in the community.