Prisoners of the mind

February 21, 2005

THE MURDER of Maryland inmate Philip E. Parker Jr. on a darkened prison bus has taken on the glossy intrigue of a whodunit. How could someone kill a 6-foot-6 inmate in a bus transporting 35 chained and shackled prisoners with five armed correctional officers on board? Did no one notice? Cry out in protest? Try to intervene?

Attention has focused on inmate Kevin G. Johns Jr. Twice convicted of murder, Mr. Johns has a troubled mental health history and had threatened to kill again if he wasn't treated. Did no one take his threat seriously? Evidence suggests it should have been -- and that's the other crime.

When Mr. Johns was last before a judge, his lawyers asked that he be referred to the Patuxent Institution, the prison system's sole treatment facility. His past certainly justified the request: He has a well-documented psychiatric history with at least six stays in treatment facilities since childhood. In a 2002 state competency evaluation for his first murder trial, Mr. Johns talked about an alternate personality, George, who told him to kill his uncle. The same evaluation found that Mr. Johns suffered from a depressive disorder but that he exaggerated or feigned psychotic symptoms.

Sometime after he entered prison, Mr. Johns was admitted to the Patuxent program for several months. But he was returned to the general prison population in the fall of 2003 and, four months later, killed his cellmate.

Mr. Parker was strangled to death on the bus after he testified for Mr. Johns in a sentencing hearing in the cellmate murder. A state investigation of Mr. Parker's death may lead to Mr. Johns. It may find that guards were negligent or worse. It may explain other issues raised by reports in The Sun. But it won't likely discuss a more systemic concern -- the incarceration of the mentally ill and problems faced in treating them.

America's prisons have become repositories for the mentally ill. A national study of prison recidivism estimates the mentally ill as 8 percent to 16 percent of the prison population. In Maryland, about 14 percent of prisoners (about 3,000) are in therapy or counseling and 9 percent to 10 percent (about 2,400) receive psychotropic medications. Prison officials say everyone in need of mental health treatment gets it if an illness is disclosed and treatable.

But prison medical contracts are often underfunded. The state is battling charges of medical neglect against its prison health care provider. Among the alleged problems at the Baltimore Detention Center cited by the American Civil Liberties Union are limited access to psychiatrists and that medication for psychiatric illnesses is scarce or unavailable.

On any given day, Patuxent serves 850 inmates and has an average waiting list of 130. Most are treated for personality disorders and substance abuse. As many as 140 are patients at an acute mental health center. Mr. Johns' release from Patuxent may have resulted from misbehavior, or he may have transitioned out of the program. But when he threatened to kill again at his recent sentencing, he became a security risk. Corrections officials should have isolated him from other inmates on the bus to Baltimore.

It's unlikely that Mr. Johns will be eligible for treatment at Patuxent again because of his life sentence. The law requires that the ill be served, but the sad reality is that treatment slots are at a premium and the mentally ill serve more of their sentences than other inmates. That leaves prison officials weighing the needs of thousands trying to cope in an environment that would addle the least-troubled mind.

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