Grading Care Behind Bars 5/04

A Vermont report examines prison health issues

The Prisoner’s Health Coalition and the Alliance for Prison Justice (APJ), a project initiated and sponsored by Toward Freedom, have heard stories about the inadequate health care received by prisoners for years. Members of the two Vermont advocacy groups also have talked to people with disabilities about their problems behind bars. To take a more detailed and systematic look, in Fall 2002 the organizations decided to survey the state’s prison population.

Questionnaires were sent to every inmate (about 1700); 192 forms came back – a respectable 11 percent response rate. The results were compiled and published in a report we co-authored, Medical Issues within the Vermont Corrections System.

According to our study, prisoners wait from two days to several months to see medical personnel. Those who need psychiatric help say they wait much longer. Medical care is often slow, at times inadequate, and occasionally life threatening. At one facility, a prisoner’s leg was amputated because he received inadequate treatment for diabetes; two nurses had their licenses suspended as a result.

For dental treatment, waits range from a couple of months to several years. One prisoner said, “Dental care sucks. [T]hey are more concerned with pulling teeth [which is cheaper] than filling in a few cavities.”

Most prisoners reported some form of disability. Almost two-thirds said it was a psychiatric problem, and a little more than one-quarter had a learning disability. Almost a quarter said that they had both. These statistics are scary. It suggests prison has become a place where people with disabilities go when they can’t get other services.

A little over 40 percent of Vermont prisoners with psychiatric and mental health needs had their medication changed after entering prison. This can be a problem: When people are abruptly withdrawn from psychotropic medicines, they may experience withdrawal symptoms, and psychiatric conditions can get worse. Prisoners reported that when this happened, they were sometimes put in segregation, resulting in escalation of symptoms and suicide attempts. Vermont Department of Corrections statistics reveal 446 suicide attempts in Vermont prisons in a 10-year period, nearly one attempt every week.

Prisoners with mental health needs reported having trouble getting the help they needed. In addition to problems with medication, staff sometimes brushed their concerns aside. One prisoner noted that guards “seem to think I’m using it for an excuse.” Another prisoner charged that medications were used to control rather than treat him. He felt “overtreated and overmedicated – overdosed …”

Those with learning disabilities reported problems meeting requirements for programs. Having trouble understanding what is expected, and the anxiety that provokes, can end up prolonging time in prison. It was hard “understanding what they want and making myself understood,” one prisoner said. Some prisoners denied having learning disabilities, yet had difficulty completing the survey.

Medical services in Vermont prisons are contracted to Correctional Medical Systems (CMS), a company that has faced criticism in other states. Virginia canceled its contract in 2001, partly because CMS allegedly failed to provide timely medical care. Missouri, Nevada, Alabama, Oklahoma, New York, and Florida have also expressed concerns about services.

In general, our findings are consistent with results from around the country. Other researchers confirm that the number of prisoners with disabilities has increased in recent years. With almost two million people incarcerated in the US, the infection rates for chronic diseases like Hepatitis C, HIV, tuberculosis, syphilis, chlamydia, and gonorrhea are up to 10 times higher behind prison walls than in the outside world.

The report recommends an independent audit of corrections contracts; adequate funding for public and private advocacy agencies; feedback mechanisms for prisoners; and an external review of existing policies, procedures, protocols, and quality assurance measures for health care and mental health care.

A copy of the report is available at the APJ-VT Website,

Dr. Phil Smith and Nanaymie Godfrey, independent researchers and consultants based in Worcester, VT, wrote the report summarized above. Smith teaches at St. Michael’s College, works with Vermont Protection and Advocacy, and has conducted disabilities research in Vermont for many years. Godfrey has worked as a nurse with the disabled, and recently completed a graduate thesis concerning the impact of the judicial process and imprisonment on people with co-occurring disabilities.

Other News

TF’s independent media directory project is progressing. At we go to press, a web-based questionnaire and survey is being tested for use in collecting information for a comprehensive regional resource. The questionnaire lets media producers provide details about what they do. The survey asks people to recommend additional media outlets and groups in Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York, New Jersey, Pennsylvania, Maryland, Delaware, Eastern Canada, and the District of Columbia. You can also view a list of media organizations we’ve identified so far, and get more background of the project. Go to and use the Independent Media Convergence Project link.

In an election upset this January, TF Board member Gerard Colby became president of the National Writers Union (NWU). According to NWU member Chris Rohmann, the leadership change can be traced to a Delegates Assembly last September; dues were hiked 60 percent for most members, and the NWU constitution and bylaws were replaced by a structure imposed by parent union, the United Auto Workers. Only after approving the changes were the delegates told that the full-membership vote they were promised wouldn’t be binding. The Working4Writers ticket, headed by Colby, called the move an undemocratic betrayal of the union’s independence and uniqueness.

In March, Board Chair Robin Lloyd led a workshop on feminism and the World Social Forum, co-sponsored by TF and WILPF at the annual Socialist Scholars Conference. Editor Greg Guma will discuss corporate media’s “perception management” at the Media Education in Action conference in Brattleboro, VT, on April 15. The conference is sponsored by Know Media, Action Coalition for Media Education (ACME), and the Green Mountain Training Center.