A local doctor calls it the epidemic of mass incarceration: Prisoners with addiction and mental illness who go untreated and are released to the community without links to treatment, and then end up behind bars again.
Dr. Jody Rich, who co-authored of a recent article on the topic in the New England Journal of Medicine, is calling for a new approach to help end the cycle.
For 17 years, Rich has spent one morning each week at Rhode Island's Adult Correctional Institutions, treating prisoners.
"In that population, there's a huge burden of disease -- both addiction, mental illness, HIV, hepatitis C, sexually transmitted diseases and many other undiagnosed conditions," Rich said.
Rich, the director of the Center for Prisoner Health and Human Rights based at The Miriam Hospital, has also seen the prison population explode.
"We, the United States, as a country have 25 percent of the world's prisoners. We have 5 percent of the world's population," Rich said.
The explosion has come since the war on drugs was waged in the 1980s. He said the war targeted users and imposed severe punishments behind bars.
"On the one hand, you could look at the rate of incarceration as a condemnation of our community treatments for both mental illness and addiction. If we had better treatment, we wouldn't be locking up so many people," Rich said.
Rich said more than half of all inmates have a history of substance abuse and dependence or mental illness, yet they're often released into the community without health insurance or access to the appropriate medical care and treatment.
His target audience is the medical community.
"As a medical community, we own part of this problem because these are at the baseline, at its very core, medical problems -- the addiction and mental illness," Rich said. "We need to try and search out alternatives to incarceration. We need to engage the public and policy makers in thinking of better ways to address the underlying problems and make our society safer and more humane."
Rich said minority populations are disproportionately affected by this epidemic of mass incarceration.
The Center for Prisoner Health and Human Rights is a collaboration between The Miriam Hospital and Brown University.
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