What President Obama's Mental Health Summit Left Out

Under his administration and prior ones, the treatment of mentally ill inmates by the Bureau of Prisons has generated harrowing allegations of abuse and neglect.


Left, Jonathan Francisco as a child with his mother, Linda Embrack; and as an adult, right (Linda Embrack)

Pledging to do his part to "bring mental illness out of the shadows," President Barack Obama on Monday delivered a poignant speech on mental health to mark the beginning of a national conference on the topic. It was the sort of speech that future historians will appreciate far more than we did. And the initiative itself is a laudable thing for this administration to do, a worthy and noble endeavor, and sensible, too, since approximately 45 million Americans suffer each year from various forms of mental illness.

The president hit all the political grace notes. He reminded the audience that the Affordable Care Act will make mental health care more accessible to tens of millions of Americans. He praised the work of veterans' groups -- the Pentagon reported a record number of suicides in 2012 -- and counseled returning veterans: "Just like you take care of yourself and each other on the battlefield you've got to do the same thing off the battlefield. That's part of being strong." And then at the end of his speech, the president said this:

If you know somebody who is struggling, help them reach out. Remember the family members who shoulder their own burdens and need our support as well. And more than anything, let people who are suffering in silence know that recovery is possible. They're not alone. There's hope. There's possibility. And that's what all of you represent with the extraordinary advocacy and work that you've already done.

But what the president did not say in his speech, what the president could not say in his speech, is that his administration is responsible for some of the most egregious examples of abuse and neglect toward mentally ill citizens the nation has seen in generations. If he is truly interested in changing the national conversation about mental health -- about eliminating the stigmas surrounding it, as he said -- the president will promptly force the Bureau of Prisons, his Bureau of Prisons, to adequately treat the mentally ill federal prisoners in its care.

Time for True Leadership

President Obama only indirectly mentioned the touchy issue on Monday -- and then only in the context of violence and suicide. He said:

The overwhelming majority of people who suffer from mental illnesses are not violent. They will never pose a threat to themselves or others. And there are a whole lot of violent people with no diagnosable mental health issues. But we also know that most suicides each year involve someone with a mental health or substance abuse disorder. And in some cases, when a condition goes untreated, it can lead to tragedy on a larger scale.

Of those people who suffer from mental illness and who become violent enough to commit crimes, or who become violent due to mental illness while in the harsh confines of prison, the president said nothing. But countless inmates have, as the president suggested, reached out for help. They have practically cried out for help and treatment, in one detailed lawsuit after another, in one anguished family's cries after another -- and, in response, the Bureau of Prisons has piled on them denial upon obfuscation upon outright defiance of constitutional norms.*

Just ask ADX-Florence prisoner Percy Barron. Feeling suicidal after the death of his mother, he asked for help. He asked and he asked and he asked. And when he was ignored by his guards he swallowed some pills. And when he was better he was initially punished by federal prisons officials for what he had done. Ask Jack Powers, another Supermax prisoner, whose descent into madness while in custody is now part of a federal lawsuit wending its way through the courts. Ask the men and women in federal custody who can't get proper medicine or who have to endure mental health therapy in chains and in earshot of their neighbors.

The mental health treatment of the nation's prisoners is deplorable -- it is as undeniable as is the tragedy of mental illness -- and the Bureau of Prisons has been willfully unaccountable for it. Congressional oversight is a joke, the Justice Department has shown no courage or any will to investigate, and the judiciary has been largely guided by the most conservative Supreme Court in three-quarters of a century, one that has broadened the contours of immunity for prison officials. Who else but the president is going to speak up for these wretched people? Who else can?

A Mother's Frantic Pleas

"The degree of civilization in a society can be judged by entering its prisons," wrote Fyodor Dostoevsky nearly 200 years ago. So President Obama should start there if he wants to send the strongest possible signal that his administration intends to treat mental illness with the respect it deserves. If it's true that government cannot alone solve the problem of mental illness, it is equally true that a president can direct policy within his own executive branch. That's all that would be required here -- new policies at the BOP, or new leadership there willing to accept the administration's enlightened view of the importance of mental health.

On Monday, the president told his audience that he hoped mental illness would be treated as quickly and resolutely as physical illnesses. "The brain is a body part, too," he said. "We just know less about it." Yet such candid acknowledgments that mental illness is as real as any physical malady is precisely what is not happening in our prisons. I bet the president doesn't even know that when federal judges recommend mental health prisons for patently ill inmates the BOP often countermands those judicial recommendations. There aren't supposed to be mentally ill prisoners at Supermax. But there are.

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Andrew Cohen is a contributing editor at The Atlantic. He is a legal analyst for 60 Minutes and CBS Radio News, a fellow at the Brennan Center for Justice, and Commentary Editor at The Marshall Project

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