Trouble in Mind

Texas's mentally impaired used to go to treatment centers. Now they go to prison.

His face is pasty and pale, a sharp contrast to his greasy coal-black hair. His dark eyes are sunken under a low forehead and thick eyebrows; he frequently jabs, mashes and grinds his eyes with the balls of his thumbs. When he speaks, he rarely makes eye contact. Even while sitting on the couch in his mother's living room — and even after 15 months of freedom — Aaron George still looks like he is in prison. And in a way, as a bipolar schizophrenic, he is: still in the prison of his own mind.

In a monotone, George recounts his recent incarceration in the Texas Department of Criminal Justice system, and he talks fatalistically about the very real possibility that he'll return to the special hell that a growing number of mentally impaired inmates inhabit.

"If I have to go back, I'll either let them kill me or I'll kill myself," he says. His voice is void of emotion; he is resigned to his fate.

At the Hodge Unit: Ruben Morales, a second-time offender serving ten years.
At the Hodge Unit: Ruben Morales, a second-time offender serving ten years.
"If I have to go back, I'll either let them kill me or I'll kill myself": Aaron George, temporarily out of prison, with his sister and mother, Beverly.
"If I have to go back, I'll either let them kill me or I'll kill myself": Aaron George, temporarily out of prison, with his sister and mother, Beverly.

It's May, and George is waiting to be retried for the 1992 shaking death of his seven-week-old son. In 1996, a Montgomery County jury found George guilty of murder and sentenced him to 60 years in prison. In January 1998, a state appeals court overturned the conviction. Four months later, he was released to await a second trial.

George, a slightly built man, looks even younger than his 25 years. During his time in prison, he says, he was raped twice and repeatedly left unprotected from predator inmates. Additionally, he says, he was also denied the psychiatric medications prescribed to him by his free-world psychiatrist — new, relatively expensive drugs that help George and other schizophrenics deal with the voices and signs that only they can detect.

Of course, accusations of barbarous living conditions within Texas prisons are nothing new. In 1972, several Texas inmates filed a landmark federal lawsuit that became known as Ruiz v. Estelle. The lawsuit challenged the constitutionality of almost every aspect of the state's prison operation, from the size of a cell to the use of solitary confinement and prisoners as guards. Following the trial that covered parts of 1978 and 1979, U.S. District Judge William Wayne Justice mandated sweeping reforms within the Texas prison system. Included in Judge Justice's ruling was an order for TDCJ to overhaul its physical and mental health care systems.

In 1995, Judge Justice released TDCJ from parts of the order but ruled that its health care system was still not sufficient. This March, he updated his opinion, ruling that the system's health care is now up to the standards of the U.S. Constitution.

But the judge still has great reservations about the quality of Texas prisons' health care. Even as he writes that treatment of the mentally impaired has improved enough to be "constitutional," he notes that TDCJ lacks compassion. "Simply stated," writes the judge, "large numbers of inmates throughout the TDCJ system are not receiving adequate [mental] health care."

He continues, writing that in light of recent rulings by the U.S. Supreme Court, "the standard for evaluating the constitutionality of medical care in prisons is Š unduly low.

"As the law stands today, the standards permit inhumane treatment of inmates. In this court's opinion, inhumane treatment should be found to be unconstitutional treatment."

Unfortunately, a growing number of mentally challenged prisoners are possibly subject to such treatment. In 1972, when the Ruiz federal suit was filed, Texas prisons held approximately 25,000 inmates. Today that number stands at more than 140,000. Mental health organizations estimate that as much as 17 percent of Texas prisoners — that is, as many as 23,800 inmates — suffer from some form of cognitive disability. But TDCJ designates fewer than 4,600 beds specifically for the mentally impaired.

And it seems ever more likely that a mentally ill person will end up in prison. Over the past ten years, according to the Texas Department of Mental Health and Mental Retardation, the number of state-funded nonprison beds for the mentally ill and mentally retarded has dropped from almost 8,000 to fewer than 5,500. Among the other states in the nation, Texas ranks a lowly 46th in mental health funding.

To Sharron Dishongh, the former head of a TDCJ psychiatric unit, the numbers point to the obvious — and they make her question the state's strategy for dealing with the people that few others want.

"The people that used to be in state [mental] hospitals are now here in prison," says ex-warden Dishongh. "But is this the best place for them?"In third grade, Aaron George was diagnosed with attention deficit disorder and began taking Ritalin. By the time he was 13, full-blown schizophrenia had been added to the diagnosis.

"He found it difficult to accept criticism," says Beverly George, Aaron's mother. "He took everything very personally. You could just ask him to take his foot off of the table and, if it was the wrong time for him, he would just be devastated. He was afraid to go into a store for fear he would make a mistake."

Often he would sit in front of the television for days without moving, talking or even eating. He grew increasingly paranoid and defensive. He suffered panic attacks. He heard voices. He became delusional. The television spoke directly to him. There were messages in numbers. Everything meant something, and it was all bad. He was convinced there was a conspiracy to kill him or, as he says, "to cross me out."

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