How Does the US Prison System Handle People With Disabilities?

Published May 4, 2020

It was something of a ‘perfect storm’ that has led to an unprecedented number of inmates with disabilities housed in prisons across the US today. Not surprisingly, administrators struggle to ensure access to services to which all inmates with disabilities are legally entitled.

How did so many people with disabilities end up in US prisons today? First, starting in the late 1970s, prison populations soared as lawmakers toughened sentencing laws in response to a rising tide of crime. This prisoner boom continued into the second decade of the 21st century where it moderated around 2010 but remains stubbornly high. The US today has the highest rate of per capita imprisonment in the world.

Second, around 60 years ago all states began closing mental health hospitals, including ones with secured wards for patients considered criminally dangerous. Many of the hundreds of thousands of people who would have been treated at these facilities today now crowd prisons, which are often ill-equipped to handle the influx of inmates with intellectual disabilities.

Third, prisoners in general are 3-4 times more likely to manifest some sort of disability than the non-incarcerated population.

Too many inmates, lots with disabilities

The result? Today the US has 4% of the world’s population, but 22% of its prisoners locked in state and federal penitentiaries. Moreover, the federal US Bureau of Justice found that more than one-in-three inmates report at least one disability.

All of this of course raises questions about what rights inmates have, and whether the overcrowded and often underfunded prisons are capable of guaranteeing those rights.

Fortunately for inmates with disabilities, the letter of the law is quite clear. Title II of the Americans with Disabilities Act (ADA) states, "No qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the services, programs or activities of a public entity, or be subjected to discrimination by any such entity."

Further all prisoners with disabilities are protected by section 504 of the Rehabilitation Act, as well as by Title II. As a table-setter for the ADA, which came later, 504 prohibits discrimination against people with disabilities in programs that receive federal financial assistance, including prisoners.

All of this of course raises questions about what rights inmates have, and whether the overcrowded and often underfunded prisons are capable of guaranteeing those rights.

Fortunately for inmates with disabilities, the letter of the law is quite clear. Title II of the Americans with Disabilities Act (ADA) states, “No qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the services, programs or activities of a public entity, or be subjected to discrimination by any such entity.”

Further all prisoners with disabilities are protected by section 504 of the Rehabilitation Act, as well as by Title II. As a table-setter for the ADA, which came later, 504 prohibits discrimination against people with disabilities in programs that receive federal financial assistance, including prisoners.

Dealing with legal gray areas

Of course in the context of legal complexities, there remain gray areas as to just what constitutes a disability within prison walls. For example, according to the American Civil Liberties Union (ACLU), the US Supreme Court has said a prisoner infected with HIV may be considered disabled even if he or she exhibits no symptoms. Yet prisoners with sight impairment in one eye is considered to have a disability only if their vision substantially limits participation in major life activities.

So specifically, what are the rights that prisoners in the US generally can count on as guaranteed under federal law? Here’s a list of what prison administrators must do and provide:

  • Prisons must give inmates with disabilities equal access to programs, services and benefits normally provided to inmates without disabilities. One notable exception is when the participation of an inmate with a disability would pose a significant health or safety risk or direct threat to others.
  • Prisons must provide effective communications means, and the list of these can include sign language interpreters, videophones, audio documents, Braille documents, captioned TV and other video provided to those without disabilities.
  • Prisons must make reasonable changes, modifications or other accommodations to give equal access. Arguably this language is somewhat non-specific, but the intent is clear.

The gulf between the law and reality

The reality of prison life today and the overwhelming numbers of prisoners with one or more disabilities make it difficult to comply with both the letter and intent of laws designed to give inmates equal access to programs and services.

For example, inmates with hearing disabilities who use sign language may often find no sign language interpreter for medical appointments. Grievance information may be written in English only (while no reliable statistics on the percent of non-English speaking inmates, about one in five are Hispanic, many of whom are either non- or marginal English speakers). Closed caption TVs are not always readily available, similarly with large print or Braille prisoner information.

For inmates with mobility disabilities, housing may be confined to a medical unit, even though they aren’t sick. Some inmate classes are held in inaccessible buildings. Access to exercise can be very limited if available at all. And there have been reports of wheelchairs being taken away as a penalty for rules infractions.

Inmates with psychiatric disorders

Perhaps the most notable area of rights violations involve patients with psychiatric disorders, owing in part to the great difficulties in properly diagnosing these disabilities. And, as mentioned, outside the prison walls there is a woeful shortage of mental health treatment facilities for inmates released from prison or for those with criminal records and who also exhibit psychiatric disorders.

It has been over 20 years since the Olmstead v. L.C. decision, which established that the segregation of people with disabilities in institutional settings is unlawful and in violation of the ADA. But the solution requires enormous investments in services and facilities outside of prison walls. Unfortunately, until that happens, US prisons too-often serve as the social service providers for people with disabilities convicted of crimes.

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