America’s bloated prison population has long held many of our society’s most vulnerable, including the mentally and cognitively impaired. Over 40% of all inmates have a history of mental health disorders, and only 60% of those are receiving treatment, according to a 2016 inmate survey.

About a quarter of state prisoners have been diagnosed with bipolar or anxiety disorder, and around 14% with PTSD. Another estimated 4% have autism and 25% have other cognitive impairments.

Inmates with these challenges find incarceration even more difficult than others. When held in a general prison population, they frequently endure harassment, manipulation and isolation, as well as mistreatment and neglect from the correctional system itself.

And some inmates die without the proper attention to their disabilities. That was the case for Anthony Talotta, an autistic man who was booked into Allegheny County Jail in 2022 after an altercation at his group home. He died of sepsis after 10 days. Correctional officers and a doctor with multiple revoked licenses neglected his care.

We have another way to address the needs of inmates with disabilities, being tested in a western Pennsylvania state correctional facility. A 3-year-old unit at State Correctional Institution Albion has a wing dedicated to serving this population in a thoughtful effort headed up by a counselor, not a correctional officer. It is the only such facility in Pennsylvania.

Known as the Neurodevelopmental Residential Treatment Unit, the space protects inmates with mental or cognitive disabilities. Sensory rooms, with dimmed lights and simple activities, help inmates who are overstimulated. Nonverbal prisoners are given ample opportunity to communicate.

The need for these kinds of facilities is obvious; The American criminal justice system, after decades of expansion at the expense of mental health facilities and social programs, has become the last resort for people with mental illness.

The type of treatment available to prisoners with cognitive and mental impairments is hard to estimate, as all correctional facilities have their own protocols and are closed to the public. Still, the need dwarfs the availability. The SCI-Albion facility, about 30 miles Southwest of Erie, only has room for about 45 men in its specialized unit.

Around 40,000 state and federal prisoners are currently held across Pennsylvania. That means 16,000 may need treatment.

Some advocates are trying to improve conditions through the courts, but the system can take years to enact change - and only if the suits are successful. A recent lawsuit against the state’s Department of Corrections from the Abolitionist Law Center highlighted how seriously mentally ill people are still being held in solitary confinement long-term, despite a 2015 statewide ban on the practice. But keeping them out of solitary confinement does not solve the problems of their being kept with the general prison population.

SCI-Albion’s unit has been running for three years now. That should be ample time to assess the effects on the inmates using the program.

Change can start with an improved understanding of what disabled inmates need and what practices will help them. It may be the only way to prove that a rehabilitative approach works better than a punitive one, and to ensure that more facilities like SCI-Albion’s are built in the future.

Pittsburgh Post-Gazette