Response to Pinta

To the Editor: While I appreciate the concerns raised by Dr. Pinta, I would like to emphasize that the quality of mental health care in prisons was not the primary focus of my editorial. Rather, my main point addressed the transfer of responsibility for the care of mentally ill individuals from the community to the prisons. My reference to inadequate care in prisons was in the context of a reference to E. Fuller Torrey’s paper, and it was not intended as a global judgment on prison care from my own data or observation. One might also have a different interpretation of Dr. Pinta’s comment that the suicide rate of 14 per 100,00 in prison settings is less than the rate in the community; that is, this rate could also be considered astonishingly high, given that it occurs under the restricted freedom and constant monitoring of the prison setting. Finally, I am not able to speak to the quality of care in prisons in Ohio or California, nor can I speak to the quality of care a decade ago, to address the 35 years of Dr. Pinta’s experience. Nonetheless, I would encourage Dr. Pinta to consider that for the benefit of persons with mental illness in prison, we should remain open to the possibility that very significant improvements do need to occur in some and perhaps many prisons.