One of the things that are very important is that we can't look at mental health and mental health services in prisons as though they are distinct from the prison they are in or distinct from the other policies that are reflected in our operation of corrections.
The problems that were created in the United States were created essentially through two measures. One was harsh mandatory minimum sentencing, and the other was reductions in the mechanisms of release. It has led increasingly to harsher and harsher penalties. Once one buys the idea that mandatory minimums will stop crime, then crime simply becomes the justification for more of it. And so we ended up, by using those two mechanisms, with a system in the United States that no one predicted, that no one thought was possible.
In 1974 Canada had an incarceration rate of 89 per 100,000. The United States had an incarceration rate of 159 per 100,000. Thirty years later, our incarceration rate had increased from 89 to 109; the American incarceration rate went to 750. It is an astonishing difference.
But the relationship here is that when you have that kind of growth, you turn your gymnasiums into dormitories, so you have eliminated recreation. When you have that kind of growth, you don't have rooms to meet demand. You don't have staff who can provide programs and mental health services.