A parody of therapy

The picture says it all. Taken by Times photographer Rick Loomis, it neatly sums up the dysfunction of California’s prison system. In the photograph, two mentally ill inmates in the Vacaville prison sit in metal cages the size of phone booths for what is supposed to be a group therapy session; a psychologist, seated several feet away and wearing a sport coat over body armor, plays an acoustic guitar and attempts to build trust by leading them in a sing-along of “Sitting on the Dock of the Bay.” It may sound ludicrous, but the inmates in the photo are positively privileged compared with others who, due to overcrowding, must sit in their therapy cages in the middle of prison living quarters, ostensibly sharing confidences while other inmates taunt them from nearby cells.

The drawbacks to such a method of delivering medical treatment seem obvious, and the efficacy of such therapy must be in doubt. Nonetheless, the value of caged therapy for mentally ill inmates is the subject of debate among psychiatric experts. Proponents say the cages provide security for those who treat inmates as well as greater freedom of movement for prisoners, whose hands are un-cuffed when they sit inside. Others say such therapy is worse than useless; it is demeaning to participants, and treating them like animals erodes confidence and self-esteem, both of which are necessary for treatment to succeed.

We are inclined to side with those who say it is pointless — a waste of time, a waste of money and a parody of therapy that seems unlikely to increase public safety when the inmates are released. Most convincing is the position of Pablo Stewart, a San Francisco psychiatrist whom The Times quotes as calling the practice “horrendous.” Stewart noted that some inmates receive caged therapy right up to the day they’re paroled. “So one day you’re so dangerous that you have to be in a cage and the person talking to you is sitting at a distance wearing a flak jacket, the next day you’re sitting on a bus,” he said. “That’s scary.”

Prison officials acknowledge that the cages are not ideal, but add that 10 years ago, a federal court judge deemed it cruel and unusual punishment to leave mentally ill prisoners without treatment, and they are doing their best to comply safely. There are, however, alternatives, and we are glad California officials say they are looking into them. Some prisons in New York, for example, use desks that lock down inmates’ legs but leave their arms free. The tension between security concerns and medical requirements is real, but we doubt that cages are the answer.