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Psychologists oppose bill that uses ‘outdated’ model to treat drug abusers in prisons


By Pedro Correa Henry

Twitter: @pete_r_correa

Special to The Star


A group of psychologists urged the Puerto Rico House of Representatives on Monday to hold public hearings and not pass Senate Bill (SB) 54, legislation that seeks to incorporate the Therapeutic Communities model in penal institutions deemed appropriate by the Department of Correction and Rehabilitation secretary to treat inmates for problematic use of psychoactive substances.


The psychologists said such legislation could infringe on inmates’ right to individual treatment, recovery and rehabilitation services.


In an interview with the STAR, Dr. Luis Román, a clinical psychologist, said SB 54, penned by New Progressive Party Sen. Thomas Rivera Schatz, violates the Puerto Rico Mental Health Act (Act 408 of 2000), which establishes that island residents are allowed to access health services, including an individualized treatment, recovery and rehabilitation plan, and retain the power of consent in the least to the most restrictive care.


“Passing a bill like this without considering everything we said infringes on the inmates’ well being, who still have every right to protect their mental health,” said Román, who works for Intercambios Puerto Rico, a coalition of psychologists that addresses and maintains oversight on public policies that focus on mental health concerns.


“Act 408 continues to protect them, no matter what,” he added.


Román, who is also working with the Puerto Rico Psychological Association Ad-Hoc Committee on Problematic Substance Use, said incorporating a Therapeutic Community (TC) model in correctional facilities would be dangerous for inmates who abuse psychoactive substances, given that “case studies reported participants facing human right infringements as it uses mainly confrontation as a treatment.”


“Science has already proven that confrontation has no therapeutic value,” he said. “What concerns us is the model has not been proven to be effective, it is highly expensive, and it is not aligned with a law that has remained in effect since 2000.”


“There are already various evidence-based initiatives to address this problem in this population, including a project that incorporates medications such as methadone, which has proven to be effective in tackling addiction to opioids,” he added. “The TC model is outdated. Studies have shown that it only works on 15% of its participants.”


The psychologist told the STAR that the TC model, which organizations such as Hogar Crea supported and defended in their deposition on the bill, does not include an interdisciplinary staff to address problematic drug use.


“This model is a pseudo-treatment, and establishing this model as a law would go against inmates’ best interests,” Román said.


Furthermore, Román said SB 54 discriminates against inmates. The bill, he said, explicitly states as part of its purpose “to regulate penal institutions so that they serve their purposes effectively, and obtain the moral and social rehabilitation of the offender.”


According to SB 54, the TC model is a rehabilitation program “implemented through residential facilities developed in penal institutions, isolated from other programs and located away from drug-related environments, in which the inmate receiving this service is referred to as a resident.”


“As a member of the community, the resident under treatment has to abide by strict and explicit rules of conduct,” states the legislation. “These rules are reinforced with specific contingencies (rewards and punishments) and are aimed at the development of self-control and responsibility.”


Dr. Debora Upegui, an analyst and author of the report “Humiliation and Abuse in Drug Treatment Centers in Puerto Rico,” noted that it was “unfortunate” that the Senate Community Initiatives, Mental Health and Addiction Committee, chaired by Independent Sen. José Vargas Vidot, submitted a positive report on a bill that includes a rehabilitation model “that supports forced labor.”


“It is concerning that a committee that is supposed to have expertise on mental health would support a bill like this,” she said. “Passing a bill like this gives psychologists a bad name because it would make others believe that we validate this sort of treatment.”

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