“Systemic Failures Persist” in California Prison Mental Health Care, Judge Rules

California Security Housing Unit Cell

California Security Housing Unit Cell

California Governor Jerry Brown’s bid to end federal control over the state prison system’s mental health system was denied in federal court on Friday, April 5, in a sharply worded ruling by U.S. District Judge Lawrence K. Karlton. In the 68-page ruling, Judge Karlton determined that “systemic failures persist in the form of inadequate suicide prevention measures, excessive administrative segregation of the mentally ill, lack of timely access to adequate care, insufficient treatment space and access to beds, and unmet staffing needs.”

The ruling comes following months of campaigning and litigating by Governor Brown and the California Department of Corrections and Rehabilitation (CDCR) to end federal oversight of the California prison system. Friday’s ruling is the latest enforcement of the 1995 case Coleman v. Wilson, a federal class action suit filed against then-California Governor Pete Wilson, which resulted in  federal oversight over CDCR’s mental health and medical treatment that continues under the jurisdiction of Judge Karlton.

An additional federal class action lawsuit, Plata v. Schwarzenegger was merged with the Coleman lawsuit and in 2009, California was ordered to reduce it’s prison population to 137% capacity, as it was determined that Constitutionally acceptable medical and mental health delivery was hindered by the beyond-capacity prison population, which was deemed an 8th Amendment violation. California in turn appealed the order to reduce it’s prison population and in 2011, in Brown v. Plata, the US Supreme Court ordered California to reduce it’s prison population by 30,000 inmates. Governor Brown has an additional appeal of this order before U.S. District Judge Thelton E. Henderson.

Governor Jerry Brown has gone on the record to claim that California  has “one of the finest prison systems in the United States,” and no longer requires federal oversight. In a January 2013 press release, Governor Brown stated: “After decades of judicial intervention in our correctional system and the expenditure of billions of taxpayer dollars, the time has come to restore California’s rightful control of its prison system.” In February, CDCR announced the completion of a new mental health treatment building at the California Medical Facility, and declared that the facility “reinforces CDCR’s ongoing commitment to provide a constitutional level of mental health treatment in California’s prisons.”

Judge Karlton’s ruling, however, strongly rebukes these claims by Brown and CDCR, saying “based on defendants’ conduct to date, the court cannot rely on their averments of good faith as a basis for granting termination. There is overwhelming evidence in the record that much of defendants’ progress to date is due to the pressure of this and other litigation.”

A major factor in Judge Karlton’s ruling was the significant rate of suicides in the California prison system, which has previously been reported to be well above the national prison average.

“In summary, for over a decade a disproportionately high number of inmates have committed suicide in California’s prison system describable inadequacies in suicide prevention in the CDCR,” Judge Karlton writes,”Defendants have a constitutional obligation to take and adequately implement all reasonable steps to remedy those inadequacies. The evidence shows they have not yet done so. In addition, while defendants represent that they have fully implemented their suicide prevention program, they have not. An ongoing constitutional violation therefore remains.”

Judge Karlton cited the overuse of solitary confinement, particularly among individuals with severe mental health problems, as a continuing problem in the California prison system. The ruling states that such individuals “face substantial risk of serious harm, including exacerbation of mental illness and potential increase in suicide risk.”

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Voices from Solitary: Suffering at the Hands of Other Human Beings

ELY PrisonThe following comes from Bryan Crawley, a prisoner at Ely State Prison in Ely, Nevada. Incarcerated since 2006 and convicted in 2008 for murder, he has been held in solitary confinement for his own protection since 2009 at the maximum security facility, after three years in a debriefing program. His involvement in the debriefing program, in which he was to provide information against the Aryan Warriors prison gang, became public news in 2009, leading to his transfer to ESP. ESP houses the state’s death row as well as the state of Nevada’s most violent and disruptive inmates, and reportedly a large number of prisoners with severe mental health problems.  Crawley has written elsewhere that he lives in “constant fear and anxiety” and that he must do his “best to never leave my cell” out of fear of assault by fellow prisoners. He writes here about the experience of solitary confinement and challenges the reader to imagine what its like to be in his situation. –Sal Rodriguez

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My name is Bryan Crawley and I am a life inmate within Nevada and I’m about to scare you, then have you contemplate on my words and on my years of experience here in the state of Nevada justice system, oh I mean the Nevada’s corruption system, the jails and NDOC prison systems.

Now let me first say in all my years within these systems I have seen, heard and experienced some very tragic, horrific, malicious, detestable acts by Nevada authority’s, I must also add this so you get a even clearer picture of who I am as a human being, in all my years within the Nevada’s jails and now prison system, I do not even have one single act of violence on my record while in custody, absolutely zero, no fights – no anything remotely violent but yet the authority’s still place me in isolation, maximum security, lockdown 23½ hours per day, 7 days a week, inside a 6 x 10 little concrete box.

I must listen to all the other HUMAN BEINGS around me who have gone INSANE with delusions, even though I sit here and find myself sentenced to the largest amount of time ever handed down by one of Nevada’s corrupt judges, I am one of the fortunate ones and you may ask why? It is because I come from a world of abuse, neglect and abandonment, you see I was built to take all this torture and torment because throughout my entire life I have enhanced my ability to resist, oppose and withstand all the oppression from these barbaric authority’s who have placed upon me many days of suffering for years and please do not take my words lightly, when I tell you torture that is what I really mean torture!

I must tell you that I have been violated many times by the Nevada authority’s – officers, it has become almost normal for a person known as an inmate to be completely DEGRADED while they are in custody here in Administration Segregation, Isolation in Ely maximum security prison.

I am surrounded by men, inmates, people who have in some form or the other thoroughly lost sight of reality, they are made to suffer day and night in their own torment, screaming, yelling, banging, hallucinating – THEY ARE GONE! COMPLETLY MAD! suffering in a little 6 x 10 cage, all by themselves, 24/7, year after year. It is very sad!  But this is the reality of a human being in custody in isolation in Americas so called Justice System. I must tell you that I see no purpose for this type of treatment of a human being, as inmates are treated worse than any animal I know of, except maybe test lab animals, now I ask you to please contemplate and ask yourself what true purpose could ever come from placing a human being inside a very small walled cage 24/7? Please think about my words because this is my reality today and every other day.

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Brandon Green, Chronicler of Solitary Confinement

Utah State Correctional FacilitySince first appearing in an October 16th, 2010 Voices from Solitary post, Utah State Prison, Draper, prisoner Brandon Green has been a consistent and prolific chronicler of “the vortex” that is the supermax Uinta One facility. Over 90 inmates are held in solitary confinement in the facility, where inmates are held in 8×6 cells for up to 24 hours a day. Inmates may be placed in the facility for protection (voluntary and involuntary) or as punishment for rules violations. Most are not allowed phone calls or visitations, and reading materials are restricted. The facility has been described as “a place of pain and terror,” with one inmate commenting ”no wonder there are  so many suicides.”

Brandon Green, 30, born and raised in Utah, has been in and out of prisons, and solitary confinement, for a decade. In 2003, he was arrested for driving a stolen truck. In an essay published on a blog operated by a supporter, he writes of his entrance into the world of solitary confinement: “115 Lbs, sick and coming off a two year crack addiction, you had to fight to stay unmolested and alive. The prison sends you to solitary confinement for fighting.”

For eleven months he served time in prison, much of which was in solitary confinement. His time in isolation would have a profoundly negative effect on him. Writing, ”While in solitary you developed these fears, this hate, this ‘animal-like’ emotion. You learned about needles from a neighbor and psychotropic medications from another neighbor. You start to shoot cocaine and methamphetamine at home. Your mom starts you on medication.  You drive 400 miles, up and back, to Las Vegas every two days to keep your dope supply up and the money supply up by selling.”

Being rearrested, he was incarcerated for 18 months, much of which was in solitary. Sent to a half-way house upon release, due to “the stress after all that solitary” he was rearrested and served two additional months before being released. In 2006, he was turned in by his mother following a resumption of involvement in criminal activity, and was arrested while driving back to Utah from Las Vegas. Upon being arrested, and not wanting ‘to come back to solitary, ” he slipped his handcuffs and reached for the shotgun in the vehicle, prompting a swift response by officers. While in jail he pulled sprinklers to flood his cell, engaged in self-harm, and threw feces. He was forcibly medicated for a month while in a strip cell following a suicide attempt.

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Mentally Ill Utah Prisoner Sentenced to 20 Days in Solitary for Not Moving Cup Fast Enough

Utah State Prison in Draper, Utah currently holds over 91 prisoners in solitary confinement in the Uinta One facility. Prisoners have described the facility as “a place of pain and terror” and a place where inmates “expect tragedy.”

While Utah Department of Corrections admits that the facility on occasion houses prisoners diagnosed as “mentally ill”, they point to the existence of the prisons Olympus Mental Health Forensic Facility.

According to the Utah Department of Corrections website:

Prisons and jails have become primary mental health care providers for mentally ill offenders in the criminal justice system. The mental health services provided by the Utah Department of Corrections is comprehensive and wide-ranging in its scope. Our mission is to provide comprehensive and cost-effective mental health treatment to those offenders who suffer from a serious mental illness.

The Clinical Services Bureau manages a 155-bed stand-alone housing unit for offenders with the most severe mental illnesses. This facility is designated to provide a therapeutic environment that promotes appropriate stabilization and behavioral change.

Solitary Watch has been in contact with an individual in the Olympus facility.  In his late 50s, he has been routinely transferred between Uinta One and Olympus for a decade. His medical documents indicate diagnoses for “Paranoid States (Delusional Disorders)…Other and Unspecified Protein-Calorie Malnutrition…Self-inflicted Injury By Cutting and Piercing Instrument” and other health issues. He reports constant harassment by the guards, who he says, among other things, falsely accused him of rules violations. In support of this, he provided documentation indicating that he was accused of a charge of “Abuse/Misuse Medications” based on “Some Evidence.” He was ultimately found not guilty of the charge, despite not participating in the Disciplinary Hearing.

“When people do wicked things to you and you complain, that isn’t paranoia, it’s circumstance driven. When you refuse to trust those whose conduct does not improve, that’s not paranoia. It’s recognition of active unremitting threat,” the prisoner writes. He reports having been placed in a wheelchair and being “upended onto my face” when the guard pushing the wheelchair “made a typical fast hard turn.” After the incident, he received “No apology from anyone whatsoever…I was told to wait until a nurse came to check on me…back in this cage I sat unmoving. I couldn’t get off the chair and on the ‘bed’…My ears are ringing incessantly…I can’t sleep more than two-hours…My eyes aren’t properly focusing,” he reports.

A month before this, he was found guilty of “Refuse Order” (see image), because he did not “fully and imediatly[sic] comply” with an order to remove an “empty cup and hand from the cuff slider.” When chastised for his behavior, according to the report, he was “disrepectful” to the staff. For this, he was ordered to 20 days in “Punitive Isolation” and assessed a $150 fine.

When asked to provide the policies that guide such punitive measures, Department Spokesman Stephen Gehrke was unaware that such policies are in writing. “I’m not aware whether there is some sort of document or guideline that lists offenses and punishments or repercussions on a case-by-case basis. I believe the response to each incident is specific to the individual details of each circumstance and takes into account aggravating or mitigating factors, which is why the prison employs hearing officers to listen to the offender’s account, review documents, and take into account all other forms of information,” he wrote via email.

“‘This is prison medicine–we don’t care and we don’t have to!’,” the prisoner in Olympus characterizes the approach of the prisons medical officials.

This kind of treatment of people in prison is all too common in the United States. A 2003 Human Rights Watch report estimated that one-third to one-half of individuals in American isolation units were diagnosed with a mental health problem. As of September 2011, one-third of Virginia’s Red Onion State Prison supermax population had a mental health diagnosis. The individual in Olympus is among many in isolation units who attempt suicide while in solitary confinement.  In 2006, it was noted that in California and Texas, suicides in prison disproportionately occurred in solitary confinement units.

Click here to read more of Solitary Watch’s reporting on Utah’s use of solitary confinement.

HRC: Pennsylvania Inmate Commits Suicide in Isolation Unit

The Human Rights Coalition in Pennsylvania has reported on the July 16th suicide of Brandon Palakovic, 23, at State Correctional Institution in Cresson (SCI-Cresson). HRC notes that the “facility that is being investigated by the U.S. Department of Justice for warehousing mentally ill prisoners in the hole and depriving them of mental health treatment.”

Out of a population of 1,400 inmates, SCI-Cresson holds over 100 in solitary confinement. According to a press release by the US Department of Justice federal officials planned to “investigate allegations that SCI Cresson provided inadequate mental health care to prisoners who have mental illness, failed to adequately protect such prisoners from harm, and subjected them to excessively prolonged periods of isolation, in violation of the Eighth Amendment to the U.S. Constitution.”

Palakovic had been institutionalized four times since he was eleven years old for mental health and related behavioral problems.  He had been variously diagnosed with Oppositional Defiant Disorder, bipolar disorder, and had noted impulse control problems. He had been incarcerated for just under a year and a half at the time of his death. It has been reported that four days prior to his death, he had refused to take medication, resulting in his being ”issued a misconduct report for refusal to obey a direct order as a consequence and sent to solitary confinement in the Restricted Housing Unit (RHU) as punishment.”

“A report from a prisoner in the RHU stated that Brandon was not taking his medication at the time of his suicide, though whether that was his choice or not was unknown. This report also discussed how Brandon had begun talking to non-existent people in his cell. Other prisoners on the block referred to Brandon by the nickname of ‘Suicide’ according to two prisoner reports,” reports HRC.

The Palakovic family has the following message: “We loved our son, Brandon Palakovic, with all of our hearts. He was a beautiful human being who struggled in some areas in his life. Things that came easy for many were a challenge for him. However, his intelligence was something that many marveled at and something that we hoped would be the key to his success someday. Unfortunately, he never had the chance to see his someday. Our hearts are so sad knowing that Brandon’s last thoughts on this earth were of desperation and hopelessness. If only he could have felt our love for him at that precise moment, maybe he would have changed his mind. We will never know. Although we cannot change what happened in that prison cell on July 16th, we can hopefully impact others and bring to light the neglect and mistreatment that many prisoners are forced to live with. If Brandon’s death can positively impact even one other prisoner’s situation, or help a family to avoid the pain of losing a loved one to suicide, then perhaps we will begin to heal and feel like his death was not in vain.”

Leading Mental Health Experts Urge Illinois Legislators to Close Tamms Supermax

When it comes to the psychological effects of solitary confinement in U.S. prisons, there are three acknowledged experts: Drs. Stuart Grassian, Craig Haney, and Terry Kupers. The three have collaborated on a joint statement on the closure of Tamms supermax prison, which was proposed last month by Illinois governor Pat Quinn. The statement is directed at the relevant committee of the Illinois state legislature, which will hold hearings on the prison closure next week. We are publishing this important statement in full.

Comments by Dr. Stuart Grassian, Dr. Craig Haney, and Dr. Terry Kupers to the April 2, 2012 Hearing of the Illinois Legislature Commission on Government Forecasting and Accountability regarding the proposal to close Tamms Correctional Center

Tamms Correctional Center has been open for over ten years, and some of its resident prisoners have been at the facility since it opened.  We have been informed that the Governor of Illinois has recommended that the Tamms facility be closed. As three long-time researchers and nationally recognized experts on the psychological effects of solitary confinement, we write to express our strong support of that recommendation.

We believe that the Governor’s recommendation is entirely consistent with a growing national trend away from the use of long-term solitary confinement.[1] Of course, there are compelling economic justifications that partially explain this trend. Supermax prisons such as Tamms are very expensive to operate.  In addition, however, there are important mental health concerns and public safety justifications that support this development. Research has shown that long-term solitary confinement places prisoners at grave risk of significant psychological harm.[2] Because this kind of confinement is not only painful but also potentially damaging—and, for some prisoners, perhaps irreversibly so—it can be a cruel and singularly inappropriate form of punishment. Beyond doing more to debilitate than rehabilitate the prisoners who are subjected to it, solitary confinement undermines the ability of many of them to succeed in the community after their eventual release from prison.[3] This evidence—that it appears to increase rather than reduce recidivism—raises public safety concerns.

The structure and operation of supermaximum security units such as Tamms are conducive to the creation of a punitive atmosphere and even a “culture of cruelty” that can harden and dispirit prisoners and correctional officers alike. Aspects of its negative atmosphere and culture may spread to and negatively affect prevailing attitudes and practices in the larger correctional system. Moreover, supermax prisons such as Tamms do not reliably reduce violence or disciplinary infractions within the larger prison systems in which they function; in some instances they appear to make it worse.[4] Nor do they alleviate the problem of prison gangs. The California Department of Corrections has aggressively pursued the use of long-term solitary confinement for more than 20 years and the state prison system is now plagued with perhaps the worst gang problem in the nation.

Our views on these matters are based on a careful review of the existing literature on solitary confinement and our own direct observations and analyses of the effects of long-term solitary confinement in work that we have been engaged in for more than three decades. Each of us has toured and inspected numerous “supermax”-type penal institutions, interviewed and evaluated numerous prisoners confined under these severe conditions, and discussed isolation practices and procedures with correctional staff and officials from around the country. We have sometimes been asked to render expert opinions in legal cases that were focused on whether being housed in supermax facilities such as Tamms constitutes “cruel and unusual punishment.” One of us (Dr. Haney) is an academic psychologist and two of us (Drs. Grassian & Kupers) are university-affiliated psychiatrists. [Read more...]