Media coverage of the issue has been influential in other instances, as well. In a 2007 series for the Portland Phoenix, Lance Tapley described scenes that "might have taken place in Abu Ghraib" and practices that "fit some classic definitions of torture" in the Maine State Prison's SMU, including spraying mace on unruly mentally ill prisoners and binding them, naked, in "restraint chairs." Tapley's reporting helped fuel a campaign that led to the introduction of a bill in the state legislature to limit the use of solitary confinement in the state's prisons--and virtually ban it for the mentally ill.
In 2001 in New York, Mary Beth Pfeiffer, a reporter for the Poughkeepsie Journal, began investigating prison suicides, leading to a series of articles exposing the treatment of mentally ill inmates in the state's SHUs. In subsequent years, a full-fledged movement grew around the issue of mentally ill prisoners in solitary, beginning with a 2002 lawsuit to restrict the practice filed by the advocacy group Disability Advocates.
Lockdowns
The movement's ammunition came largely from a 2003 report by the non-profit Correctional Association of New York. The group had visited nearly all of New York's 26 SHUs, where some 5,000 prisoners were held in lockdown for periods that in some cases lasted 23-hours-a-day or more. Its report found that a quarter--and in some units as many as half--of the prisoners were "identified as seriously mentally ill." The SHUs held about 10 percent of the system's prisoners, but accounted for nearly half of its suicides.
A third of the SHU prisoners engaged in cutting or other forms of self-mutilation. "Unthinkable to outside observers," the Correctional Association said, "the Department [of Corrections] issues misbehavior reports to inmates who attempt to kill or harm themselves"--and the punishment was often more time in lockdown. While the state's prison population had tripled in the previous 20 years, it still had the same number of places--just 200--in its sole psychiatric center. The Correctional Association's Executive Director Robert Gangi would later describe placing mentally ill inmates in solitary as "state-inflicted brutality."
After the release of the Correctional Association report, the chair of the New York Assembly's Corrections Committee, Jeffrion Aubry, held hearings and introduced legislation to improve treatment for mentally ill inmates and forbid their placement in SHUs. By the following year, a coalition of advocates for prisoners' rights and the mentally ill were organizing a "Boot the SHU" campaign, with the slogan "Think Outside the Box."
In time, the legislation passed in both houses of the state legislature with broad bipartisan support and was endorsed by newspaper editorial boards across the state and by the New York State Correctional Officers union. But it faced opposition from Department of Corrections leadership. In 2006, then-Governor George Pataki vetoed the bill, saying prisons needed to be able to use solitary confinement to protect inmates and staff "from those who are unwilling to adhere to even the most minimum levels of civilized behavior."
Then-Governor Eliot Spitzer finally signed a version of the bill--with some compromises brokered to reduce costs--at the start of 2008. Its sponsor, Assemblyman Aubry, spoke of the legislation as a victory for public safety as well as for mentally ill inmates themselves, who "would complete their entire sentence in SHU and then go back into the community without being adequately treated. It might have kept the prison system safe, but it wasn't safe for the public having these people confined and made worse and then sent back into the community without."
The legislation came atop a 2007 settlement in the lawsuit by Disability Advocates, which will sunset when the law goes into full effect in 2011. In theory, New York State has made a commitment--within limits--to move existing mentally ill prisoners out of solitary confinement, and keep new ones from being placed in lockdown.
In practice, this is a complicated task.
Under the terms of the settlement, the state is now required to provide the mental health screening of all incoming prisoners. This screening is conducted in one of the state prison processing units by a state Office of Mental Health team, usually consisting of clinicianspsychologist, social worker, and/or therapistand overseen by a psychiatrist. The team has every inmate fill out a questionnaire asking whether they have attempted suicide, thought about doing so, and so on. If the person is judged to be seriously mentally ill, the psychiatrist will make the final diagnosis and prescribe medication--no simple matter, since prescribing psychotropic medications is a highly inexact science, and requires frequent follow-ups to make sure the drugs are working.
"Most mentally ill people also have individual counseling sessions, on a weekly to monthly basis, plus at least one psychiatric session every three months," Dianna Goodwin, the staff attorney at Prisoners' Legal Services of New York in Albany whomonitors the settlement, said in a telephone interview with the authors. The monitoring includes two visits of the prisons a year, and continual oversight of prison hearings on discipline problems that involve mental health.
If an inmate is judged to suffer from serious mental illnessconditions that include schizophrenia, bipolar disorder, serious depression, and psychotic or delusional disordershe or she can still be placed in a solitary cell. But according to the settlement, these prisoners must be allowed out every day for one hour of exercise and two hours of treatment. The new law, which is considered by advocates to be stronger than the settlement terms, demands four hours of treatment--two back-to-back, two hour sessions of therapyplus one hour of exercise each day.
In some instances inmates will be sent to live in a facility prepared for the mentally ill. In other instances they may stay in other prisons, but in sections especially organized for themwhere, for example, some parts of a steel cell door may be replaced with mesh screening. In either setting, the prisoners are supposed to be overseen by mental health clinicians as well as guards who receive training in how to handle mentally ill patients. In December, the state opened the 100-man Residential Mental Health Unit at the upstate Marcy Correctional Center,Goodwin said that the state hopes to increase the unit's capacity to 200.
Confining the Mentally Ill
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