1)11-10-9
Treatment units for mentally ill inmates on hold
State cites budget crunch as talks to end suit fail
By Jonathan Saltzman, Globe Staff | November 10, 2009
The Patrick administration has shelved plans to build special treatment units for hundreds of seriously mentally ill inmates, two years after advocates for prisoners alleged in a federal lawsuit that the state’s practice of keeping such inmates in solitary confinement 23 hours a day was inhumane and causing suicides.
Citing the state budget crisis, lawyers for top state prison officials said negotiations to settle the civil rights suit by the Disability Law Center against the Department of Correction out of court have ended. The center has asked a federal judge in Boston to schedule a trial for January 2011, while the state wants it to start a year later.
The collapse of negotiations, made public in court filings Friday, marks a startling reversal from where things stood a year ago. Last November, Harold W. Clarke, the correction commissioner appointed by Governor Deval Patrick, and Leslie Walker, executive director of Massachusetts Correctional Legal Services, said they expected the suit would be resolved shortly with the announcement of plans to build maximum-security residential treatment units.
Inmates would be exposed to more types of therapy in such units, and advocates want the prisoners to have more time out of their cells.
“We’re hoping to be able to say, ‘We don’t have to go to court, we can avoid litigation,’ which I’m certain will serve all parties best,’’ Clarke said in a Globe report Nov. 16.
On Friday, however, lawyers for the prison system filed a document in US District Court that said, “Due to the fiscal crisis, the parties have discontinued formal settlement negotiations.’’ The state’s lawyers did not elaborate on the financial constraints.
The nonprofit Disability Law Center sued the state in March 2007, alleging that hundreds of mentally ill prisoners were kept in closet-size solitary confinement cells in response to unruly behavior. The conditions had led to self-mutilation, the swallowing of razor blades, and numerous suicides, said the center.
The suit, which resembled legal challenges that led to changes in other states, said Massachusetts ignored repeated calls from its mental health providers and consultants to provide high-security treatment units for violent, mentally disturbed inmates.
A Globe Spotlight Team series in December 2007 reported 15 suicides in the prisons from 2005 through 2007, most by those in solitary confinement with histories of mental illness or drug addiction. There had also been more than 3,200 suicide attempts and self-inflicted injuries in the prior decade, the Globe found.
Walker, of Massachusetts Correctional Legal Services, which helps represent the Disability Law Center in the suit, said yesterday that she was “deeply disappointed that we’re not going to be able to resolve this case short of trial.’’ She said she could not comment further because settlement talks were confidential.
In a brief statement, Diane Wiffin, a spokeswoman for the prison system, said correction officials plan to “continue providing appropriate levels of service to segregation inmates with serious mental illness.’’ She declined to elaborate, citing the litigation.
There is nothing appropriate about the segregation of inmates with mental illness, according to Laurie Martinelli, executive director of the National Alliance on Mental Illness of Massachusetts, an advocacy group that supports the lawsuit.
She said keeping such prisoners in their cells 23 hours a day violates the constitutional prohibition against cruel and unusual punishment and that the state’s fiscal crisis was irrelevant.
“You can’t get around a constitutional violation by saying, ‘We don’t have money,’ ’’ she said.
Fred Cohen, a retired criminal justice professor at the State University of New York at Albany and an expert on the treatment of the mentally ill in prisons, agreed, saying no federal court has ruled that finances trump an inmate’s constitutional rights. If the case goes to trial, however, plaintiffs would have to prove that the isolation of inmates violates their civil rights. In some states, Cohen said, politicians were glad for judges to order them to improve conditions for inmates; that way, judges, rather than the politicians, had to take the heat from the public for spending scarce tax dollars on convicted criminals.
“It’s not unheard of, and it’s especially popular during times of economic duress,’’ he said.
Several states, including Connecticut, New Mexico, Ohio, Texas, and Wisconsin have faced lawsuits in recent years that have been resolved by settlements or court orders requiring improvements in the treatment of mentally ill prisoners.
Kevin M. Burke, Patrick’s public safety secretary, was quoted as saying in 2007 that it would cost “several million’’ dollars to fully fund high-security treatment units. A spokesman for Burke, whose office oversees the prison system, said yesterday that the secretary would not comment on the litigation. Patrick also declined to comment through a spokeswoman.
Prisoner rights groups as well as specialists on the treatment of inmates have repeatedly criticized the Massachusetts prison system for failing to address the needs of inmates with mental illnesses.
An independent study of the state prison system released in February 2007 found that the number of mentally ill inmates increased by nearly 1,000 between 2000 and 2005 but that the state was not responding adequately to the challenges they presented. There are about 11,000 inmates in the state system.
Lindsay M. Hayes, a national specialist in prison suicide prevention who wrote the report, said suicidal inmates were being punished instead of being helped. The study, commissioned by the department after an increase in prisoner suicides in 2005 and 2006 left the state’s rate nearly double the national rate over the prior decade, made 29 recommendations. They ranged from improving the suicide-prevention training of correction officers to increasing the frequency of observation of at-risk inmates.
Although prison officials immediately said they embraced all of the recommendations, the department never endorsed a blanket ban on the segregation of mentally ill inmates. Inmates in segregation are typically allowed out of their cells for an hour only to shower or to get exercise in a small caged space.
In April 2008, the state prison system took a modest step to improve treatment of mentally ill inmates when it opened a unit for such prisoners at Souza Baranowski Correctional Center, a maximum-security prison in Shirley. The unit is called the Secure Treatment Program and it houses 14 prisoners, Wiffin said.
2) 8/12/12 Judge orders prison suicide records
Advocacy group sues over care of inmates
By Jonathan Saltzman, Globe Staff | August 12, 2010
A federal judge in Boston ordered a former contractor for the state prison system yesterday to provide him with the psychiatric treatment records of about 25 inmates who committed or attempted suicide while in solitary confinement from 2005 to 2007.
US Chief District Court Judge Mark L. Wolf gave the University of Massachusetts Correctional Health Program until Aug. 27 to turn over thousands of pages of mental health reviews written by therapists after the suicides and attempts. He wants to determine whether he can legally turn them over to a nonprofit advocacy group that has sued the state over the care of mentally ill inmates.
UMass Correctional Health, which is not a defendant in the suit and is a program of the University of Massachusetts Medical School, contends that federal law requires the records to remain confidential under a privilege between psychotherapists and patients. The only way the privilege can be waived, UMass said yesterday, is if the inmates, or their representatives, give permission to release them.
But lawyers for the Disability Law Center said the records are crucial to their case. The center filed a civil rights suit against the prison system in 2007 alleging that hundreds of mentally ill inmates are held in cells 23 hours a day in inhumane conditions.
“We’re seeking documents that analyze what happened,’’ Carol E. Head, a lawyer for the Disability Law Center, told Wolf during a two-hour hearing. The records, she said, might indicate whether inmates were improperly diagnosed or harmed themselves because of conditions in solitary confinement.
James A. Bello, a lawyer for UMass, called the plaintiffs’ request for the records a “fishing expedition’’ and said inmates might have committed suicide for reasons that had nothing to do with conditions in prison.
But Wolf countered that the records were relevant even if the plaintiffs have no idea what they say. It was possible, he said, the documents might contain damaging evidence, such as a comment by a mental health clinician that “if we don’t change the way we deal with prisoners in segregation with serious mental health needs, I predict the number of suicides will soar.’’
Lawyers for the Department of Correction have taken no position on the request for records and were mostly silent at the hearing.
Suicides in the state prison system have been a focus of concern for years.
In February 2007, following seven suicides the previous year, a nationally renowned suicide prevention specialist hired by the state issued a 63-page report that found serious shortcomings in the state’s handling of inmates at risk for suicide. The state immediately pledged to comply with all 29 recommendations in the report.
A Globe Spotlight Team series in December 2007 revealed deepening mental illness and misery behind the walls of the state’s prisons and identified numerous problems, including bungled background screenings of suicidal inmates, missing mental health records, and skipped security rounds by correction officers.
Although suicides fell after the state promised to comply with the 29 recommendations, they surged again this year. Eight inmates killed themselves in the first seven months of the year, a suicide rate more than four times the national average. In response, the Patrick administration announced it would rehire the suicide prevention specialist.
Few of the suicides this year occurred in solitary confinement, according to James Pingeon, director of litigation for Prisoners’ Legal Services and a member of the Disability Law Center’s legal team. But some of the inmates who killed themselves had spent considerable time in solitary confinement, including one with a history of mental illness who was mentioned in the center’s lawsuit.
The suit, which alleges that solitary confinement has caused inmates to mutilate themselves, swallow razor blades, and commit suicide, demands that the state build maximum-security residential treatment units. In late 2008, the Patrick administration signaled that it would build such units in the hopes of settling the suit out of court. But the administration shelved the plans a year later, saying the state’s finances made that impossible.
Wolf said yesterday that the state and Disability Law Center have tried to settle the dispute, and he hoped they could continue to talk, given the “high human stakes here.’’
He ordered UMass to provide complete mental health records pertaining to the 25 inmates as well as records redacting the information that the vendor says is privileged, so he can compare them.
UMass no longer provides mental health services at the state prisons, although it does provide inmates with medical services. State officials replaced UMass with another vendor for mental health services, Virginia-based MHM Services Inc.
2)March 2007March 9, 2007
Mentally Ill Inmates at Risk in Isolation, Lawsuit Says
By PAM BELLUCK
BOSTON, March 8 2007— Placed in solitary confinement in a Massachusetts prison, Mark Cunningham tried to kill himself last year, advocates for inmates say.
Mr. Cunningham cut his legs and arms. He tried to hang himself with a tube from a breathing machine he used for sleep apnea. He smashed the machine to get a sharp fragment to slice his neck and ate pieces of it, hoping to cause internal bleeding. Five weeks ago, after being placed in solitary confinement again, Mr. Cunningham, 37, hanged himself.
With that, Mr. Cunningham, who lawyers said had a long history of mental illness, including depression, became the 13th inmate to commit suicide in Massachusetts since November 2004.
Mr. Cunningham’s case is one of 18 suicides and suicide attempts by inmates in solitary confinement described in a federal lawsuit filed Thursday by advocates for inmates and the mentally ill. They are seeking to prevent Massachusetts from placing mentally ill inmates in such segregated cells.
“We aren’t saying these folks should go free; we aren’t saying they shouldn’t be under high security conditions,” said Stanley J. Eichner, executive director of the Disability Law Center. But Mr. Eichner said putting prisoners in solitary conditions and denying them adequate mental health services was “literally the fatal flaw in the system.”
“How many more men will have to die,” he asked, “how many more men will be driven to harm themselves before this problem is fixed?”
The lawsuit reflects an increasing concern nationally as the number of mentally ill inmates rises, experts on inmates and mental illness say.
Several states, including Connecticut, New Mexico, Ohio, Texas and Wisconsin, have faced lawsuits that have recently been resolved by settlements or court orders requiring improvements in the treatment of mentally ill prisoners. Those changes include more frequent monitoring, better training of corrections officers and removal of fixtures that could be used for hangings.
In January, Indiana agreed to stop putting some mentally ill inmates in isolation cells. While not all agreements in other states have resulted in excluding mentally ill prisoners from isolation, many have called for better screening or monitoring of isolated inmates.
In California, after a record number of prison suicides — 44 — in 2005, a special master appointed by a federal judge reported that inmates “in overcrowded and understaffed administration segregation units are killing themselves in unprecedented numbers.” The judge, Lawrence Karlton, ordered the administration of Gov. Arnold Schwarzenegger to spend more than $600 million to improve mental health services.
In New York, the Legislature passed a law last year to remove mentally ill inmates from solitary cells, but Gov. George E. Pataki vetoed it. A 2002 suit seeking to end the practice is close to a settlement, said Nina Loewenstein, a lawyer for Disability Advocates, which filed it.
“That’s what states around the country are struggling with — when they have inmates that are very violent and out of control and need to be segregated from other inmates, but they are also mentally ill,” said Lindsay M. Hayes, a national expert in prison suicide prevention who was hired last year by the Massachusetts Department of Correction to study why the suicide rate was so high.
A segregated inmate is typically locked up for 23 hours a day, allowed out only to shower or get outdoor exercise in a small caged space.
In a report Mr. Hayes issued last month, he found that of 10 prisoners who killed themselves in 2005 and 2006, 5 had recently been on suicide watches and 9 committed suicide in solitary or segregated conditions. A prisoner who tried to kill himself was left brain dead.
“Confining a suicidal inmate to their cell for 24 hours a day only enhances isolation and is antitherapeutic,” Mr. Hayes wrote.
When the report was released, the State Department of Corrections said it would adopt all 29 of Mr. Hayes’s recommendations, which included better assessment, supervision and monitoring of inmates, and better officer training, a recommendation Mr. Hayes also made in a 2000 report. He did not specifically recommend excluding mentally inmates from segregation units, saying it was not his area of expertise.
The Department of Corrections declined to comment on the suit or its position on segregated cells.
But in a statement, the department said: “We are well aware of the national trend of the increasing number of prisoners with mental illness” and added that it was “committed to the full implementation of the Hayes recommendations and improvement of prison mental health care.”
The statement said the department had already taken several steps, including briefing senior staff, revising the training curriculum and evaluating cells for design improvements. It said it also was soliciting bids for a residential treatment facility for mentally ill inmates.
Leslie Walker, executive director of Massachusetts Correctional Legal Services, said that advocates had been pressing for change for 17 years and that she was not confident the state would do enough on its own.
Frances Armstrong, whose nephew, Andrew Armstrong, 22, killed himself in a segregation unit in 2005, said in an interview that Mr. Armstrong had been put in isolation several times for cutting himself.
“Even in the Bible it says man is not meant to be alone,” Ms. Armstrong said. “He just lost his will to live. He thought if this is going to be the way it’s going to be, I better check out now.”
Correction: March 12, 2007
An article on Friday about a lawsuit filed in Massachusetts by advocates for inmates and the mentally ill misstated the number of prison suicides in 2005 in California, which has been ordered to spend $600 million to improve mental health services in prisons. There were 36, not 44.
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