When he was five years old, Adam Hall tried to burn down his family home outside Utica in upstate New York. Afterwards, he drew a picture of his family having a happy reunion in heaven. Adam's mother, Carole Hall, knew the incident was a cry for help--and possibly an early suicide attempt--but she had no money to get Adam decent treatment. Through the rest of his childhood, the boy would be in and out of psychiatric institutions and group homes. Carole Hall says he was molested in two of them, but never effectively treated for what would eventually be diagnosed as a panoply of mental illnesses, including bipolar disorder.

What happened next is all too typical of what happens to young people with untreated psychiatric disabilities in New York and throughout the United States, in an era when psychiatric hospitals have closed and jails and prisons have become the default inpatient facilities for the nation's mentally ill. Adam Hall ended up in prison for a relatively minor felony, then in solitary confinement. Before long, he would have years added to his sentence for offenses committed in prison--offenses once again stemming from his mental illness. If the pattern continues, he could end up spending decades behind bars.

Hall's erratic and sometimes violent behavior got him in trouble with the law while he was still a teenager. By the time he was 22, in 2009, he had been convicted of assault after stealing a car and resisting arrest. Sentenced to three years, he joined the estimated 5,000 or more prisoners in New York State's prison who are suffering from mental illness.

According to correspondence with Adam Hall and interviews with his mother, he bounced around the prison system for a while. And like many people with mental illness, he quickly got in trouble for breaking prison rules and was disciplined by being placed in lockdown. A 2003 report by New York's Correctional Association found that while inmates diagnosed with mental illness made up 11 percent of the state's overall prison population, they constituted nearly a quarter of the inmates in isolated confinement in the state's Special Housing Units (SHUs). Many of the SHU prisoners the CA interviewed for the report were "actively psychotic, manic, paranoid or seemingly overmedicated."

Eventually Hall landed in the Residential Mental Health Unit (RMHU) at Marcy State Correctional Facility. The RMHU is considered an alternative to long-term solitary confinement for difficult to control prisoners with mental illness. In these units, inmates are locked down for much of the day, but receive they a greater measure of out-of-cell time and mental health treatment. Recent litigation and 2008's so-called SHU Exclusion Law were designed to reduce the population of mentally ill inmates in solitary, in part by increasing the number of RMHU beds. And considering the alternatives, it was probably the best placement available to Adam Hall within the prison system.

But Adam Hall remained unstable and suicidal, and in 2011 he attempted to kill himself the same way he had when he was five: he set fire to his RMHU cell. Prison officials had the option to treat the incident as a symptom of Hall's mental illness, and address it through internal disciplinary and classification processes. Instead, they chose to send Hall's case to a grand jury in Utica, where he was indicted for arson. Facing up to 25 years, Hall let his public defender enter a guilty plea to third-degree arson, and was sentenced to three to six additional years in prison.

Hall was shipped to another RMHU, this one in Attica, where he remains today. The Department of Corrections has charged him for damages to his cell totaling more than $4,000, which he cannot pay. Because of his debts to the prison, his mother says, any money sent to him to buy food and sundries from the canteen is requisitioned by the state. Adam says he has to sell his prison food to get enough to buy postage stamps.

Adam's situation--spelled out in a rap sheet he sent to Solitary Watch along with health records provided by his mother--appears to fly in the face of the intent of the state's hard-won SHU exclusion law. The law is designed to protect and help mentally ill inmates who face prison disciplinary proceedings. But it leaves prison officials the option to deal with behavior problems as crimes rather than as mental health issues, and ship them out to the local DA. (Some laws, in fact, appear to have been passed for this express purpose. It is now a felony in New York, for example, to throw feces at a prison officer--and offense that is committed almost exclusively by mentally ill inmates in the SHU, as well as those driven mad by solitary.)

"The part that bothers me,'' said one attorney with experience representing prisoners, "is: why did DOCCS refer this particular case to the DA for outside prosecution? We don't have a lot of info, but it appears that if he did have a discipline hearing for this incident it was dismissed, and it may have been dismissed because of his mental health. That they would refer for outside prosecution a case that does not even warrant internal discipline is quite troubling. However, I know of no law that applies. As far as I know, DOCCS simply has discretion to refer cases to local DAs."

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