There are other places for the mentally ill scattered throughout the system. When the Marcy unit opened, the New York State Department of Corrections said that only about 200 prisoners with serious mental illness were in SHUs for disciplinary violations. (The state says it does not use "solitary confinement.") Of its 58,690 inmates, 7,844 were diagnosed with mental illness, including 2,359 with serious mental illness, a DOC spokesperson told the Associated Press in December.These numbers are different from the 2003 findings of the Corrections Association, which estimated a quarter of the 5,000 inmates in SHUs were seriously mentally ill.
What comes into play here, of course, are the methods for classifying prisoners. Critics say that the Office of Mental Health tends to be overly conservative in assessing an inmate as seriously mentally ill, with things like personality disorders, PTSD, or the effect of head trauma often not considered "serious."
And the view still lingers--among the public as well as the DOC--that inmates are likely to con them, claiming mental illness to excuse bad behavior or get an easier berth in the prison system. According to Nina Loewenstein, the staff attorney at Disability Advocates in charge of the lawsuit and settlement, mental health professionals do the initial screening and monitor inmate care.
But decisions about who to put where and for how long are still made by the prison administration. If there is a review--and in many cases there need be no review, Loewenstein says--an inmate's future is determined by prison officials, which includes doctors, but no outside representatives. In other words, if a prisoner wants to contest a decision, he can't have his own attorney or psychiatrist present to advocate on his behalf. Still, Loewenstein believes there already are improvements in the overall process, with the prisons sometimes suspending sentences or cutting them back in duration due to recognition of mental illness.
Even the legislation, which most advocates see as stronger than the court settlement, does not ban the use of solitary confinement for all mentally ill inmates. Prison officials can still segregate such prisoners when they deem it necessary for the safety of staff, other prisoners, or the mentally ill inmates themselves, or when those inmates refuse to participate in treatment. Finally, the law does not apply to prisoners held in local jails.
Dianna Goodwin of Prisoners' Legal Services acknowledges these problems, and would like to see the program opened up to more people. One major issue, she said, "is that they don't do a whole lot with PTSD. Almost everyone in prison has it. It is not part of the lawsuit or the statute, but it is a huge problem."
Prison life brings "ongoing trauma," Goodwin added, "so people with bad PTSD have all kinds of triggers that aren't being addressed as a mental health issue. I don't know what kind, if any, of training they have for correctional officers on this issue."
Nevertheless, she declared that, overall, "there is a very sincere effort by both Corrections and the Mental Health Office to put everyone who they classify as seriously mentally ill into an appropriate program." While top officials at the DOC had resisted the legal sanctions and earlier denounced the Correctional Association report, corrections staff who deal with mentally ill inmates on a daily basis tend to welcome the changes. "The correctional staff has told us over and over again that even long time officers are coming on board, since everyone knew they had a problem dealing with these prisoners," Goodwin said. "Mentally ill people have been incarcerated in unprecedented numbers since the closure of most community mental facilities over the last decades; DOC has had to handle the change but until the settlement did not have the resources or institutional commitment to deal with large numbers of mentally ill inmates."
A Step Towards Decency
While most advocates see the settlement and especially the legislation as what a 2007 New York Times editorial called "a step toward basic human decency," Fewbelieve that it goes far enough. "Maltreatment of mentally ill prisoners is a national shame," the Times editorial continued. "The basic problem is that severely ill inmates should not be held in lockdown at all." In the eyes of some critics, what New York and a handful of other states have done is simply reduce the frequency and severity of a practice they equate with torture.
The UN Human Rights Committee, European Committee for the Prevention of Torture, Amnesty International, and Human Rights Watch have all, in various terms, deemed long-term solitary confinement cruel and unusual punishment for all prisoners. A 2003 Human Rights Watch report stated: "Even if they have no prior history of mental illness, prisoners subjected to prolonged isolation may experience depression, despair, anxiety, rage, claustrophobia, hallucinations, problems with impulse control, and/or an impaired ability to think, concentrate, or remember."
When it comes to mentally ill prisoners, several U.S. Courts have joined in denouncing the use of any segregated confinement. In the most famous of the relevant cases, Madrid v. Gomez, a federal judge in California declared that solitary confinement "may press the outer bounds of what most human beings can psychologically tolerate," while for mentally ill prisoners it is "the mental equivalent of putting an asthmatic in a place with little air to breathe."
No widespread ban on the lockdown of mentally ill prisoners is likely to take place without changes in the trend toward criminalizing the mentally ill, which has been underway for more than 20 years. In 2003, Human Rights Watch concluded that America's prisons and jails held three times as many mentally ill people as its psychiatric hospitals. The Los Angeles County Jail and New York's Rikers Island effectively functioned as the nation's two largest inpatient mental health facilities, and incarceration had become its default treatment for mental illness.
According to Bureau of Justice Statistics data more than half of all prison and jail inmates self-report that they suffer from mental health problems--five times the rate in the general population. According to the National Alliance on Mental Illness approximately 24 percent of inmates in U.S. prisons and 17 percent of those in local jails have what would be diagnosed as serious mental illness.
Non-Violent Offenders in Majority
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