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Ruling: DOC 'indifferent' to mentally ill inmates

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A recent ruling against Indiana prisons is the latest in a wave of federal court judgments finding that treatment of the mentally ill behind bars – in particular, subjecting those inmates to prolonged isolation – is unconstitutionally cruel and unusual.

Judge Tanya Walton Pratt of the District Court for the Southern District of Indiana on Dec. 31 ruled that a lack of basic treatment for mentally ill Indiana Department of Correction inmates held in isolation violates the U.S. Constitution’s Eighth Amendment. She concluded that, in accord with Brown v. Plata, 131 S. Ct. 1910, 1928 (2011), “[a] prison that deprives prisoners of . . . adequate medical care . . . is incompatible with the concept of human dignity.”

“Mentally ill prisoners within the IDOC segregation units are not receiving minimally adequate mental health care in terms of scope, intensity, and duration and the IDOC has been deliberately indifferent,” Walton Pratt wrote. “Based on the facts and law set forth in this Entry, therefore, it is the Court’s conclusion that the treatment of mentally ill prisoners housed in IDOC segregation units and the New Castle Psychiatric Unit, and the failure to provide adequate treatment for such prisoners, violates the Eighth Amendment’s proscription against the imposition of cruel and unusual punishment. The Plaintiffs have met their burden in that respect and are entitled to prevail.”

The case brought by the American Civil Liberties Union of Indiana asserted that about half of the 13 suicides at DOC over a recent five-year period were committed by mentally ill inmates held in isolation – a population that accounts for just 6 percent of prisoners.

“Now, unfortunately, the state is in the position of being told what to do” as a result of the court order, said Lindsay Hayes, project director for the Mansfield, Mass.-based National Center on Institutions and Alternatives, who monitored the Indiana case and has advised states facing similar litigation.

California, Massachusetts, New York, Pennsylvania and Wisconsin are among states in which federal courts have intervened after mentally ill inmates sued as a class over isolation in prison, Hayes said. NCIA has been involved in an advisory or advocacy role in several of those cases.

“The bottom line is, people with serious mental illness housed in isolation for a prolonged period of time, their mental illness only debilitates further, and there’s a higher incident of serious suicide attempts,” he said.

According to a 2006 National Institute of Corrections study, 41.1 percent of inmates nationwide in long-term detention were held in isolation or segregation at the time of their deaths.

The DOC has yet to determine whether it will appeal Walton Pratt’s ruling, in which the judge ordered a conference within 45 days “for the parties to discuss and establish the appropriate development of a remedy.” The case is Indiana Protection and Advocacy Services Commission on behalf of its clients and constituents v. Commissioner, Indiana Department of Correction, 1:08-CV-01317.

“We do what we think is all we can do” to prevent suicides, DOC spokesman Doug Garrison said. “We do have mechanisms in place to monitor those who have exhibited suicidal behavior.” He said it was important to note that mentally ill inmates held in isolation usually are “there for their behavior.” A common reason for placing inmates in isolation is violent behavior directed toward staff, he said.

DOC also is challenged by staff limitations, despite institutional safeguards to prevent suicides. “When you have to react to behavior that’s like that, sometimes it’s difficult in the best circumstance to frustrate someone who’s intent on ending their life,” Garrison said.

ACLU of Indiana Legal Director Ken Falk said during a news conference Jan. 2 that plaintiffs were sympathetic to the challenges DOC staff faces due to budget constraints, and both sides agree the problem is a societal one.

“These people are going to be released,” Falk said, estimating that 90 percent or more of the class of inmates covered by the ruling would be freed eventually. “The question you have to ask yourself as a Hoosier is, do you want someone released who is acutely psychotic?”

“There are a lot of good people at DOC and they like to provide more services than they can,” said Fran Watson, ACLU of Indiana vice president of litigation and a professor at the Indiana University Robert H. McKinney School of Law in Indianapolis.

Watson said she expects the state to appeal, but she said, “I also think what’s likely to happen is (the DOC will) take their obligation seriously under the federal court order.

“That said, it’s going to come down to resources,” she said.

Similar cases in New York and Massachusetts, for instance, have resulted in outcomes that required a commitment of resources, Hayes said. He said prison administrators in New York “agreed they need to do a better job of programming for seriously mentally ill,” and settled a federal case.

There, an agreement provided frameworks to identify the seriously mentally ill and to give inmates a level of due process that involves mental health staff when an inmate’s behavior rises to a level that isolation might be warranted.

New York and Massachusetts also have built alternative housing units for the seriously mentally ill or refurbished other facilities for that purpose, Hayes said. The units offer appropriate programming and require a much higher staff-to-inmate ratio, he said. “They’re used as an alternative to (inmate) placement into isolation.”

Hayes said such results, in part, represent an acknowledgement that there is a need to tailor specialized institutional care for the seriously mentally ill as had been common decades ago.

He said DOC can use the ruling to persuade lawmakers to fund appropriate care.

More than 1,600 segregation beds are spread among 14 correctional facilities around the state, including the psychiatric unit at New Castle. According to the ACLU of Indiana, about 450 mentally ill prisoners are being held in isolation, but the ruling will affect hundreds, if not thousands, of inmates across the state.

“It’s one of those problems society puts behind closed doors and you don’t want to look at it because it’s tough,” Watson said.•

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  • miserable
    A lot of state prisons and jails have miserable conditions. I applaud this decision. Lets do somethign to stop prisoner rape in the bad facilities, too.

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  1. I have been on this program while on parole from 2011-2013. No person should be forced mentally to share private details of their personal life with total strangers. Also giving permission for a mental therapist to report to your parole agent that your not participating in group therapy because you don't have the financial mean to be in the group therapy. I was personally singled out and sent back three times for not having money and also sent back within the six month when you aren't to be sent according to state law. I will work to het this INSOMM's removed from this state. I also had twelve or thirteen parole agents with a fifteen month period. Thanks for your time.

  2. Our nation produces very few jurists of the caliber of Justice DOUGLAS and his peers these days. Here is that great civil libertarian, who recognized government as both a blessing and, when corrupted by ideological interests, a curse: "Once the investigator has only the conscience of government as a guide, the conscience can become ‘ravenous,’ as Cromwell, bent on destroying Thomas More, said in Bolt, A Man For All Seasons (1960), p. 120. The First Amendment mirrors many episodes where men, harried and harassed by government, sought refuge in their conscience, as these lines of Thomas More show: ‘MORE: And when we stand before God, and you are sent to Paradise for doing according to your conscience, *575 and I am damned for not doing according to mine, will you come with me, for fellowship? ‘CRANMER: So those of us whose names are there are damned, Sir Thomas? ‘MORE: I don't know, Your Grace. I have no window to look into another man's conscience. I condemn no one. ‘CRANMER: Then the matter is capable of question? ‘MORE: Certainly. ‘CRANMER: But that you owe obedience to your King is not capable of question. So weigh a doubt against a certainty—and sign. ‘MORE: Some men think the Earth is round, others think it flat; it is a matter capable of question. But if it is flat, will the King's command make it round? And if it is round, will the King's command flatten it? No, I will not sign.’ Id., pp. 132—133. DOUGLAS THEN WROTE: Where government is the Big Brother,11 privacy gives way to surveillance. **909 But our commitment is otherwise. *576 By the First Amendment we have staked our security on freedom to promote a multiplicity of ideas, to associate at will with kindred spirits, and to defy governmental intrusion into these precincts" Gibson v. Florida Legislative Investigation Comm., 372 U.S. 539, 574-76, 83 S. Ct. 889, 908-09, 9 L. Ed. 2d 929 (1963) Mr. Justice DOUGLAS, concurring. I write: Happy Memorial Day to all -- God please bless our fallen who lived and died to preserve constitutional governance in our wonderful series of Republics. And God open the eyes of those government officials who denounce the constitutions of these Republics by arbitrary actions arising out capricious motives.

  3. From back in the day before secularism got a stranglehold on Hoosier jurists comes this great excerpt via Indiana federal court judge Allan Sharp, dedicated to those many Indiana government attorneys (with whom I have dealt) who count the law as a mere tool, an optional tool that is not to be used when political correctness compels a more acceptable result than merely following the path that the law directs: ALLEN SHARP, District Judge. I. In a scene following a visit by Henry VIII to the home of Sir Thomas More, playwriter Robert Bolt puts the following words into the mouths of his characters: Margaret: Father, that man's bad. MORE: There is no law against that. ROPER: There is! God's law! MORE: Then God can arrest him. ROPER: Sophistication upon sophistication! MORE: No, sheer simplicity. The law, Roper, the law. I know what's legal not what's right. And I'll stick to what's legal. ROPER: Then you set man's law above God's! MORE: No, far below; but let me draw your attention to a fact I'm not God. The currents and eddies of right and wrong, which you find such plain sailing, I can't navigate. I'm no voyager. But in the thickets of law, oh, there I'm a forester. I doubt if there's a man alive who could follow me there, thank God... ALICE: (Exasperated, pointing after Rich) While you talk, he's gone! MORE: And go he should, if he was the Devil himself, until he broke the law! ROPER: So now you'd give the Devil benefit of law! MORE: Yes. What would you do? Cut a great road through the law to get after the Devil? ROPER: I'd cut down every law in England to do that! MORE: (Roused and excited) Oh? (Advances on Roper) And when the last law was down, and the Devil turned round on you where would you hide, Roper, the laws being flat? (He leaves *1257 him) This country's planted thick with laws from coast to coast man's laws, not God's and if you cut them down and you're just the man to do it d'you really think you would stand upright in the winds that would blow then? (Quietly) Yes, I'd give the Devil benefit of law, for my own safety's sake. ROPER: I have long suspected this; this is the golden calf; the law's your god. MORE: (Wearily) Oh, Roper, you're a fool, God's my god... (Rather bitterly) But I find him rather too (Very bitterly) subtle... I don't know where he is nor what he wants. ROPER: My God wants service, to the end and unremitting; nothing else! MORE: (Dryly) Are you sure that's God! He sounds like Moloch. But indeed it may be God And whoever hunts for me, Roper, God or Devil, will find me hiding in the thickets of the law! And I'll hide my daughter with me! Not hoist her up the mainmast of your seagoing principles! They put about too nimbly! (Exit More. They all look after him). Pgs. 65-67, A MAN FOR ALL SEASONS A Play in Two Acts, Robert Bolt, Random House, New York, 1960. Linley E. Pearson, Atty. Gen. of Indiana, Indianapolis, for defendants. Childs v. Duckworth, 509 F. Supp. 1254, 1256 (N.D. Ind. 1981) aff'd, 705 F.2d 915 (7th Cir. 1983)

  4. "Meanwhile small- and mid-size firms are getting squeezed and likely will not survive unless they become a boutique firm." I've been a business attorney in small, and now mid-size firm for over 30 years, and for over 30 years legal consultants have been preaching this exact same mantra of impending doom for small and mid-sized firms -- verbatim. This claim apparently helps them gin up merger opportunities from smaller firms who become convinced that they need to become larger overnight. The claim that large corporations are interested in cost-saving and efficiency has likewise been preached for decades, and is likewise bunk. If large corporations had any real interest in saving money they wouldn't use large law firms whose rates are substantially higher than those of high-quality mid-sized firms.

  5. The family is the foundation of all human government. That is the Grand Design. Modern governments throw off this Design and make bureaucratic war against the family, as does Hollywood and cultural elitists such as third wave feminists. Since WWII we have been on a ship of fools that way, with both the elite and government and their social engineering hacks relentlessly attacking the very foundation of social order. And their success? See it in the streets of Fergusson, on the food stamp doles (mostly broken families)and in the above article. Reject the Grand Design for true social function, enter the Glorious State to manage social dysfunction. Our Brave New World will be a prison camp, and we will welcome it as the only way to manage given the anarchy without it.

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