Lawsuits address segregation of mentally ill prisoners

Concern over the use of solitary confinement for inmates who suffer from mental illness has propelled a spate of lawsuits over the past few years in the state of Vermont.

In one case, settled last August, a prisoner known as Patient A was held in segregation for nearly seven months. The settlement included reforms to the system including the requirement to seek a hospital bed when needed, twice-daily mental health checks in prison and weekly psychiatric evaluation.

The most recent case, which has also been filed by Disability Rights Vermont, accuses the state of holding a 34-year-old man, known as Patient X, in segregation for more than 26 days after a mental health professional recommended he be placed in psychiatric care.

“During the entire 26 days, the Department of Corrections’ psychiatrist was recommending that he be moved,” said A.J. Ruben, the supervising attorney for Disability Rights Vermont. “The hospital wouldn‘t take him because he had personality disorder and [they said that] a hospital is not the appropriate place for treatment.”

If the case goes to trial, the client can only claim for monetary damages but the issue is more about changing that system than about financial gain, said Ruben.

“He would settle for less if the state would offer systemic changes,” said Rubin.

The use of segregation with mentally ill inmates has been under a spotlight throughout the country after the recent publication of research showing the dangers for long-term stability and recovery.

In Massachusetts, attorneys for Prisoners’ Legal Services requested meetings with Governor Baker after reviewing cases of mentally ill inmates at two state prisons being placed in isolation for months and even years.

In Connecticut, a 2015 settlement guaranteeing treatment and financial remuneration was won by a man suffering from mental disabilities who had been held in segregation for six years.

In Vermont, the issue has garnered the attention of lawmakers who established a commission on offenders with mental illness following the settlement of the Patient A case to look at “the acute and complex set of issues arising from treating and housing offenders with mental illness within the correctional system,” according to a statement released by the Joint Legislative Justice Oversight Committee in September.

There are also several bills before the legislature designed to re-structure and better fund the entire mental health system.

One bill, S61, was introduced by Senators Dick Sears (D-Bennington) and Tim Ashe (D-Chittenden) and could directly affect the use of segregation in the state prison system. The bill includes a requirement for the Secretary of Human Services to provide a report by October 15, 2017, on how to “best provide mental health treatment and services to offenders in the custody of the Department of Corrections.”

Another section of the bill states that inmates who are identified by a mental health professional “as requiring inpatient evaluation, treatment, or services” must be provided with the recommended care within 48 hours in a “setting appropriate to the clinical needs of the inmate.”

That need for an appropriate setting is where the crux of the issue lies, some experts attest. According to Thomas Powell, Ph.D., a founding partner of Vermont Forensic Assessments and former director of clinical services for the Vermont Department of Corrections, the real concern is not with the intent of the corrections officials or mental health professionals who work with inmates but with the basic infrastructure of the system.

“The problem is of course that secure psychiatric institutions are not always available for these people so they end up in jail,” he said. “Jail is the system that can’t say no.”

And jails are not always designed for treating acute mental illness. When the former state hospital was destroyed by the flooding of Hurricane Irene in 2011, the new system created did not include a forensic psychiatric unit. Powell spoke before legislative committees tasked with designing the mental health system, a memory that frustrates him, he said.

“They built an institution that is not adequately staffed or has the facilities to deal with these people who needed higher security,” he said, something that is needed now “rather than foisting it on a prison system to just wing it, out of sight, out of mind.”

The good news in all of this, according to Lisa Menard, commissioner of the Vermont Department of Corrections, is that the overall use of segregation in the state prison system has decreased dramatically in the past few years. A 10-bed unit in Springfield has been virtually empty since mid-September.

“As a best practice resulting from research showing the potential side effects of segregation,” she said, “we have looked to reduce the use of segregation while still addressing issues of security for staff and inmates.”

The facilities in the state, she added, are anywhere from 14 to 79 years old and were not built to the current standards and practices expected in today’s corrections world. The reports requested by the state legislature should begin to address the needs to bring Vermont’s system up to date.

“If a facility were to be built, how would it look?” she said. “Could it be built to be more flexible in both staffing and functionality? We have made progress. The first concern is always safety but the goal is to house people in the most compassionate ways and the least restrictive.”