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Federal judge in SPLC case orders drastic overhaul of Alabama prison mental health care system

A federal judge today declared the mental health care system in Alabama prisons to be “horrendously inadequate” – an unconstitutional failure that has resulted in a “skyrocketing suicide rate” among prisoners.

U.S. District Judge Myron H. Thompson ordered state officials to reform the system and directed them to work with the Southern Poverty Law Center and others who filed the lawsuit three years ago.

Thompson identified multiple areas where the Alabama Department of Corrections (ADOC) has failed to maintain a constitutionally adequate mental health care system – ranging from a failure to identify prisoners with serious mental health needs to inadequate treatment for suicidal prisoners. Thompson’s 302-page ruling comes after a two-month trial that ended in February.

“[T]he evidence from both sides … materially supported the plaintiffs’ claim,” Thompson wrote. He later added: “Simply put, ADOC’s mental-health care is horrendously inadequate.”

The ruling caps the second of three phases of a lawsuit filed in 2014 by the Southern Poverty Law Center, the Alabama Disabilities Advocacy Program, and the law firms Baker Donelson, and Zarzaur Mujumdar & Debrosse.

Thompson highlighted a key issue facing the system: “persistent and severe shortages of mental-health staff and correctional staff, combined with chronic and significant overcrowding.” The judge noted that during the trial, Corrections Commissioner Jeff Dunn “described the prison system as wrestling with a ‘two-headed monster’: overcrowding and understaffing.”

The judge also noted the ADOC fails to provide individualized treatment plans to prisoners with serious mental health needs as well as psychotherapy by qualified and properly supervised staff and with adequate frequency and sound confidentiality. He also described a system that disciplines mentally ill prisoners for the symptoms of their illness and segregates them for prolonged periods.

“This ruling means that prisoners with mental illness may finally get the treatment they have been denied for so long,” said Maria Morris, SPLC senior supervising attorney. “The suffering some of these men and women have endured is excruciating and inhumane. We are pleased Judge Thompson has demanded that the state of Alabama meet its constitutional obligation to provide adequate care.”

Thompson noted that the ADOC has long known about problems plaguing the mental health care it provides to prisoners.

“ADOC officials admitted on the stand that they have done little to nothing to fix problems on the ground, despite their knowledge that those problems may be putting lives at risk,” Thompson wrote.

He noted, “The skyrocketing suicide rate within ADOC in the last two years is a testament to the concrete harm that inadequate mental-health care has already inflicted on mentally ill prisoners.”

In 2016, the plaintiffs settled the first phase of the lawsuit regarding violations of the Americans with Disabilities Act. In that settlement, the ADOC committed to provide services and fair treatment to incarcerated people with disabilities. The third phase in the lawsuit will determine whether the prison system’s poor medical services violate the Eighth Amendment’s ban on cruel and unusual punishment.

“For far too long, Alabama prisons have been little more than warehouses where many people struggling with mental illness have been hidden away and abandoned by the state,” said Lisa Borden, an attorney with Baker Donelson. “Once locked behind prison walls, in deplorable conditions with little or no treatment, any hope for improvement or recovery was lost, and many became more profoundly ill. We look forward to now having the opportunity for our clients to receive real treatment for their illnesses, and to seeing them afforded the basic dignity to which any human being is entitled.”

During the trial that began in December, lawyers for the prisoners presented witnesses and evidence depicting a cash-strapped, understaffed prison system whose failure to ensure proper mental health care amounts to “deliberate indifference” – a violation of the U.S. Constitution’s ban on cruel and unusual punishment.

As the trial progressed, a picture emerged of an Alabama corrections system that rarely connects prisoners with their mental health caregivers, cannot provide them with a safe environment and the therapy they need, and fails to identify those who most need help. The ADOC, it became clear, is fatally slow to respond to suicidal thoughts among prisoners and keen on saving money whenever it can.

Ten days after his testimony, 24-year-old prisoner Jamie Wallace was found dead in his cell from suicide.

Incarcerated witnesses told the judge about horrific conditions, especially in the spaces designated for mental health treatment. Expert witnesses recounted hearing inmates plead with them from their cells during official visits.

“This place is killing me,” a 24-year-old prisoner named Jamie Wallace had said, “please get me out of here.”

During the trial, Wallace testified about the ADOC’s failure to provide him with treatment other than multiple medications. He told the court that the only times he received even minimal attention from mental health professionals was when he was on suicide watch. Less than a month after his testimony, Wallace died by suicide, alone and unmonitored, in an ADOC prison cell.

After Wallace’s death, Thompson ordered the ADOC to enact a 15-point plan to better care for suicidal inmates. The judge referenced Wallace’s testimony and death throughout his order today.

“The case of Jamie Wallace is powerful evidence of the real, concrete and terribly permanent harms that woefully inadequate mental-health care inflicts on mentally ill prisoners in Alabama,” Thompson wrote.

Several expert witnesses called by the plaintiffs testified about horrible conditions in Alabama’s prisons, which are among the nation’s most overcrowded and understaffed. Conditions are so grim and dangerous, said nationally renowned prison psychology expert Dr. Craig Haney, that the ADOC is “rolling the dice” in its handling of prisoners with mental illness, placing them at “grave risk.”

Dr. Kathryn Burns, chief psychiatrist at the Ohio Department of Rehabilitation and Correction, said the ADOC mental health system is the “worst system” she’s ever seen – so bad that “it’s difficult, really, to call this a system.”

In May, Thompson preliminarily approved a settlement between the parties on the issue of involuntary medication that would protect inmates’ due process rights. Under the terms of the settlement, the ADOC must revise the way it decides when a prisoner should receive medication despite his protests.

The court has not yet set a date for the final phase of the case, the challenge to medical and dental care in the prison system.