Mentally Ill Inmates at Risk in Isolation, Lawsuit Says

March 9, 2007
Mentally Ill Inmates at Risk in Isolation, Lawsuit Says
By PAM BELLUCK
Correction Appended
BOSTON, March 8 — Placed in solitary confinement in a Massachusetts prison, Mark Cunningham tried to kill himself last year, advocates for inmates say.

Mr. Cunningham cut his legs and arms. He tried to hang himself with a tube from a breathing machine he used for sleep apnea. He smashed the machine to get a sharp fragment to slice his neck and ate pieces of it, hoping to cause internal bleeding. Five weeks ago, after being placed in solitary confinement again, Mr. Cunningham, 37, hanged himself.
With that, Mr. Cunningham, who lawyers said had a long history of mental illness, including depression, became the 13th inmate to commit suicide in Massachusetts since November 2004.
Mr. Cunningham’s case is one of 18 suicides and suicide attempts by inmates in solitary confinement described in a federal lawsuit filed Thursday by advocates for inmates and the mentally ill. They are seeking to prevent Massachusetts from placing mentally ill inmates in such segregated cells.
“We aren’t saying these folks should go free; we aren’t saying they shouldn’t be under high security conditions,” said Stanley J. Eichner, executive director of the Disability Law Center. But Mr. Eichner said putting prisoners in solitary conditions and denying them adequate mental health services was “literally the fatal flaw in the system.”
“How many more men will have to die,” he asked, “how many more men will be driven to harm themselves before this problem is fixed?”
The lawsuit reflects an increasing concern nationally as the number of mentally ill inmates rises, experts on inmates and mental illness say.
Several states, including Connecticut, New Mexico, Ohio, Texas and Wisconsin, have faced lawsuits that have recently been resolved by settlements or court orders requiring improvements in the treatment of mentally ill prisoners. Those changes include more frequent monitoring, better training of corrections officers and removal of fixtures that could be used for hangings.
In January, Indiana agreed to stop putting some mentally ill inmates in isolation cells. While not all agreements in other states have resulted in excluding mentally ill prisoners from isolation, many have called for better screening or monitoring of isolated inmates.
In California, after a record number of prison suicides — 44 — in 2005, a special master appointed by a federal judge reported that inmates “in overcrowded and understaffed administration segregation units are killing themselves in unprecedented numbers.” The judge, Lawrence Karlton, ordered the administration of Gov. Arnold Schwarzenegger to spend more than $600 million to improve mental health services.
In New York, the Legislature passed a law last year to remove mentally ill inmates from solitary cells, but Gov. George E. Pataki vetoed it. A 2002 suit seeking to end the practice is close to a settlement, said Nina Loewenstein, a lawyer for Disability Advocates, which filed it.
“That’s what states around the country are struggling with — when they have inmates that are very violent and out of control and need to be segregated from other inmates, but they are also mentally ill,” said Lindsay M. Hayes, a national expert in prison suicide prevention who was hired last year by the Massachusetts Department of Correction to study why the suicide rate was so high.
A segregated inmate is typically locked up for 23 hours a day, allowed out only to shower or get outdoor exercise in a small caged space.
In a report Mr. Hayes issued last month, he found that of 10 prisoners who killed themselves in 2005 and 2006, 5 had recently been on suicide watches and 9 committed suicide in solitary or segregated conditions. A prisoner who tried to kill himself was left brain dead.
“Confining a suicidal inmate to their cell for 24 hours a day only enhances isolation and is antitherapeutic,” Mr. Hayes wrote.
When the report was released, the State Department of Corrections said it would adopt all 29 of Mr. Hayes’s recommendations, which included better assessment, supervision and monitoring of inmates, and better officer training, a recommendation Mr. Hayes also made in a 2000 report. He did not specifically recommend excluding mentally inmates from segregation units, saying it was not his area of expertise.
The Department of Corrections declined to comment on the suit or its position on segregated cells.
But in a statement, the department said: “We are well aware of the national trend of the increasing number of prisoners with mental illness” and added that it was “committed to the full implementation of the Hayes recommendations and improvement of prison mental health care.”
The statement said the department had already taken several steps, including briefing senior staff, revising the training curriculum and evaluating cells for design improvements. It said it also was soliciting bids for a residential treatment facility for mentally ill inmates.
Leslie Walker, executive director of Massachusetts Correctional Legal Services, said that advocates had been pressing for change for 17 years and that she was not confident the state would do enough on its own.
Frances Armstrong, whose nephew, Andrew Armstrong, 22, killed himself in a segregation unit in 2005, said in an interview that Mr. Armstrong had been put in isolation several times for cutting himself.
“Even in the Bible it says man is not meant to be alone,” Ms. Armstrong said. “He just lost his will to live. He thought if this is going to be the way it’s going to be, I better check out now.”
Correction: March 12, 2007
An article on Friday about a lawsuit filed in Massachusetts by advocates for inmates and the mentally ill misstated the number of prison suicides in 2005 in California, which has been ordered to spend $600 million to improve mental health services in prisons. There were 36, not 44.