Politics & Government

California prisons to dramatically alter treatment for mentally ill inmates

Four months after a federal judge in Sacramento declared that conditions for mentally ill inmates in the state’s prisons were “horrific,” California corrections officials unveiled sweeping new policies that will house them in specially designed units, provide greater time out of their cells and offer vastly increased treatment for the ill prisoners.

The new policies, outlined in a filing Friday in federal court, dramatically alter the manner in which tens of thousands of state prison inmates are to be treated, and are designed to reduce the number of prisoner suicides and deaths.

“This is a tremendous breakthrough in the long struggle to bring treatment of mentally ill inmates into line with the Constitution,” said Michael Bien, lead attorney for the inmates.

“There was a different atmosphere during the negotiations with Corrections on these modifications. We felt we were listened to. We didn’t get everything we wanted, but there was an openness that has not been there in the past. We felt there was an acknowledgment that the old ways were not effective, and even dangerous for the inmates.

Bien said one of the most significant elements of the new plan is the “case-by-case, length-of-stay review” of every inmate in segregation, which corrections officials agreed to even though it is not called for in U.S. District Judge Lawrence K. Karlton’s April order mandating changes.

“We anticipate that process will show us that many seriously mentally ill prisoners who are in segregation do not need to be there,” he said.

“Today could be a real milestone in the history of this litigation.”

The new policies call for the creation of short-term and long-term housing units where mentally ill inmates will have access to regular psychiatric care, as well as exercise and recreational equipment and greatly increased time out of their cells, the California Department of Corrections and Rehabilitation said.

“CDCR will provide games and exercise equipment for inmate use on the exercise yards,” the court filing states. “Ninety minutes per week of out-of-cell time will consist of a structured therapeutic group activity.”

The policies are designed to get roughly 2,450 mentally ill inmates out of solitary confinement cells where they have little access to other human beings or the ability to exercise outside, leading to further deterioration of their emotional and mental stability. Lawyers for the inmates have fought for years to improve conditions for their clients, many of whom end up in ultra-secure housing as punishment for violations stemming from their mental illnesses and an inability to control their actions and understand the consequences.

Prison officials say the new policies exceed what Karlton ordered in April, following months of testimony on how mentally ill inmates are treated and how deeply ill some are. Evidence included testimony about one San Quentin inmate who was so sick he believed he was living in a church. Others were described as living naked, acting out and smearing feces on their cell walls and themselves, sometimes sparking the use of large amounts of pepper spray against them.

Karlton ordered the changes after graphic testimony and video displays of mentally ill inmates being pepper-sprayed repeatedly for seemingly minor offenses. The corrections department already has changed its policies to sharply restrict the use of force against such inmates.

Friday’s policy revisions offer “a robust mental health care program,” the department said, including daily rounds by psychiatric technicians to check on inmates and daily meetings between custody staff and mental health workers to “discuss any current behavioral issues or concerns.” Corrections officials could not give an estimate on the cost of the changes.

There are about 30,000 inmates considered to have a mental illness among the 116,000 housed in the state’s 34 adult prisons. The new policies are designed to discard a culture in which mental health staffers felt their concerns for the patients often were ignored and their instructions often overruled by custody staff in the name of security.

Inmate lawyers say the harsh conditions their clients have sometimes been subjected to exacerbate their illnesses. The new policies are aimed at avoiding that outcome by offering secure, standalone units where mentally ill inmates do not have to interact with the general population and can have more freedom of movement and more regular care.

“Standalone unit cells are provided electricity, allowing each inmate to have an electrical appliance in his cell,” a report on the policies explains. “Each inmate in the standalone unit will receive a general orientation packet and a (workbook), as well as pen fillers, paper, a calendar, a radio provided on the first day of placement, nonfiction and fiction books, regular offering of puzzles, crosswords, games, current events materials, the unit’s menu, and personal property such as photographs and notebooks.”

A major focus will be on getting inmates out of their cells to exercise or play with balls or games. Inmates in short-term housing will get 20 hours a week of such time, double what they are afforded in administrative segregation units.

“If adopted by the court, each inmate will now be offered out-of-cell time at least once a day, 7 days a week,” the policy states.

Karlton, who has overseen for nearly a quarter century the legal battle over how mentally ill inmates are treated, signed off on the revised policies Friday afternoon, marking what is likely to be the final order he will issue that dramatically reshapes California prison policy before his retirement Oct. 1.