American Jails Are Wretched Hell Holes for the Mentally Ill

By Grace Wyler

Orleans Parish Prison, in New Orleans, is a cesspool of rape and violence. Photo by Flickr user Bart Everson

In the latest gruesome dispatch from the clusterfuck that is America's corrections system, the Associated Press reported last week that Jerome Murdough, a mentally ill former Marine, “basically baked to death” in his 6'-by-10' cinderblock cell in Rikers Island. According to the AP, Murdough, who was homeless and on anti-psychotropic and anti-seizure medication, had been at Rikers for about a week, after being picked up by police in February on a misdemeanor trespassing charge for sleeping on the roof of a Harlem housing project. On the night he died, Murdough had complained of being overheated. Because he was housed in a special unit for mentally ill inmates, officers were supposed to check on his cell every 15 minutes, but instead he was ignored and left alone. When his cell was finally opened, four hours later, Murdough was already dead, and his internal body temperature and the temperature in his cell were at least 100 degrees.

The incident is horrifying, but also perhaps unsurprising, given the grim—and often deadly—conditions for mentally ill inmates at big urban jails like Rikers Island. The number of mentally ill people housed in American prisons and jails has “skyrocketed” over the past few decades, said Bandy Lee, a professor of psychology at Yale University who specializes in violence at prisons and jails. Murdough’s death, Lee said, “is actually a natural consequence” of putting mentally ill inmates in facilities that are neither designed nor equipped to deal with them. “It’s evidence of the level of ignorance that corrections officers have of the mentally ill.”

In a statement, New York City's acting correction commissioner Mark Cranston said that the department is conducting a "full investigation of the circumstances surrounding Mr. Murdough's unfortunate death, including issues of staff performance and the adequacy of procedures." While the cause of death is still under investigation, Cranston did confirm in his statement that there were "unusually high temperatures" in Murdough's cell, and said that "remedial action" has been taken to resolve mechanical issues in the immediate facility. 

But the problems at Rikers Island extend beyond faulty temperature control. On Monday, federal agents announced that they had arrested and charged a New York City corrections officer with "deliberate indifference" in the death of a mentally ill inmate who ate a toxic soap ball and then pounded on his cell door for hours begging for medical help.

As Lee and other experts and prisoners'-rights advocates have noted, both deaths underscore the challenges city jails face in dealing with growing populations of mentally ill prisoners. At Rikers, the proportion of inmates with a diagnosed mental illness has jumped to 40 percent, up from 20 percent just eight years ago, according to the Department of Corrections. Jails are neither designed nor equipped to be mental institutions and, unsurprisingly, locking up people who are in need of psychiatric care has resulted in mayhem. A New York Times investigation into conditions at Rikers Island, published just one day before Murdough’s death was reported, found that at least 12 inmates have been slashed or stabbed since New Year's Eve. According to internal reports obtained by the Times, inmates and corrections officers have suffered lacerations, concussions, punctured eardrums, and fractures to noses, eye sockets, jaws, and hips. The investigation found that in the past ten years, the use of force by corrections officers has jumped 240 percent, even as the Rikers population has declined 15 percent.

The Times report notes that officers are also regularly abused by inmates—in one incident this month, an officer was stabbed in the face with a pen. According to the Corrections Department, mentally ill prisoners are responsible for about two-thirds of infractions at New York City jails. 

“With that number of people who are mentally vulnerable in very stressful situations, of course there is going to be more disruptive behavior and escalation of violence,” Lee said. "Corrections officers are trained to respond with punitive measures or more violence, expecting that individuals will be in control of their behavior. But of course, with the mentally ill, for most of them there is a high probability that they won't be. Rather than follow rules and behavioral guidelines, they will act even more unpredictably. And the corrections officers panic and respond with more violence.”

The chaos isn’t limited to Rikers. Jails and prisons have become the country’s de facto mental institutions, thanks to decades of deinstitutionalization policies that have gutted federal funding for mental health facilities and moved thousands of people out of mental hospitals and into community treatment facilities, homeless shelters, jails, and prisons. As of 2010, there were 43,000 psychiatric beds in the US, or about 14 beds per 100,000 people—the same ratio that existed in 1850, when the country first started to push for humane care for the mentally ill. Meanwhile, the US incarceration rate has jumped 350 percent since the 1970s, according to Department of Justice statistics. Studies have found that the increase in the prison population has actually been almost directly equal to the decrease in the number of people in mental institutions—in other words, the percentage of the population that is institutionalized has stayed constant, but just moved from mental hospitals to prisons.

Image via The Texas Review

“Jails, especially large urban jails, have become the default mental health hospitals for their cities,” said Amy Fettig, the senior staff counsel for the ACLU’s National Prison Project. “It’s a job that they are in no way prepared for, trained for, or resourced to handle.”

The situation has exacerbated what experts say is an epidemic of violence in big-city jails. Due to lack of state or federal oversight of local correctional facilities, there is little comprehensive data on what goes on inside jails. But in Los Angeles County, where the daily jail population averages 22,000—the largest in the country—reports from the ACLU have found a pervasive use of excessive force by deputies in the corrections system. A 2012 study, for example, reported that 64 people had witnessed incidents in which deputies struck an inmate in the head—in 14 cases, the inmates suffered broken facial bones, three inmates had to receive emergency operations, and one inmate was blinded in one eye. The ACLU reports have also found an alarming lack of adequate mental health treatment in the LA County jails, along with a jump in the number of suicides among inmates with diagnosed mental illnesses. This past fall, the Department of Justice announced it was opening an investigation into the jails' treatment of mentally ill inmates, citing the jump in suicides at LA jails in 2013 and the "obsolete and dilapidated conditions" for inmates diagnosed with serious mental illnesses. In New Orleans, a federal monitor said Thursday that the high rates of violence, rape, and shoddy mental health care at the Orleans Parish Prison are “the English definition of mayhem.”

“This is a very toxic mix,” said Fettig. “It’s a toxic mix for the prisoners, toxic mix for the staff, and unfortunately it's also a toxic mix for the public, because an institution that's designed to protect public safety can't do that when it's asked to be a mental health hospital.” 

In New York City, Mayor Bill de Blasio has taken incremental steps to reform the treatment of mentally ill inmates at Rikers and other city jails. In January, the Department of Corrections announced that it would end the use of solitary confinement as punishment for mentally ill prisoners and instead house that population in special treatment units, according to the New York Times. But Murdough was housed in one of those special treatment facilities. His death last week prompted de Blasio to call for further improvements in mental health treatment and training for corrections officers. 

To spearhead those efforts, de Blasio has tapped Joseph Ponte, a veteran corrections official who is currently the head of Maine's prison system, as the city's new corrections commissioner. Ponte, who has a reputation for turning around violent jails and prisons, is known among prison-reform advocates for his successful efforts to curb aggressive treatment of prisoners and decrease the use of solitary confinement. So far, though, it is not clear how he plans to deal with the growing population of mentally ill people in the city's prisons. (Ponte's office in Maine did not respond to interview requests.) 

But other attempts to reform large urban jail systems have been slow-going, and their success has been marginal, at best. In New Orleans, for example, the US Justice Department has ordered the prison to start implementing reforms that at the very least bring conditions up to minimum constitutional standards,  but the city and the sheriff's office have been tied up in court battles over who will pay for the changes. In Los Angeles, the Sheriff's Department has implemented only a handful of recommended changes to improve conditions and curb inmate abuse at county jails, after two years of stalling reforms.

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