Supermax Prisons and the Constitution: Liability ... - Supermaxed

19■Mental retardation.■Clinicians provided documented evidence of■■Impulse-ridden personality.History of psychiatric problems or chronicdepression. 37repeated treatment failures, determined thatfurther treatment would not improve theinmate’s mental health condition, and establishedan appropriate system for monitoringthe inmate after return to the SHU.Mental HealthThe court later modified this list after reviewingextensive work by Pelican Bay’s Special Master(court-appointed monitor) and his mental healthexpert, Dr. Jeffrey Metzner, who had not testifiedin the trial. The court deleted “borderline” and“impulse” personalities from the list and refinedthe remaining categories to include inmates diagnosedwith:■ A mental disorder that includes being activelysuicidal.■ A serious mental illness that is frequentlycharacterized by breaks with, or perceptionsof, reality that lead the individual to significantfunctional impairment.■ Corrections officials determined that securityconcerns precluded placement in a unit otherthan the SHU.As of July 2003, Pelican Bay had not invoked thisexception. 39One knowledgeable observer has defined a“Madrid Exclusion Standard” as follows:Documented diagnosis of evidence of any ofthe following DSM–IV—Axis I conditions currentlyin existence or within the precedingthree months:1. Schizophrenia (all subtypes).■■■An organic brain syndrome that results in asignificant functional impairment if not treated.A severe personality disorder that is manifestedby frequent episodes of psychosis ordepression and results in significant functionalimpairment.Mental retardation with significant functionalimpairment. 382. Delusional disorder.3. Schizophreniform disorder.4. Schizoaffective disorder.5. Brief psychotic disorder.6. Substance induced psychotic disorder(excluding intoxication and withdrawal).The court later approved an “exception to theSHU exclusion process” by which an inmate withone or more exclusion factors could be returnedto the SHU from a treatment unit if both of thefollowing conditions are met:7. Psychotic disorder [not otherwisespecified].37Madrid, 889 F. Supp. at 1265.38Madrid v. Gomez, Remedial Order re: Exclusion From the Security Housing Unit, December 15, 1995, unreported.39Author’s discussions with the Pelican Bay Special Master.