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

21A Case Study in ECU Mental Health LitigationThis case study is derived from records of lacked the initial screening report (i.e., the reportthe preliminary injunction hearing in the that was supposed to be part of the initial referralWisconsin Jones’El case, in which plaintiffs process), one had the report completed a yearraised mental health-related issues about confinementin the state’s supermax facility in Boscobel. a another had an incomplete report (it overlookedafter the inmate arrived at the supermax, andthe inmate’s several earlier hospitalizations forScreening. The corrections department had set upmental health reasons). These failings led thea three-level mental health screening process forexpert (and the court) to question the quality ofinmates referred to its supermax facility. The firstthe initial screening procedures. By contrast, however,the defendants’ expert examined records ofscreening took place at the sending institution,where each inmate considered for transfer to the100 supermax inmates and found the necessarysupermax was examined by a psychologist or psychiatristto determine whether the inmate couldscreening report in all of them. He felt that theabsence of reports noted by the plaintiffs’ expertbe safely transferred. The second screening waswas not routine. The court did not accept thisperformed by a psychiatrist at the departmentview. blevel. Finally, when an inmate arrived at the supermax,he was screened again by facility mental Monitoring. The monitoring program also camehealth staff. The record indicated that someunder severe criticism from the plaintiffs’ expert,inmates had been screened out at each of the who interviewed 20 inmates as part of his 3-daythree levels.tour (some chosen because they were taking psychotropicmedication, some pointed out by otherInmates new to the facility (and those who hadinmates as having mental health problems, andfailed a step of the facility’s multistep program)others selected at random) and another inmate onwere housed in a unit where security and restrictionswere greater than in other units. Thesethe telephone, after his tour. He concluded that 8of these 21 inmates were suffering from psychiatricreactions to conditions in the supermaxinmates were screened by a mental health specialistonce a week. Other inmates were interviewedfacility and that these 8 inmates reflected a larger,by the specialist at the cell front once a month.general problem throughout the facility. The courtMental health and unit staff reviewed inmatesaccepted his testimony over that of the defendants’expert, who offered contrary opinions, andweekly in unit meetings. A psychologist wasassigned to any inmate diagnosed as mentally ill,ordered that five of the eight be transferred outand the psychologist would see the inmate asof the supermax and that two others who hadoften as deemed clinically necessary. Any inmatealready been transferred not be returned to theon mental health medications would also be seensupermax.by a psychiatrist and would be observed regularlyby the nurse who delivered medication to the cell. The court also ordered that all inmates currently inMental health staff could recommend transfer of the supermax who met certain criteria be examinedby mental health professionals not employedan inmate to another facility.by the corrections department. If these examinationsfound an inmate to be seriously mentally ill,This sounds like a prison system that is paying substantialattention to inmate mental health issues.that inmate could not be housed in the supermax.But when the plaintiffs’ mental health experttoured the supermax for 3 days and examined Conflicting Diagnoses: An Example. The plaintiffs’records of 20 inmates, he found that two records expert concluded that one inmate he hadMental Healthcontinued on page 22