Suit urges state to overhaul prisons - Group says mentally ill held in poor conditions

Hundreds of seriously mentally ill prisoners are held in cells 23 hours a day in inhumane conditions that have led to self-mutilation, the swallowing of razor blades, and at least seven suicides since November 2004, an advocacy group alleged yesterday in a federal lawsuit demanding that the inmates be housed in special treatment units.

The Disability Law Center, a nonprofit organization that provides legal help for the disabled, sued the state Department of Correction in US District Court in Boston after a yearlong investigation during which the advocates questioned more than 220 inmates in segregation units at two maximum-security prisons, Souza-Baranowski Correctional Center and MCI-Cedar Junction.

In in-depth follow-up interviews, the advocacy group found that at least two dozen of the 220 segregated inmates displayed signs of mental illness. Extrapolating those numbers, the advocates estimated that hundreds of prisoners in the state with mental health issues are confined in such units, the group said, which is demoralizing for any inmate but exceeds "the limit of human endurance" for those with psychological problems.

The suit, similar to legal challenges that have led to changes in other states, says Massachusetts has ignored repeated calls from its mental health providers and consultants to stop segregating mentally ill prisoners. The suit demands that the state build maximum-security residential treatment units.

"The system is broken," Stanley J. Eichner , executive director of the Disability Law Center, said at a press conference where he and advocates for prisoners displayed graphic photographs of a mentally ill inmate at Cedar Junction who had repeatedly slashed his neck, torso, and arms while in segregation.

"We are not saying these prisoners are folks without [criminal] records," said Eichner, who interviewed the inmates, some of whom were violent felons, over three days in November. "What we are saying is that prisoners should not be driven to the point of mutilation and self-destruction."

Putting such prisoners in segregation units, the advocates say, violates the constitutional prohibition against cruel and unusual punishment and should be banned. The Disability Law Center also said the segregation of mentally ill inmates violates federal statutes, including the Americans with Disabilities Act.

The Department of Correction said in a statement that it does not comment on pending litigation. However, the department said it was "well aware of the national trend of the increasing number of prisoners with mental illness" and that it had begun taking steps to reduce the risk of suicide for the state's nearly 11,000 inmates.

On Feb. 22, an independent study of Massachusetts prisons, requested by the Correction Department after a sharp increase in suicides in 2005 and 2006, concluded that prison policies and practices had contributed to the problem.

In addition to criticizing the condition of segregation, the report found that staff lacked adequate suicide-prevention training, did not check frequently enough on inmates at risk of suicide, and isolated inmates on suicide watches by denying visits, showers, phone calls, and time outside cells.

The study done for the state by Lindsay M. Hayes, a national specialist in prison suicide prevention, had 29 recommendations, including increasing monitoring of suicidal inmates, adding training for staff, and improving mental health treatment. The Department of Correction immediately said it would comply with the recommendations and was seeking bids for a private contractor to improve mental health treatment. But the department gave no indication it intended to stop segregating the mentally ill.

"It's a response, but we feel that it's an inadequate response," Leslie Walker, director of Massachusetts Correctional Legal Services, said yesterday at the news conference at the law firm of Bingham McCutchen , which is representing the advocates pro bono. Several of the advocates said they believe the state commissioned the study because it knew the Disability Law Center was gearing up for a suit.

The suit describes 18 mentally ill prisoners, identified only by letters, who engaged in self-destructive behavior while in segregation units. Nine medium- and maximum-security prisons in Massachusetts have such units. About 500 prisoners are held in such cells across the state, the suit said.

In Massachusetts, the suit says, cells in segregation units often have minimal furnishings, little if any natural light, and solid doors with a narrow slot used to deliver food. Inmates are allowed out only an hour a day to exercise, and some are so depressed that they decline to do so, the suit said. The units hold prisoners who have committed serious disciplinary infractions, threaten security, or are in protective custody. Lengths of stay vary from days to years.

The only inmate whose name was released yesterday was Andrew Armstrong , 22, an inmate at Souza-Baranowski in Shirley who hanged himself in October 2005 from the bars of his cell window. On a desk in his cell, he had written in soap, "Dust in the wind."

Armstrong had a history of bipolar disorder and had been placed in segregation because of a fight with another prisoner while in a paranoid state, the suit said. He complained about cameras and listening devices in his cell. As with other mentally ill inmates, his erratic behavior and agitation had prompted prison officials to shuttle him multiple times between the prison and Bridgewater State Hospital.

"Did no one realize what was going on?" his aunt, Frances Armstrong of Cheslea, wrote in a letter that Walker read aloud. "Did they not understand this 22-year-old was on a fast-moving ride to the depths of hell?"

The suit described other inmates who injured themselves swallowing razor blades, batteries, and parts of eyeglasses. Another bruised his head by banging it against the wall, and another smeared feces over his body. Several had a history of hallucinations, including one who complained of seeing demons.

The advocates said in the suit that they want the state to build residential treatment units for inmates with mental disorders and provide at least 15 hours a week of therapy out of their cells as well as 10 hours a week for recreation and showers. The advocates had no estimate for the cost of building such units. They also want independent mental health professionals to screen inmates to ensure that mentally ill prisoners are not placed in segregated units and to operate treatment units.

Dr. Stuart Grassian, a Newton psychiatrist who has studied the effect of solitary confinement on inmates for more than 25 years, said the US Supreme Court noted in an 1890 decision that even healthy prisoners often become confused, hallucinatory, psychotic, and agitated in such conditions.

"Now if you take someone who is already mentally ill and put them in an environment that is supposed to be painful psychologically, what do you expect?" he said.

Since 1995, federal courts have ruled in at least six states -- California, Connecticut, Indiana, Ohio, New Mexico, and Wisconsin -- that seriously mentally ill prisoners must be removed from segregation units, said David Fathi of the ACLU National Prison Project in Washington.

"So, this Massachusetts case is really building on a body of unanimous case law that says you simply cannot house mentally ill prisoners in conditions of extreme isolation," he said.