Feds investigate treatment of mental health inmates at Cresson state prison

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HARRISBURG -- The U.S. Department of Justice said Friday it will investigate Pennsylvania prisons statewide after finding a soon-to-close facility in Cambria County violated the rights of mentally ill inmates through prolonged and extreme isolation.

Federal investigators found that SCI Cresson routinely locked prisoners with serious mental illness in cells for 22 to 23 hours a day, for months or years at a time, while denying them basic necessities and subjecting them to excessive use of force. The department concluded the prison's misuse of solitary confinement on mentally ill inmates "leads to serious harms, including mental decompensation, clinical depression, psychosis, self-mutilation and suicide," according to a news release.

It found the prison came to rely on solitary confinement as a way of "warehousing" mentally ill prisoners because of a disorganized and fragmented mental-health program with a marginalized staff and disciplinary procedures that punished disability-related behavior.

The Corbett administration announced in January it would close SCI Cresson, along with SCI Greensburg in Hempfield, and replace the two older prisons with a new facility in Centre County. The last inmate left SCI Cresson on May 22, spokeswomen for the Department of Corrections said.

The Department of Justice said in December 2011 that it would investigate how Cresson confined prisoners. The investigation was to focus on whether the prison kept inmates with serious mental illness in isolation for unnecessarily long periods, failed to prevent suicide and neglected to provide adequate mental health treatment. The inquiry grew to address concerns about the use of force on prisoners with mental illness and the use of isolation on those with intellectual disabilities.

"We found that Cresson often permitted its prisoners with serious mental illness or intellectual disabilities to simply languish, decompensate and harm themselves in solitary confinement for months or years on end under harsh conditions in violation of the Constitution," Roy L. Austin Jr., deputy assistant attorney general for the Civil Rights Division, said in a statement. "These practices have serious public safety consequences because many of these individuals are returned to the community."

The agency noted that the state Department of Corrections "faces enormous challenges" at Cresson and the other prisons because of a growing proportion of prisoners with mental illness. Since 1999, the percentage of prisoners on the state's mental health roster has increased more than 50 percent, so that more than 20 percent of all prisoners have the designation, the Justice Department said. The percentage of Cresson inmates on the roster reached 28 percent, after increasing by more than one-third since 2007.

The Justice Department said Corrections Secretary John Wetzel and his staff fully cooperated throughout the investigation.

Susan McNaughton, a spokeswoman for the Department of Corrections, said the agency received the findings Friday evening and would review them.

"The secretary believes that, yes, we need to make improvements to the mental health system, and we have made some improvements," she said. "We believe our mental health system today is better than it was a year ago. We believe a year from now it will be even better."

House Judiciary Committee Chairman Ron Marsico, R-Lower Paxton, said it was "amazing" that no one had informed his committee of the justice department's broadened investigation and that he planned to ask the corrections secretary as early as today for a meeting to discuss the prison system's treatment of mentally ill prisoners. If warranted, he said, committee hearings could follow.

"The secretary and the corrections administration, they've got to come up with some solid answers," Mr. Marsico said. "It's astonishing, it's unbelievable that those folks would be put into the situation they were put into."

A House resolution passed May 13 also asks the Joint State Government Commission to study all aspects of Pennsylvania's mental health system and report back with proposed improvements, particularly as to how current policies and programs deal with mentally ill criminal defendants. A public meeting on that topic, with Allegheny County Common Pleas Judge John Zottola, was scheduled for this Wednesday morning, even before the federal justice department decided to widen the scope of its investigation.

Vic Walczak, legal director of the American Civil Liberties Union of Pennsylvania, said the justice department's investigation complemented that undertaken by the ACLU and the Disability Rights Network of Pennsylvania in connection with a lawsuit it filed against Mr. Wetzel on behalf of mentally ill inmates on March 11.

"The state department of corrections has a problem with essentially warehousing mentally ill inmates in solitary confinement, and that is certainly cruel and unusual punishment," Mr. Walczak said.

The lawsuit seeks a federal court injunction to ensure prisoners get adequate mental health care.

Last fall, the corrections department began training all staff members with a 40-hour program focused on prisoners with mental illness, Ms. McNaughton said. The agency is in the final stages of writing a new mental-health policy that will improve how it identifies mental illness in prisoners entering the system.

A request for proposals to replace an expiring contract for mental health services includes incentives for vendors to improve outcomes, such as the compliance of prisoners taking medicine and the rate of recommitments to mental health units, she said.

In a letter of findings addressed to Gov. Tom Corbett, the Justice Department describes a prison in which mentally ill prisoners are disproportionately found in isolation cells.

"Too often, instead of providing appropriate mental health care, Cresson's response to mental illness is to confine vulnerable prisoners in its isolation units without meaningful services or activity," the letter states.

Investigators found prisoners with mental illness accounted for less than 30 percent of the overall population, but more than 60 percent of those housed in isolation units.

"Thus, the prisoners at Cresson who suffer the most in isolation and are the most ill-suited to it are precisely the ones subjected to isolation most often."

While most inmates with serious mental illness were not kept in isolation, most self-harm involving mentally ill prisoners took place in the isolation units, the Justice Department found. In 2011, 14 of the prison's 17 documented suicide attempts occurred in isolation units, the letter said.

The investigation found that prisoners isolated for prolonged periods did not receive adequate mental health treatment. In one instance, a prisoner with a history of self-harm and suicide attempts was continually placed in isolation, "eventually leading to his death" by suicide in July 2012. The letter claims the inmate requested one-on-one counseling less than two weeks before his death, but that the psychiatrist neither ordered counseling nor referred him to the psychology staff.

The investigation also found the prison combined prolonged isolation with other harsh conditions, such as hostility to prisoners with mental illness. Three members of the prison psychology staff told the Justice Department they had witnessed a senior staff member telling prisoners with intellectual disabilities they had to sing the song "I'm a Little Teapot" if they wanted to improve their living conditions and receive additional mental health treatment.

"When we asked one of the alleged victims about being required to sing in this way, the victim looked embarrassed and sad, and explained, 'I just couldn't remember the song,' " the letter states.

A spokesman for the Pennsylvania State Corrections Officers Association, when asked about the findings as a whole, said he had not seen them and would not comment until doing so.

Justice Department inspectors visited Cresson from March 19 to 22, 2012, interviewing staff and prisoners, reviewing documents and observing prisoners. They met with Department of Corrections leadership in October to share their concerns and hear about new initiatives the state had undertaken to improve its mental health and suicide prevention programs.

Ms. McNaughton said the department invited the federal officials to return to Cresson to witness "significant changes."

"They chose not to, so whatever their findings, they are not representative of Cresson after our changes," she said in an e-mail.

The Department of Justice wrote in its letter that its findings at Cresson prompted it to expand its investigation to how prisoners with mental illness or intellectual disabilities are confined at the other state prisons. The agency plans to work with the Department of Corrections to gather information, and does not expect to tour most of the prisons, it said.

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Karen Langley: klangley@post-gazette.com. Amy McConnell Schaarsmith contributed. First Published May 31, 2013 5:30 PM


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