It is said that no one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but its lowest ones.
– Nelson Mandela
Few Hoosiers are as helpless as mentally ill prison inmates, and Indiana should be ashamed about how they are treated. Their treatment isn’t just poor – it’s an unconstitutional violation of the Eighth Amendment prohibition against cruel and unusual punishment, a federal judge ruled last week.
The issue is more than how Indiana is judged. The appalling lack of treatment offered to inmates often means they will get worse, not healthier, creating more problems for society when they are released.
Not only are inmates sorely lacking in treatment, they are segregated from other inmates, generally spending 23 hours a day in isolation.
More than 200 years of scholarship has recognized that which should be obvious to all: Placing seriously mentally ill persons in segregated settings featuring prolonged isolation and little to no treatment merely increases mental illness and is incredibly damaging, said Ken Falk, legal director for the American Civil Liberties Union of Indiana, which brought a lawsuit on behalf of mentally ill inmates and a commission that advocates for the mentally ill.
Consider what Dr. Kathryn A. Burns, a psychiatrist and expert witness in the case, found in her inspection of the New Castle Psychiatric Facility, where many of the most mentally ill inmates are imprisoned:
What was surprising was the lack of intensive treatment provided, Burns wrote. Treatment plans are not adjusted or revised to address on-going or worsening symptoms; medication adjustments are infrequent and some inmates who had inappropriately been taken off of medications by one psychiatrist hadn’t yet been seen by the new doctor even though they had been identified as priority cases; some inmates were receiving no treatment whatsoever; some were held in the program with no improvement or access to property, recreation or out-of-cell time for extended periods of time (years in some instances) without treatment.
And this was at one of just two units in Indiana specifically reserved for mentally ill inmates, where care should be best.
Hundreds more are held in segregation at other prisons.
U.S. District Judge Tanya Walton Pratt noted that nearly half of the suicides occurring in Indiana prisons were by mentally ill inmates held in isolation. Of Indiana’s 26,800 inmates, 22 percent are mentally ill.
Pratt did not order specific relief, instead directing lawyers for the prison system and the mentally ill inmates to meet in mid-February to discuss possible solutions.
One factor that those lawyers should consider is the profit motive of the private contractors who provide mental health services and operate the New Castle facility.
Undoubtedly, Indiana will have to spend more money on mental health services in prisons, and there is no shortage of needs elsewhere. But allowing the illness of inmates to progress has its own costs – financial and otherwise – when they are released back into society, and no state has permission to violate the Constitution because it costs more than state officials would like.