South Carolina’s Mentally Ill Prisoners Abused, Neglected: What Happens When Good People Do Nothing


Much of the keynote speech that I gave over the weekend at the opening session of the South Carolina Psychiatric Association’s annual meeting in Charleston focused on how 3,500 inmates in that’s state’s prisons are being abused, neglected and mistreated.  My comments were sparked by a judge’s recent ruling in a horrific class action lawsuit.

“The evidence… has proved that inmates have died in the South Carolina Department of Corrections for lack of basic mental health care, “ Circuit Court Judge Michael Baxley wrote in a ruling released in January, “and hundreds more remain substantially at risk for serious physical injury, mental de-compensation, and profound, permanent mental illness.”

The judge found that mental health care in South Carolina prisons is so  “inherently flawed and systemically deficient in all major areas” that it violates the prisoners’ fundamental constitutional rights.  The judge called the lawsuit the most troubling of the 70,000 cases that he has adjudicated in the past 14 years.

Journalist Andrew Cohen, who has been a lone voice in the national media in spotlighting how inmates with mental illnesses in prisons are often abused, translated the “antiseptic words judges often use” in their rulings for readers in an Atlantic magazine article.

   What do those words mean? They mean that one mentally ill inmate, James Wilson, was kept in solitary confinement for at least 2,491 consecutive days. It means that an intellectually disabled (and schizophrenic) man was abused and neglected, and then left to rot in his own feces and vomit, until he died of a heart attack. It means that force was used 81 times on a severely mentally ill inmate named James Howard. It means that some mentally ill inmates were restrained at length in what they called a “crucifix position.”

It means some mentally ill prisoners were “routinely placed” naked “in shower stalls, ‘rec cages’, interview booths, and holding cells for hours and even days at a time.” It means that suicidal prisoners who were supposed to be receiving anti-psychotic medication were not receiving them. No surprise, the judge wrote, since SCDC’s “computer system cannot retrieve the names or numbers of all inmates referred” for mental health treatment, “the number of inmates who have made serious suicide attempts; or the number of inmates whose psychotropic medications have expired without being timely renewed.”

It means that mentally ill inmates are routinely caged for days in their own feces and urine, having to eat literally where they shit. It means, Judge Baxley wrote, that “the deposition testimony of some psychiatrists reveals an alarming lack of knowledge about the policies and procedures at SCDC.” One such psychiatrist did not know “what mental health counselors do, and had ‘no idea’ who drafted treatment plans” for inmates. And even if the mental health professionals knew what they were doing, they wouldn’t have been able to do much. The ratio of inmates needing treatment to professionals able to provide it was astronomically high.”

Cohen entitled his blistering article:  When Good People Do Nothing: The Appalling Story of South Carolina’s Prisons, pointing out that prison officials and, more importantly, prominent members of the South Carolina legislature have been aware for years about how prisoners were being neglected, but have chosen to do nothing.

In his ruling, Judge Baxley noted that instead of acknowledging there was a problem and trying to fix it, South Carolina officials did everything they could to fight the class action suit.

We are now eight years into this litigation. Rather than accept the obvious at some point and come forward in a meaningful way to try and improve its mental health system, Defendants have fought this case tooth and nail—on the facts, on the law, on the constitutional issues, portraying itself as beleaguered by the burdensomeness of Plaintiffs’ discovery, and generally harrumphed by the invasive nature of Plaintiffs’ counsels’ tactics and strategies.

This Court has spent dozens of hours in hearings and conferences in an effort to resolve discovery disputes, most of which involved delay, missed deadlines, and recalcitrance on the part of the Defendants.

Tax dollars would have been better spent funding improved services than wasting the court and lawyers’ time, the judge noted.

The class action lawsuit was filed by the Protection and Advocacy for People with Disabilities agency in South Carolina, and Columbia’s Nelson Mullins law firm which handled the litigation free. Every state has a Protection and Advocacy organization financed in part by the federal government and I often have been critical of them because many have become advocacy groups that focus exclusively on helping individuals, who have been deemed dangerous enough to merit an involuntary commitment hearing, gain their freedom regardless of the threat that their release might pose on society or that individual’s own safety. (For an example, read about the Joe Bruce case here.)

This is an instance where a state P and A did what it was created by Congress to do. This suit also speaks volumes about the importance of pro bono legal work by conscientious firms such as Nelson Mullins, whose lawyers and paralegals spent at least 43,000 hours on the litigation. That would have cost about $9 million. Attorney Stuart Andrews, who first called my attention to the lawsuit several years ago, and his partner Don Westbrook, should be congratulated for their determination. The suit seeks no monetary damages, no big bonus checks for the attorneys. What it sought during the eight years that the case slugged its way through the justice system was that the Corrections Department do the right thing: “develop and fund a reasonable and adequate system for the mental health care of inmates suffering from mental illness.

Sadly, during my travels, I have come to believe that what is happening in South Carolina prisons is not an aberration.  I witnessed prisoner abuse at the Miami Dade County jail involving inmates with severe mental illnesses and journalist Cohen has written, as have I, about another equally disturbing class action suit filed against the federal Bureau of Prisons by lead attorney Ed Aro, a Denver based lawyer with Arnold and Porter, and the DC Prisoners’ Project of the Washington Lawyers’ Committee for Civil Rights and Urban Affairs. (See earlier blogs on this troubling matter.)

It’s easy to turn our backs on prisoners – after all, they must be guilty if they are in prison, right? But if you read my book you will see how jails and prisons have become our new asylums and some of the inmates — who get trapped in the system — have committed only one real crime. They got sick.

The title of journalist Cohen’s story says it all: abuses like those found in South Carolina happen when good people do nothing.

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.