Prisoners With Serious Mental Illnesses Held In Isolation For Up To Six Years. Where? In Federal Prisons.

(10-16-17) Public outrage about how Americans with mental illnesses were treated inside state mental hospitals helped spark de-institutionalization.

So where is that anger and fury now when it comes to abuses of Americans with mental illnesses currently being warehoused in our jails and prisons?

This week, the Chicago Sun Times newspaper reported:

“Thousands of  (Illinois state) prisoners are experiencing the symptoms of untreated or inadequately treated mental illness, including paranoia, hallucinations, anger, withdrawal, confusion, agitation, anxiety, depression, self-harm and suicidal ideation…To allow one human being unnecessarily to suffer these symptoms is unacceptable. To allow thousands to suffer is a moral and legal catastrophe.”

When I spent a year inside the U.S. Penitentiary in Leavenworth, Kansas, reporting for my book, The Hot House, the federal Bureau of Prisons set the highest standard for professionalism.

But an Office of Inspector General report released earlier this year reveals our federal prison system, which houses 148,227 prisoners in 122 institutions, has become one of the most abusive and neglectful in its handling of inmates with serious mental illnesses.

Among the most damning findings is how prisoners with serious mental illnesses are being held in complete isolation not for days, weeks, or even months, but for years. That’s right: isolation for as long as six years!

The Office of Inspector General found that on average, BOP prisoners with serious mental illnesses were confined about 896 consecutive days, or about 29 months, in so-called “special management units (SMUs)” between 2008 and 2015.  Incredibly, 13% of these inmates with serious mental illness were released directly into the community after spending an average of 29 consecutive months in isolation cells.

Meanwhile, the BOP insists it does not place a single prisoner with mental illness or any other inmate in solitary confinement.

This is because the BOP refuses to use the word solitary confinement. Instead, it calls it “single celling” – a wonderful euphemism as pointed out in a Washington Post editorial entitled Solitary confinement is torture. Will the Bureau of Prisons finally stop using it?

“You have no contact, you don’t speak to anybody, and it’s a form of torture on some level,” a BOP psychologist quietly acknowledged to OIG investigators.

If you have ever been incarcerated or have visited a jail or prison, you know there is a major difference between being housed in a one person cell in a general population unit where the doors are opened daily and you are allowed contact with other prisoners and staff, and total isolation. The BOP’s highest security prison located in Florence Colorado, known as ADX. (Supermax) was specifically designed to create a “no human contact” atmosphere with cell doors controlled electronically and movements directed under the watchful eyes of cameras. 

Isolation at the ADX is so harsh the BOP’s own regulations prohibit anyone with a diagnosed serious mental illness (SMI) from being held here. Yet Office of Inspector General Michael E. Horowitz found that inmates with SMI had been held in the ADX for an average of 69 consecutive months

Five years ago, Andrew Cohen began chronicling abuses at the ADX in Florence in a shocking series of articles published in Atlantic Magazine entitled: An American Gulag: Descending into Madness at Supermax. A year later, the magazine revealed prisoners who were seeking mental health care were being punished. (See Should Mentally Ill Federal Prisoners Be Punished for Suicide Attempts?)

Sadly, the exposes have been met with crickets by BOP management and members of Congress responsible for overseeing the Justice Department.

The ADX in Florence is not the only BOP facility that utilizes “restrictive housing units (RHUs)” to house inmates with serious mental illnesses.  Inspector General Horowitz’s report found that SMI prisoners were routinely held for long periods in 111 BOP facilities.

The report also disclosed the bureau does not limit the maximum time or even monitor the time that inmates with SMI spend in restrictive housing units (RHUs) or special management units (SMUs).  

This would appear to violate international codes of conduct, specifically what is known as The Mandela Rules – the United Nations’ Standard Minimum Rules for the Treatment of Prisoners.

    Rule 44 states: “For the purpose of these rules, solitary confinement shall refer to the confinement of prisoners for 22 hours or more a day without meaningful human contact. Prolonged solitary confinement shall refer to solitary confinement for a time period in excess of 15 consecutive days…The imposition of solitary confinement should be prohibited in the case of prisoners with mental or physical disabilities when their conditions would be exacerbated by such measures.” 

According to the U.S. Department of State, the United States “whole-heartedly” endorses all of the United Nations Rules regarding treatment of prisoners. 

Now read this next fact carefully.

Nationally, the number of inmates with serious mental illnesses in jails and prisons averages 17 percent. Yet, the BOP claims that only 3% of federal inmates under its custody require mental health treatment.

Why such a low number?

If you read the OIG report closely, you will learn the BOP adopted new mental health treatment standards in 2014. After those new standards were adopted, the total number of prisoners receiving treatment decreased by approximately 30%, including a 56% reduction in mental health treatment in special management units (isolation), and a 20% overall reduction in restrictive housing units (isolation.)

That doesn’t make much sense until you note that the OIG report speculates the decrease was prompted by a reticence by the BOP to diagnose people with mental illness.  If you diagnose people, you have to treat them in accordance with the new standards so don’t diagnose them or admit they are mentally ill.   

Once a leader in prison management, the BOP has become an embarrassing laggard. Three states (Colorado, Maine and Pennsylvania) no longer place inmates with SMI in restrictive housing, while three other (New York, Massachusetts and Mississippi) limit such placements to 30 days.

There was a period under legendary BOP Director Norman Carlson when the federal prison system was a model recognized by the world as the premier prison system.

Now it hides behind semantics, dodges its responsibility of providing adequate health care to inmates, and literally tortures individuals with serious mental illnesses by confining them in isolation for years.

Going against tradition, the Trump Administration went outside the BOP in choosing the agency’s new director. Previously, Mark S. Inch had oversight of the U.S. Army’s Correctional System before becoming only the ninth director to run the federal prison system.

Hopefully, he will pay attention to the fifteen policy recommendations contained in the Office of Inspector General’s report and restore the BOP’s reputation rather than continue its shameful downward slide.


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.