Judge Calls for Plan To Prevent Isolation of Mentally Ill Inmates

A federal judge has given California prison officials until Sunday to establish a plan for preventing inmates with mental illnesses from being placed in isolation units, KQED's "State of Health" reports (Small, "State of Health," KQED, 8/19).

Background

About 30% of the state's 133,000 adult inmates have a mental illness.

In April, a federal judge ruled that the state corrective department's use of excessive force against prisoners with mental health issues violates the inmates' constitutional rights. Specifically, U.S. District Judge Lawrence Karlton made recommendations for how the California Department of Corrections and Rehabilitation could modify rules for using pepper spray and isolation units when dealing with prisoners with mental health issues (California Healthline, 8/4).

Details of Isolation

California State Prison spokesperson Stephan Riley said inmates in isolation units generally spend about 90% of their time in a cell and 10% in a fenced-in yard. He added, "Every time they walk out of their cell, they're in restraints."

Inmates that are segregated in such a way still have access to psychiatric services, such as group therapy, but they remain locked in holding cells during treatment.

Advocates' Concerns

Advocates say that excessive isolation can worsen some mental health conditions.

Terry Kupers, a psychiatrist and expert on mental health care in correctional facilities, said isolation units can cause:

• Compulsive activities, such as cleaning or pacing;
• Disordered thoughts, including paranoia in some cases;
• High anxiety, including panic in some cases;
• Memory problems;
• Mounting anger; and
• Problems concentrating.

Details of Judge's Order

Karlton said inmates who were hospitalized for mental health issues after spending time in an isolation unit should not be sent back to such a unit.

In addition, he said a psychiatrist must determine that inmates are not being placed in segregation because of an action caused by a mental illness. The psychiatrist also must certify that isolation will not make the inmate's mental health condition worse.

Reaction

CDCR said it is undergoing "sensitive" negotiations over how to comply with Karlton's order, according to "State of Health."

Meanwhile, Michael Bien, an attorney representing inmates, said corrections facilities should grant mental health providers more authority to determine how inmates with mental illnesses are treated. He said Karlton's ruling will break the cycle of inmates being hospitalized for mental health problems and then sent back to isolation units ("State of Health," KQED, 8/19).