As the result of extreme overcrowding, budget cuts, and the profit priorities of for-profit health care providers, people in prisons, jails and detention facilities with medical needs suffer from poor medical care.
When someone who is detained gets sick, he or she cannot make an appointment with a doctor, visit the emergency room, or even run down to the corner store to buy some aspirin. In detention, a person who is sick is entirely at the mercy of the prison or jail for their medical care.
Substandard medical care has created a public health crisis, with more than 600,000 people being released from prison every year and going home to their communities, carrying with them both infectious diseases and medical conditions requiring immediate attention and resources. Medical failures are particularly pervasive in jails, where detainees with serious medical needs are often ignored by a system that knows the average length of stay for jail detainees is 3 months. Rather than treat the individual as a patient, medical systems in jails more often treat them as problems that will leave their jurisdiction in a matter of months.
To ensure adequate medical care for people who are incarcerated, SCHR brings class action lawsuits. Some examples of litigation that have improved critical medical care:
Julia Tutwiler Prison for Women
SCHR filed Laube v. Allen, a class action lawsuit on behalf of all of the Alabama women prisoners naming the Alabama Department of Corrections as the Defendant. In addition to claims about severe overcrowding, horrendous conditions, and terrible mental health care, the lawsuit contended that the level of medical care the ADOC was providing to the women was unconstitutional. After a Preliminary Injunction hearing, Federal District Court Judge Myron Thompson issued a Preliminary Injunction Order on December 2, 2002 granting the women’s request for emergency relief. Judge Thompson declared
Tutwiler to be unconstitutionally unsafe, and ordered the state to submit a plan for improving conditions. A plan was submitted and changes at the prison were initiated. The parties signed a Medical Settlement Agreement which became part of the Court's Consent Order when Judge Thompson ordered defendants to comply with all provisions of the Agreement. By order of the Court, medical monitors visit Tutwiler, Birmingham Work Release and Montgomery Women’s Facility on a quarterly basis to determine whether the ADOC is following the terms of the Consent Order.
Limestone Correctional Facility
SCHR filed Leatherwood v. Campbell, a federal class action lawsuit on behalf of all male HIV-positive prisoners incarcerated at Limestone Correctional Facility in Harvest, Alabama. The lawsuit challenged the inadequate medical treatment and deplorable housing provided to HIV-positive men at the facility. The defendants named in the lawsuit were the Alabama Department of Corrections (ADOC) and NaphCare Inc., the state’s former private medical provider. The ADOC and the plaintiffs entered into a two-year settlement agreement in which the Defendants agreed to improve medical care for HIV-positive prisoners at Limestone by ensuring that all prisoners received their medications, by hiring a full-time HIV Specialist, and by improving the living conditions for HIV-positive prisoners at the institution. A year later, SCHR filed for contempt as, a year into the settlement agreement, HIV-positive men at Limestone were still encountering serious problems obtaining their medications and the ADOC had failed to maintain a full-time HIV specialist on staff.
Fulton County Jail
SCHR filed Foster v. Fulton County, a class action lawsuit on behalf of all present and future HIV-positive detainees at the Fulton County Jail in Atlanta, GA against approximately 25 defendants, including Fulton County, and Correctional Healthcare Solutions, Inc. ("CHS"), the private medical care company providing services at the Jail at the time that the lawsuit was filed. In the two years leading up to the filing of the lawsuit, 23 HIV-positive detainees had died at the jail. The case was settled by order of Federal District Court Judge Marvin Shoob. This litigation resulted in remarkable long-term improvements in medical care at the Fulton County Jail, benefiting the Metropolitan Atlanta area and the thousands of people housed in the Jail each year.
Because of the steady depletion of community-based addiction and mental health services, prisons and jails have become mental institutions by default. In communities where no mental health court or similar diversionary court exists, people with mental illness charged with a crime are either released to the streets or prosecuted without regard for the role of the mental illness and sent to prison.
Prisons have largely failed to develop treatment programs that would permit mentally ill inmates to establish a routine that would allow them to control their symptoms and their lives. Mentally ill inmates are prime candidates not just for recidivism, but for destructive behavior and suicide when prisons fail to manage their illness properly.
The Southern Center for Human Rights has long advocated that community standards of care for the treatment of mental illness and addiction be applied to care in jails and prisons. SCHR has brought civil cases alleging constitutional violations of the right to be free from cruel and unusual punishment. One such case highlighted the violence and self-injurious behavior all too common in prisons with inadequate safety and treatment of mental illness.
In 2002, SCHR brought a class action case on behalf of all mentally ill and mentally retarded prisoners at Phillips State Prison seeking protection from physical, mental and sexual abuse; from excessive use of force; from improper and prolonged placement in administrative and disciplinary segregation for manifestations of their mental impairments; and from the ongoing risk of suicide, self-injury and death.
The defendant of the lawsuit is Phillips State prison, and there are three complaints for that lawsuit, which you can download [1] here.
Click here to read the Laube v. Alabama Order by Federal District Court Judge Myron Thompson regarding prison violence.
Click here to read the Complaint filed on behalf of a class of prisoners at
Phillips State Prison in Georgia regarding guard brutality in the prison's mental health dorm.
Click here to read the Complaint filed on behalf of an individual prisoner incarcerated at Phillips State Prison.
In 2008, SCHR sued Alabama prison officials and medical staff on behalf of the family of Farron Barksdale who died within days of his transfer from jail into the prison system. He was administered large doses of psychotropic medications, confined in isolation and died of hyperthermia (extreme heat) and coagulopathy (failure of the blood to clot). To read that complaint click here.
Oftentimes, prisoners with mental illnesses are sent to lockdown for failing to obey prison rules -- easy to understand given that many of these men and women suffer hallucinations and delusions that get worse when they are sent into confinement. Lockdowns require fewer corrections officers and are therefore cheaper to run. But psychiatrists have long known that severely punitive measures do not work with psychotic inmates and often cause them to act out their frustrations even more. When their prison terms are finished, these people are dumped onto the streets, often without essential medication or information on resources or services that could help them negotiate reentry.
In county jails, about 15 percent of the population has a mental illness and receives some type of treatment, whether it be psychotropic medications or counseling. Many of these people are in jail solely as a result of their mental illness. Mr. George Herron, director of medical services at the Fulton County Jail in Atlanta, reported in October 2008 that 500 new psychotropic prescriptions are written per month by jail medical staff. The jail population averaged 2,800 in Fall 2008.
Lisa Smith was paroled in 2006 from Metro Women's Prison in Atlanta to a friend's address. Ms. Smith had been diagnosed with paranoid schizophrenia. She was also addicted to crack cocaine. Soon after her release she stopped taking any medication and began to use drugs instead. Ms. Smith's behavior became erratic. She was convinced she saw family members on the street and would run through traffic to speak to them, or yell at the people with them. She walked into a stranger’s home one day thinking it was hers and began to make a sandwich when the owner came home and called the police. She was arrested for criminal trespassing and taken to the county jail. Because of her mental illness, she was found incompetent to stand trial and after months, was sent to the regional mental hospital for evaluation and treatment. After spending a few days in the regional mental hospital, she was released to a homeless shelter. Since her release from prison, Ms. Smith has been in and out of jail nearly a dozen times for similar quality of life crimes. She has been offered medication in jail and has on occasion been committed to the hospital for her behavior, but because she is homeless and has no insurance, she is stabilized and quickly released back to the streets or a shelter.
It will take a commitment of communities to provide treatment to people like Ms. Smith so that she doesn't end up in jail or prison for the rest of her life.