by David Reutter

Alabama prisoners live in “human warehouses” where “systemic indifference discrimination and dangerous – even life-threatening – conditions are the norm.” That factual finding was drawn in a 2014 report that followed an investigation by the Southern Poverty Law Center (SPLC) and Alabama Disabilities Advocacy Program (ADAP).

The 23 page report compiles the findings of SPLC and ADAP after they inspected Alabama’s 15 prisons, interviewed over 100 prisoners, and reviewed thousands of pages of medical records, depositions, media accounts, and the policies and contracts of the Alabama Department of Correction (ADOC) and two major contractors.

The result is “one inescapable conclusion,” that Alabama’s prisons violate federal law protecting people with disabilities and the U.S. Constitution’s ban on “cruel and unusual punishment.” The report’s three sections focus on the inadequacy of medical staff that leads to treatment delays, the systematic failure in mental health care, and the violation of the rights of prisoners with disabilities.

As of March 2014, ADOC held 25,055 prisoners. “Yet, there are only 15.2 doctors and 12.4 dentists for this city behind bars,” states the report. “A doctor’s average caseload is 1,648 patients and a dentist’s is more than 2,000.” Corizon, ADOC’s medical contractor provides a 493 person medical staff, which includes doctors, nurses, administrative, and records staff.

The understaffing results in predictable “delay, failures to diagnose and treat problems, failure to follow up with patients, errors and decisions to not treat seriously ill prisoners.” For a prisoner who had overcome prostate cancer in 2006, this systemic problem turned deadly. In mid-2011, a test showed his cancer had returned. He was not given further testing or diagnosed until February 2013. By then, his prostate cancer had spread to his bones. He died in January 2014.” The report highlights other cases where routine care could have prevented complications.

It also found emergency responses are slow or nonexistent, and there is no effective system for preventing or managing infectious diseases. Errors in the administration of medication have caused prisoners harm and death. Guards are also an obstacle to medical care, for they deny prisoners access to the infirmary or suggest to medical personnel the prisoner is lying or untruthful.

While ADOC has over 3,000 prisoners receiving mental health care, it has just 4.7 full-time psychiatrists. “At many prisons there is no psychiatrist,” states the report. “There are only 5.6 psychologists for the entire system.” MHM Correctional Services is ADOC’s mental health contractor.

ADOC not only fails to identify the mentally ill in its prisons, it fails to provide those it had identified with proper care. The report cites case of prisoners who repeatedly harmed themselves, but they were not provided mental health care. In some cases, a prisoner’s request to be protected from himself were ignored.

Even those receiving care are not assured of its continuation. “There are numerous, credible reports that psychiatric medication is improperly decreased, ended, or changed to less effective forms,” states the report. “Even after numerous suicide attempts prisoners’ medications are not reinstated nor are they returned to the mental health caseload.”

It also found that some prisoners have been fully medicated without a proceeding to determine if they could be medicated against their will. ADOC, additionally, has inadequate mental health facilities. Those in such units “have reported an extraordinary level of violence and abuse by guards.” Finally, ADOC fails to protect suicidal prisoners from themselves by not keeping dangerous instrumentalities out of their possession.

In the final section, the report found that prisoners “with disabilities often encounter discrimination throughout the prison system.” Guards prohibit healthy prisoners from assisting those in wheelchairs. “This policy excludes wheel-chair-bound prisoners from the most basic services of the prison system, including medical care, found, and even access to bathroom facilities.

ADOC excludes prisoners from work release solely because their medical code, “a code that is based not on any medical but on [their] disability." ADOC’s facilities are not fitted to accommodate the disabled, and it has no plan in place to accommodate them.

The report calls on agencies to address the injustices behind its prison walls.

Source: “Cruel Confinement: Abuse, Discrimination, and Death within Alabama Prisons”, June 2014

The full text is available on PLN’s website.