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DOJ Applauds Pennsylvania’s Commitment to Treatment for Mentally Ill Prisoners

by David M. Reutter

The U.S. Department of Justice (DOJ) has ended its investigation into the Pennsylvania Department of Corrections’ (PDOC) use of solitary confinement for prisoners with serious mental illness or intellectual disabilities (SMI/ID).

PLN reported the January 5, 2015 settlement of that investigation after the DOJ found prison officials had subjected prisoners with SMI/ID to solitary confinement under conditions that violated their constitutional rights and Title II of the Americans with Disabilities Act. [See: PLN, Nov. 2015, p.30].

The DOJ’s post-settlement April 14, 2016 letter to Governor Tom Wolf said the PDOC had made “significant improvements” by showing a “commitment to reforming its use of solitary confinement on prisoners with SMI/ID.”

The PDOC’s willingness to work with the DOJ’s “experts to change policies and procedures that lay the groundwork for protecting prisoners with SMI/ID from inappropriate and harmful solitary confinement,” its implementation of initial reforms and its receptivity to the DOJ’s concerns about implementation of those reforms indicated it was headed in the right direction.

The DOJ’s letter highlighted five points which convinced them “that the same pattern or practice of violations we found early in our investigation does not exist today.”

Topping the list was the use of solitary confinement and discipline. To assure prisoners with SMI/ID are not subjected to solitary confinement, the PDOC is now diverting them to specialized treatment units. For serious misconduct charges, such prisoners are evaluated by mental health staff to consider mitigating circumstances; those charged with non-violent misconduct “no longer face discipline at all because resolutions are reached informally.” Plus, prisoners are not disciplined for self-injurious conduct.

The PDOC also offers prisoners with SMI/ID up to 20 hours per week of out-of-cell activities and treatment to meet their individual needs. Those options “are less stark than in the past and feature colorful murals and recovery-based messages.” Previously, prisoners could be subject to solitary confinement so long as they were not experiencing active mental health symptoms. “Today, all prisoners with a current or past serious mental illness diagnosis are diverted to treatment units,” the DOJ noted.

The delivery of mental health care was streamlined “by designating certain facilities to specialize in treatment for prisoners with disabilities.” The PDOC also hired 100 new mental health staff, and prison guards have received training on “suicide prevention and assessment risks,” mental illness symptoms and management of those symptoms, the impact of solitary confinement and “communication and de-escalation techniques.” Finally, more than 500 prisoners have been trained as peer specialists. Such reforms should have a positive impact on reducing the number of suicides in Pennsylvania prisons. [See: PLN, March 2013, p.18].

In addition to those initial reforms, the PDOC assured federal officials it plans to implement changes in seven other areas. For example, it intends to ensure its new “specialized treatment units do not devolve into restrictive housing style units.” Further, it appears the PDOC is using restraint chairs less frequently. Staffing for mental health care is expected to increase, as will record keeping and commitment capacity for mental health care.

The DOJ also wants the state prison system to expand reviews for mental illness “to prisoners with IQ scores of 70 and above.” Quality assurance mechanisms must also be expanded.

“Solitary confinement should be used only when necessary – never as a default solution,” said then-Deputy Assistant Attorney General Vanita Gupta, who headed the DOJ’s Civil Rights Division. In the DOJ’s letter to Governor Wolf, Gupta recognized that institutional changes take years to implement.

The PDOC, however, has set an example for other prison systems to follow. With prisons and jails being the nation’s de facto mental health providers, more states need to follow the PDOC’s lead in providing humane treatment for mentally ill prisoners. 

Sources: www.justice.gov, www.forbes.com

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