Locked in The Box
When mentally ill inmates are put into solitary confinement for breaking the
rules, their illness often grows worse
By PAUL GRONDAHL, Albany Times Union Staff writer October 21, 2002
The spiral into mental illness for Pat and William Harding's son, Billy, 32, of
Yorktown Heights, Westchester County, began after his wife left him. He grew
despondent over not seeing enough of his three children. He started drinking
heavily and shooting heroin. He lost his $80,000-a-year job as a long-haul truck
driver.
"He felt like such a failure and was so depressed, he couldn't think or function
anymore," Harding's mother said.
Brushes with the law, jail time and parole violations forced him to seek
treatment for depression. He was diagnosed with bipolar disorder and was sent to
a psychiatric facility, where he attempted suicide.
Harding is serving 1 to 3 years at Green Haven Correctional Facility for a
probation violation after quitting an alcohol rehabilitation program and
confronting his estranged wife, who filed an order of protection.
"It's been a nightmare in Green Haven. He's just gotten worse and worse," Pat
Harding said. "He started acting out and was put in 23-hour lockdown. He's going
crazy in there. He's not getting the proper therapy and treatment for his
bipolar disorder because he's locked down."
Harding said Billy has tried to commit suicide at least seven times while in
disciplinary lockdown -- by hanging himself with a bedsheet, by slitting his
throat with the lid of a vegetable can and other methods. He was originally
sentenced to 90 days in The Box, but received additional time for fighting and
failing a drug test.
The Box is what prisoners call 23-hour disciplinary confinement. At the end of
2001, nearly 5,300 inmates were in The Box, roughly half of them in
maximum-security facilities. Last week, DOCS officials announced they took out
of service 124 disciplinary confinement beds at nine medium-security prisons as
part of a cost-cutting restructuring plan.
Prison watchdog groups contend that cases like Billy Harding's disintegration
into suicidal desperation illustrate an all-too-common outcome created by the
extreme mental stresses of solitary confinement.
Human rights groups say such imprisonment meets the definition of torture under
international law, and prison watchdog organizations claim it violates the U.S.
Constitution's Eighth Amendment, which prohibits cruel and unusual punishment.
State correction officials credit Gov. George Pataki's expansion of disciplinary
housing cells, which isolate disruptive prisoners, with reducing the rate of
inmate-on-staff and inmate-on-inmate assaults to the lowest levels in two
decades.
Currently, the average sentence in The Box is 160 days. But many inmates have
spent years -- in rare cases 15 years or more -- in The Box for repeated
violations.
"The Box is a highly stressful and psychologically debilitating environment,"
said Gregory Warner of The Correctional Association of New York, who has spent
the past year preparing a comprehensive report on mental health in the state's
prisons. "The deprivation, isolation and idleness are extreme."
Dr. Stuart Grassian, a Harvard Medical School professor who practices psychiatry
in the Boston area, calls The Box "a breeding ground for mental illness."
His 1979 study of prisoners confined to 23-hour lockdown in special housing
units coined the term "SHU syndrome." Symptoms include depression, increased
paranoia, agitation, manic activity, delusions, florid psychotic illness and
suicide.
"Mentally ill inmates should not be placed in segregation cells, especially
those who are extremely despondent or pre-suicidal, because the isolation can
easily push them over the edge," said Hans Toch, a professor of criminal justice
at the University at Albany who has studied the effects of disciplinary
segregation in the United States and internationally.
Toch recently returned from a visit to prisons in Scotland. Across Europe,
typically fewer than 1 percent of inmates are confined to disciplinary housing;
New York's percentage is eight times higher. Seriously mentally ill prisoners
are moved from the prison system and placed in mental health settings as a
matter of policy throughout European countries, Toch said.
"Instead of treating mentally ill people like bad inmates and sending them to
The Box, they need treatment and services," said Robert Corliss, associate
director for criminal justice with the National Alliance for the Mentally Ill of
New York State.
Corliss and other prison advocates criticized a lack of coordination and unclear
lines of authority between the state Office of Mental Health and the Department
of Correctional Services staff in caring for mentally ill inmates.
"There is no discrepancy, seemingly or otherwise, in authority or
responsibility" for mentally ill inmates, said Jim Flateau, a DOCS spokesman.
Under state correction law, OMH is responsible for providing clinical services
to mentally ill inmates in DOCS-run prisons. "We have the final say in all
matters," Flateau said.
Roughly one in four inmates -- 505 out of 2,235 -- housed in 23-hour
disciplinary isolation cells in maximum-security prisons are mentally ill and
are on the caseload of the state Office of Mental Health staff, according to
DOCS statistics.
Increased staff training on mental health issues has contributed to a declining
number of attempted suicides in solitary confinement disciplinary cells -- a
drop from 37 attempts in 1995 to 19 attempts last year, according to the DOCS.
In the overall prison population, there were 105 suicide attempts in 1995 and 46
attempts last year.
OMH staff evaluate inmates they believe are suicidal. "OMH does not always
believe that every inmate who says he is suicidal actually is," Flateau said.
A federal lawsuit filed recently by prisoner advocacy groups focuses on the
psychiatric damage created by lengthy sentences in solitary confinement and
urges reform.
Experts concur
"Providing high-quality treatment for mental illness is a costly and
difficult proposition for prisons," said David Lovell, a former correction
official who is now an associate professor in the department of psychosocial and
community health at the University of Washington in Seattle. "It's like trying
to have a green lawn in Phoenix, Ariz. Prisons just aren't set up for it."
The current system of mental health services is broken, parents of mentally ill
inmates contend. "My son is still in lockdown, going crazy because he's all
alone," Pat Harding said of her son, Billy. "If they take him out to a psych
unit, the other inmates pick on him, call him retarded and beat him up."
When Pat Harding visited her son at Green Haven recently, his mind seemed
detached and blank. All he could manage was a sobbing plea -- "Ma, help me" --
over and over again.
"I'm afraid of what's going to happen if he stays in The Box," she said.
State Sen. Thomas Duane, D-Manhattan, has visited disciplinary housing units and
introduced bills to reduce the number of prisoners in The Box. He believes a
majority of inmates in The Box are mentally ill.
"Healthy inmates know enough not to do something that gets them put in The Box.
And if they had any symptoms of mental illness before they were put in
isolation, they'll get worse," he said.
"Putting more and more prisoners in The Box, even if they're mentally ill, makes
the job of corrections officers easier. Politicians and the general public would
just as soon write off prisoners and not spend any more money to improve
treatment."
Source:
http://www.timesunion.com/AspStories/story.asp?storyID=63619&BCCode=&category=FRONTPG&newsdate=10/21/2002
----------------------------------------
Living on the loaf
By PAUL GRONDAHL, Albany Times Union Staff writer October 21, 2002
The state Department of Correctional Services calls it a restricted diet. It is
a form of added punishment for inmates in disciplinary isolation who have
already lost all privileges and continue to be disruptive and refuse guards'
orders.
Prisoners call it "going on the loaf." Some have described surviving the loaf as
a badge of courage and defiance.
Regular prison food is suspended and replaced by a loaf of dense bread, shredded
raw cabbage and water. The loaf is made from flour, milk, yeast, sugar, salt,
margarine, potatoes and carrots. It is served three times a day. DOCS said
nutritionists analyzed the loaf and reported it meets health and dietary
standards.
Thirty-six inmates were on the loaf in July, and 60 percent of them were placed
on the restricted diet for a week or less, according to DOCS.
One inmate in disciplinary isolation at Southport prison, who had been on the
loaf for two months and had lost 20 pounds, told officials with The Correctional
Association of New York he considered the restricted diet a challenge of
toughness between him and his guards.
"They are not going to break me! I'm a strong individual. They can't break me!"
the inmate shouted to the watchdog group's visitors.
Other prisoners on his cellblock joined in the shouting and banged on their bars
in solidarity, according to an account in the association's report, "State of
the Prisons," released in June.
Source:
http://www.timesunion.com/AspStories/story.asp?storyID=63614&BCCode=&category=FRONTPG&newsdate=10/21/2002
-----------------------------
At Marcy, treatment for the worst cases
State's sole in-patient mental health hospital near Utica strives to reduce
the number of times inmates return
By PAUL GRONDAHL, Albany Times Union Staff writer October 21, 2002
The Central New York Psychiatric Center, five miles west of Utica, where the
state's most deranged and dangerous prisoners are sent, has a split personality.
On the outside, it's a maximum-security prison with three rings of tall fences
bristling with razor wire encircling the 10-acre complex.
On the inside, it's a hospital with spotless linoleum floors, examination rooms
and a therapeutic calm.
The duality of the architecture underscores a debate that has gone on for 160
years: How best to treat the so-called criminally insane in New York state.
Beginning with the Utica Lunatic Asylum in 1843, convicted state prisoners with
mental illness and violent pasts have been shuffled between two agencies:
correction and mental health. Class-action lawsuits brought on behalf of the
inmates in the mid-1970s forced the closure of two correction-run psychiatric
facilities and the opening of CNYPC under the state Office of Mental Health in
1977.
The toughest prisoners to manage wind up at CNYPC, known as Marcy. It is the
state's sole in-patient mental health hospital for 68,000 inmates at 70 prisons
statewide. Only prisoners who are involuntarily committed through a court
procedure are treated here.
Marcy has 500 employees and 190 beds for prison inmates. The number of beds has
remained roughly the same for two decades.
Two years ago, the facility operated at 105 percent capacity. In 1991, the peak
year, there were 1,400 admissions for Marcy's 190 beds. Exceeding capacity was a
chronic problem, according to executive director Hal Smith, who oversees the
state's entire forensic mental health system. Smith said he has stabilized the
annual number of admissions to about 850 per year in recent years.
His facility is a confinement of last resort.
"Being both mentally ill and criminal, they're the most disenfranchised
population there is," said Smith, a 30-year veteran of the field who was
involved with the design of the facility.
The average length of stay at Marcy is 42 days. Smith's stated goal is to
provide medication and treatment, to stabilize the inmates and to return them to
prison. Undercutting that objective is Smith having to turn over each of his 190
beds four to five times each year to meet demand.
Budget constraints come into play. It costs $550 per day for an inmate at Marcy.
By comparison, the cost is $70 per day for an inmate in a standard prison cell.
The readmission rate is 65 percent. Some inmates have been in and out of Marcy
more than a dozen times. About one-third of the patients come directly from
solitary confinement in The Box, the most rigid and punitive level of
incarceration.
At Marcy, patients are not handcuffed, shackled or locked down as they had been
in prison. Patients live in dormitory rooms. Their weekly schedule involves a
minimum of four classroom sessions and four recreation periods, in addition to
therapy sessions.
There has been just one suicide death in the 25 years Marcy has been operating.
Six of seven patients interviewed there said they had been patients in community
mental health facilities or state psychiatric hospitals before winding up in
prison. Five of them had been convicted of murder. They agreed to talk if their
last names weren't used.
"I like it here. It helps relieve my stress," said Gary, 37, who'd spent six
years in prison for armed robbery and assault on Long Island. He's been in and
out of Marcy 15 times.
"He's one of our frequent fliers," Smith said.
Dan, 29, entered prison at 16 and is serving a 23-year-to-life sentence for
murder in Tioga County. He spent seven of those years in solitary confinement
for his behavior.
"I really bugged out in The Box. I'd get into an extreme rage and flood my cell,
try to start a fire, anything I could," he said. After 13 months at Marcy, Dan
graduated from a leadership program and will work as a mentor when he's sent
back to prison. Reducing the number of "frequent fliers," as Smith calls them,
is one of his top priorities. Advocacy groups cite the revolving-door aspect as
a major failing.
Smith contends he can reverse the high recidivism rate at Marcy as a result of a
recent state Supreme Court decision OMH won. It gives OMH staff the legal
authority to medicate over an inmate's objection any former CNYPC patient for
one year after he has been released back to a prison setting. Previously, an
inmate could be medicated over his objection only while confined to Marcy.
"That will give us some continuity so they don't go off their meds and
decompensate once we send them back to prison," Smith said.
Prisoner advocates consider the ruling a setback in their efforts to gain more
humane treatment for mentally ill inmates.
"It's horrible," said Cliff Zucker, executive director of Disability Advocates.
"Imagine guards holding you down as you object and then you're injected with a
powerful tranquilizer. That's supposed to be therapeutic?"
Source:
http://www.timesunion.com/AspStories/story.asp?storyID=63628&BCCode=&category=FRONTPG&newsdate=10/21/2002
----------------------------------
A troubled young life ends
Emotional disorder steered teen's pattern of fighting, larceny and eventual
self-destruction
By PAUL GRONDAHL, Albany Times Union Staff writer October 21, 2002
Growing up in Kingston, Jesse McCann's emotional problems surfaced early. He was
often in trouble at school for fighting. He was diagnosed with "intermittent
explosive disorder" at 12 and prescribed psychiatric medication as a teenager.
He ran away from home, was arrested for petty larceny and was placed in foster
care.
"He always had trouble controlling his emotions. He had a short fuse," said his
uncle, Bryce McCann, of Hopewell Junction, who was close to Jesse. "He was a
very sensitive kid with a lot of problems."
Jesse McCann was arrested for larceny and sent to Ulster County Jail, where he
tried to hang himself. He was eventually transferred to Downstate Correctional
Facility in Dutchess County. Downstate is a maximum-security reception and
classification center that processes 15,000 to 20,000 newly sentenced felons
before transferring them to other prisons.
"At Downstate, he was in trouble since Day One," said Bryce McCann, who visited
Jesse weekly in prison. "Even though he was small, he wouldn't be pushed around
by anyone. He got into a fight with a prisoner and got 30 days in lockdown. As
soon as he got out, he was in an altercation with a correction officer and was
put back in solitary confinement."
Bryce McCann said prison officials knew about Jesse's emotional problems and
diagnosis, and his suicide attempt in the county jail. They were experimenting
with medications to see what might work, he said.
"They never should have left him alone in his cell," Bryce McCann said.
On March 16, 2001, seven weeks after arriving at Downstate, Jesse McCann, who
weighed 150 pounds and stood 5 feet, 7 inches, hanged himself with a bedsheet
tied to his cell's window frame.
He died two weeks before his 18th birthday.
Source:
http://www.timesunion.com/AspStories/story.asp?storyID=63635&BCCode=&category=FRONTPG&newsdate=10/21/2002
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