IDOC Mental Health Care Still Unconstitutional After 5 Years

The latest court-ordered report on mental health care in Illinois state prisons was released to the public Friday. This report was created by Dr. Pablo Stewart, an independent, court-appointed monitor, as a result of the class action lawsuit Rasho v. Jeffreys, brought by Dentons, Equip for Equality, and Uptown People's Law Center. This lawsuit alleged that the mental health care provided to prisoners in the Illinois Department of Corrections (IDOC) is unconstitutional, and was settled in May of 2016.

Stewart's report found that in the two years since the court ordered IDOC to make changes in its provision of mental health care, IDOC has failed in complying with any one of five court mandates:

* Staffing: "It remains the opinion of the Monitor that the major impediment preventing the Department from meeting the requirements of the Court's orders is inadequate staffing. This lack of staffing applies to clinical and custody staff."

* Crisis Watch: "[T]reatments were not sufficient to stabilize the symptoms and protect against decompensation, demonstrated in part by the very long crisis watches in which the patients presumably were not stable."

* Out-of Cell-Time for Prisoners in Solitary: "The amounts of counseling and out-of cell-structured and unstructured time [provided to prisoners in solitary confinement] are far below what is needed and sufficient to protect against decompensation."

* Medication Management: "I am disappointed to note that several of the IDOC facilities with large numbers of class members persist with unacceptably early morning medication distribution times." (Prisoners at times have to stand outside at, e.g., 4 a.m. to get medication.)

* Individual Treatment Plans: "All class members do not have a treatment plan that is individualized and particularized based on the patient's specific needs."

A prisoner is placed in crisis watch when a clinician determines they are in danger of committing suicide. The prisoner is placed naked in a cell with nothing but a "suicide smock," a thick covering to wear and sleep under. Often not provided proper treatment, the person is held there under 24/7 watch, until they are considered no longer a threat to themselves.

IDOC says over 42% of prisoners have mental illness, though prisoners' advocates say that, due to the lack of adequate screening, and the stigma around mental illness, that figure is likely incorrectly low.

"Tragically, this state has decided to lock people with the most serious mental illnesses in prison, rather than place them in a hospital," said Alan Mills, executive director of Uptown People's Law Center. "Having made this choice, the state then has a constitutional obligation to treat their mental illnesses.

"Five years after the original case settlement, people are still suffering terribly. I have toured the prisons where people are housed: the pain and suffering is indescribable, and must be seen to be understood. These are some of the most vulnerable people in society, and we are damaging them again and again during their time in prison. It is long past time for Illinois to comply with the court's orders, and the United States Constitution."

Said Harold Hirschman, of Dentons: "How many roads must we go down, for how many years, when, despite pious assurances of an commitment to deliver constitutional care, we always end up at the same place - unalleviated mental suffering caused by ignoring community standards of care. Will this ever end?"

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Previously:

* May 2017: Federal Court Certifies Lawsuit Charging Unconstitutional Illinois Prison Healthcare.

* May 2018: Mentally Ill Prisoners Win Injunction; Judge Declares IDOC's Failure To Provide Mental Health Care An "Emergency Situation."

* October 2018: Judge: "Deliberate Indifference" Of IDOC Mental Health Care Requires Federal Oversight.

* December 2018: Federal Judge To IDOC: Get Your Unconstitutional Shit Together.

* January 2019: Overhauling Illinois' Unconstitutional Prisons.

* March 2021: Illinois Prisoners' Health Care Still Unconstitutional.

* June 2021: Judge Certifies Class Action Lawsuit Against IDOC.

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