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

U.S. District Court Judge Michael M. Mihm issued an opinion Friday in the class action case Rasho v. Baldwin ordering the Illinois Department of Corrections to provide mental health treatment to prisoners who are on "crisis watches" and in segregation, as well as to provide medication management, mental health evaluations and necessary mental health staff throughout the system.

The judge ruled that IDOC's failure to provide mental health care constitutes cruel and unusual punishment, in violation of the U.S. Constitution, as well as violates the settlement agreement that the department entered.

In a 42-page decision, Mihm found that IDOC's deliberate indifference to mentally ill prisoners is causing "irreparable harm" that requires the court to issue injunctive relief. The court decision states that the constraints faced by IDOC "are dwarfed by the immense harm to the inmates."

"These are mentally ill individuals, who themselves are left, in a very real way, at the mercy of the IDOC to provide them with the constitutionally minimal level of health care. And this is simply not being done, and based on the record presented, will not be done unless there is a preliminary injunction issued by this Court."

This order comes almost two years to the day after a settlement agreement was reached by IDOC and lawyers representing the more-than 12,000 prisoners with mental illness in Illinois. The original class action challenge to the treatment of prisoners with mental illness was filed in 2007.

Last year, the court-appointed independent monitor's report of Illinois prisons characterized the psychiatric care provided by IDOC as "grossly insufficient," "extremely poor in quality" and "oftentimes dangerous." When IDOC failed to address the monitor's findings, he sent them a letter declaring that psychiatric care in Illinois prisons was in "a state of emergency."

After IDOC repeatedly failed to address the monitor's findings, lawyers for the prisoners filed a Motion to Enforce the federal settlement agreement in October of 2017. The court held evidentiary hearings that began in December 2017 and completed in March 2018.

Testimony at the hearings demonstrated how mental illness is negatively impacted by isolation. Several prisoners testified how their own mental illness became worse - with increasing paranoia and distress - as a result of years of segregation (or isolation). One prisoner testified to multiple suicide attempts in recent months, including that at the time of the testimony he had batteries in his stomach that he had swallowed. In response, IDOC placed him in isolation for months with no mental health treatment other than psychiatric medications. He was frequently strapped to a bed with his hands restrained over his head (in a painful and unnecessary position) for hours to days at a time.

IDOC's Chief of Mental Health admitted in his testimony that mentally ill prisoners in segregation are "across the board" getting worse without the treatment and out-of-cell time that they need, and which was promised by the settlement agreement. Likewise, IDOC's former Chief of Psychiatry testified that the psychiatric system was in a state of emergency and was causing actual physical and mental injuries to prisoners with mental illness.

The Court decision states that:

"The testimony of almost all of the medical doctors at the hearing clearly stated, in one form or another, the system in place to treat mentally ill inmates at the IDOC is in a state of emergency . . .

"The testimony during the hearing shows deficiencies in medical treatment in segregation have created an extremely dangerous situation. The length of time, sometimes staggering, that inmates are put in segregation, without properly addressing their mental health medical needs, furthers the mental decomposition of the inmate."

At last week's hearing, Mihm reprimanded the state for its failure to address these problems, noting that the Department of Corrections has long known about the mentally ill prisoners being harmed.

Currently, IDOC mental health appointments are extremely backlogged; psychiatrists do not review the powerful medications they prescribe or check for potentially devastating side effects; treatment plans either do not exist, or are so vague as to be useless; mental health referrals are backlogged; and those in crisis and solitary confinement continue to suffer without the treatment they need. Isolation, itself detrimental to mental health, is the typical response to prisoners with serious mental health issues.

"We are gratified the court reached the conclusion that mentally ill inmates are receiving grossly inadequate care. We remain saddened that IDOC has simply failed to fulfill the promises it made in the settlement agreement," said Harold Hirshman, senior counsel, Dentons, and lead pro bono counsel in the case.

"We are thrilled that the judge is addressing this important issue by forcing the Department of Corrections to comply with the settlement. It is appalling that a year after the monitor informed IDOC that its psychiatric care was in a 'state of emergency,' the Department still has no plan to fix it," said Alan Mills, attorney and executive director at Uptown People's Law Center. "It is clear that IDOC wants to run its prisons without accountability. It counts on people not caring enough about prisoners to investigate prison conditions and force the Department to improve them to meet constitutional standards."

"Thousands of people with mental illness throughout Illinois prisons are suffering every day because they are not getting the treatment that the Department admits they need," said Amanda Antholt, senior attorney at Equip for Equality and one of the attorneys representing the plaintiffs. "This court order is necessary to stop the Department from further harming our clients with mental illness."

Among other things, the order to enforce requires:

  • IDOC to provide appropriate mental health treatment to stabilize symptoms;
  • Treatment and out-of-cell time to protect against deterioration of mental health in segregation;
  • Individualized treatment planning and psychiatric care; and
  • Sufficient staffing levels to provide mental health care.


Comments welcome.


Posted on May 28, 2018

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