August 16, 2013
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When Amir Hall entered New York state prison for a parole
violation in November 2009, he came with a long list of psychological
problems. Hall arrived at the prison from a state psychiatric hospital,
after he had tried to suffocate himself. Hospital staff diagnosed Hall
with serious depression.
In Mid-State prison, Hall was in and out of solitary confinement for fighting with
Hall did not want to be moved. When his
mother and grandmother visited him that spring, Hall warned them: If he
didn't get out of prison soon, he would not be coming home.
"There
was somebody who looked defeated, like the life was beat out of him,"
said his sister Shaleah Hall. "I don't know who that person was. The
person in that video was not my brother."
Multiple studies
have shown that isolation can damage inmates' minds, particularly those
already struggling with mental illness. In recent years, New York state
has led the way in implementing policies to protect troubled inmates
from the trauma of solitary confinement.
A 2007 federal court order required New York to provide inmates with "serious" mental illness more treatment while in solitary. And a follow-up law enacted in 2011 all but bans such inmates from being put there altogether.
But
something odd has happened: Since protections were first added, the
number of inmates diagnosed with severe mental illness has dropped. The
number of inmates diagnosed with "serious" mental illness is down 33
percent since 2007, compared to a 13 percent decrease in the state's
prison population.
A larger portion of inmates flagged
for mental issues are now being given more modest diagnoses, such as
adjustment disorders or minor mood disorders.
The New
York Office of Mental Health says the decrease reflects improvements to
the screening process. Efforts to base diagnoses on firmer evidence "has
resulted in somewhat fewer, but better-substantiated diagnoses" of
serious mental illness, said a spokesman for the office in an emailed
statement.
In Hall's case, prison mental health staff never labeled his problems as "serious."
Instead,
they repeatedly downgraded his diagnosis. After three months in
solitary — during which Hall was put on suicide watch twice — they
changed his status to a level for inmates who have experienced "at least
six months of psychiatric stability."
Two weeks after
his diagnosis was downgraded, and two days after he was transferred to
solitary at Great Meadow, guards found Hall in his cell hanging from a
bed sheet.
As part of a report issued on every inmate death, the Corrections Department's Medical Review Board found no documented reason behind the change in Hall's diagnosis.
A 2011 Poughkeepsie Journal investigation detailed a spike in inmate suicides in 2010, which disproportionately took place in solitary confinement. Death reports from the state's oversight committee obtained by the Journal suggest several inmates who have committed suicide in recent years may have been under-diagnosed.
Hall's
family is suing the Corrections Department and the Office of Mental
Health, among other defendants, for failing to treat his mental illness
and instead locking him in solitary.
New York State's
Office of Mental Health, which is in charge of inmates' mental health
care, declined to comment on Hall's case, citing the litigation.
Amir
Hall (or Mir, as his family calls him) was originally arrested in
October 2007, for the unarmed robbery of a Verizon store. He made off
with $86. Released on parole, he lived with his sister Shaleah Hall and
her two sons while working at a local Holiday Inn and studying to become
a nurse.
"Sometimes I sit there thinking that he's
going to walk through the door and make everybody laugh," said Shaleah,
who has "In Loving Memory of Amir" tattooed in a curling ribbon on her
right bicep. "He was the life of the party. If you met him, you would
just love him."
But Hall's mood could shift in an
instant, Shaleah said. He was often paranoid, worried that people judged
him for being gay. He would snap, then apologize repeatedly for it
afterward.
"You had to walk on eggshells sometimes,
because you never knew if he was going to be happy or sad that day,"
Shaleah said. "It was like this ever since we were kids."
One of those outbursts landed Hall back in prison for violating parole, after he got into a fight with Shaleah's friend.
Knowing her brother's history of mental illness, Shaleah said solitary confinement must have "drove him crazy."
"I feel like they treated him like an animal," she said. "They just locked him away and forgot about him."
The
lawsuit over Hall's death claims mental health and prison staff ignored
recommendations that he receive more treatment, and that staff members
failed to properly assess his mental health when he arrived at Great
Meadow.
In a response
to the state oversight committee's assessment of Hall's case, the
Office of Mental Health said they were retraining staff on screening for
suicide risk. The Corrections Department said they were working to
improve communication when inmates are transferred to new facilities.
Sarah Kerr, a staff attorney with the Prisoners' Rights Project of the Legal Aid Society, noted Hall's case during a Senate hearing on solitary confinement.
"The repeated punitive responses to [Hall] as he psychiatrically
deteriorated in solitary confinement exemplify the importance of
vigilance and monitoring, and the need for diversion from harmful
solitary confinement," she wrote.
Kerr points out that
significant improvements have been made for inmates diagnosed above the
"serious" mental illness line. The new mental health units provide at
least four hours of out-of-cell treatment a day, and speed up an
inmate's return to the general population.
"I don't
think those improvements should be taken lightly," said Kerr. "In terms
of mental health policy, we're way ahead of the country."
But
when it comes to solitary confinement, "New York is among the worst
states," said Taylor Pendergrass of the New York Civil Liberties Union,
which is suing the state
over its use of isolation. "Even if you're totally sane and you go into
solitary, it's incredibly hard to deal with the psychological toll of
that," he said.
Solitary confinement is used in jails
and prisons across the country, though there's no reliable data to
compare its prevalence among states. Experts say New York stands out for
sentencing inmates to solitary for infractions as minor as having too
many postage stamps or a messy cell. A report from the NYCLU found that five out of six solitary sentences in New York prisons were for "non-violent misbehavior."
Under
the state's new law, all inmates housed in solitary — known in New York
as Special Housing Units, or SHU — receive regular check-ins from
mental health staff. The screenings are meant to catch inmates not
originally diagnosed with a disorder who develop problems in isolation.
But
Jennifer Parish, director of criminal justice advocacy at the Urban
Justice Center, said she thinks many staff members still view inmates'
symptoms as attempts to avoid punishment. "If you don't believe that
being in solitary can have detrimental effects to a person's mental
health, you're going to see someone who just says, 'I want to get out of
here,'" she said.
Beck has seen the same skepticism in
conversations with some prison staff. "There's a bias in the system
that looks at the incarcerated population as anti-social, malingerers,
manipulators," Beck said. "I hear that all the time."
When
inmates ask to see mental health staff, "we have found far too often
that it appears security staff really resent people asking for these
interventions," Beck said. "We have in a few facilities what I think are
credible stories of individuals being beaten up when they want to go to
the crisis center."
As Sarah Kerr sees it, "if mental
health staff are overly concerned that people are feigning illness, that
they're conning their way out of special housing ... that will lead to
tragedies."
The Corrections Department says any unusual
behavior by inmates or attempts to hurt themselves are reported to
mental health staff. A spokesman for the Office of Mental Health said
"inmates reporting psychiatric symptoms are taken seriously and assessed
carefully."
Donna Currao said prison staff ignored her
and her husband, Tommy Currao, when he attempted suicide at least 10
times over the course of 10 months in solitary confinement. According to
his wife, Currao had been sent to solitary after testing positive for
heroin.
Currao's first suicide attempt in solitary was
in July 2012, when he tried to overdose on heroin. That October, guards
found him attempting to hang himself in his cell. While on suicide watch
after he tried again to overdose, Currao broke open his hearing aid and
used the metal inside to cut his wrists. (He received a bill of $500
for "destruction of state property," Donna said.)
Both the Corrections Department and the Office of Mental Health declined to comment on Currao's case.
According
to the Corrections Department, an inmate can be returned to solitary
confinement after being on suicide watch if they're cleared by the
Office of Mental Health. In 2011, 14 percent of the 8,242 inmates
released from New York's mental health crisis units were sent to
solitary confinement.
After just three weeks in
isolation, Donna noticed a dramatic change in her husband. He "was
withdrawn, all he would do is apologize," Donna said. He was no longer
laughing with her, playing cards or chatting with other inmates. She
watched him drop from 240 pounds to 160.
Currao stopped
writing the almost daily letters he'd sent for 13 years. When Donna
persuaded him to start again, as a way to escape, he talked of an
overwhelming sadness.
Donna says she repeatedly called the prison. She faxed them copies of Currao's suicidal letters. But he remained in isolation.
"I
don't know if they don't want to spend the money, or think it's a
joke," she said. "They still thought he wanted out of solitary. He
wanted out of the picture is what he wanted."
A survey
by the state's independent oversight committee found many family
members who said prison officials didn't listen to concerns about
inmates' psychological wellbeing. None of the mental health files
reviewed by the oversight committee contained information from family
members about a prisoner's psychiatric history.
The
Office of Mental Health says it's working on creating new procedures to
"insure that the call is responded to promptly and in a manner that
addresses the family member's concern as best as possible."
Prisoner
rights advocates are also working on a new legislative proposal to
ensure that mentally ill inmates get the treatment they need. A coalition of groups
is drafting a new bill, which would expand protections from solitary
for inmates with mental illness, and put a limit on solitary confinement
sentences for any prisoner, whether or not they're diagnosed with a
disorder.
"Even though there's a law that says you
can't do this for people with serious mental illness, it hasn't stopped
[Corrections] from using solitary," said Parish. "I think they just
replaced it with lower-level tickets instead of some of the most serious
ones."
In May, Donna's persistence in trying to get
her husband treatment finally saw results. Currao met with a
psychologist, and was diagnosed with "serious" anti-social personality
disorder and dysthymic disorder. He was moved out of solitary
confinement and into one of the 170 Residential Mental Health Treatment
beds created under the recent law.
Currao "seems to be
1,000 times better" since entering treatment, Donna said. He talks about
wanting to become a counselor when he's released.
But
Donna wonders why it took so many suicide attempts and nearly a year of
pressure to get her husband a proper diagnosis and the treatment he was
legally owed. "They are not enforcing this law," she said. "Why do we
have to fight so hard to get them evaluated?"
Hall's
family is left with the same questions as they search for answers about
his death. "How many more people have to die?" Shaleah asked. "They need
help. Locking them away is hurting them more."
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