ANALYSIS: California seeks to terminate federal oversight of prison mental health system

Treatment Cage Used to Conduct Individual Clinical Contacts for Prisoners in Mule Creek State Prison’s Mental Health Crisis Bed Unit. SOURCE: Coleman v. Brown declaration of Dr. Craig Haney for the plaintiffs.

Claiming that California now runs “one of the finest prison systems in the United States”, Gov. Jerry Brown is seeking to stop further reductions to the state’s prison population and to terminate the federal court’s oversight of the prison mental health system.

“There’s no question that there were big problems in California prisons – overcrowding, lack of health care, lack of mental health care, lots of other problems. But after decades of work, the job is now complete,” said Brown. “We’ve spent billions of dollars. We’ve hired hundreds, if not thousands, of professionals to make sure that we have excellent health care and excellent mental health care. And because of that, it is now time to return the control of our prison system to California.”


For decades, severe overcrowding has created unsanitary and dangerous conditions in California’s prisons.

By August 2008, the state prison population ballooned to 156,352 inmates in 33 prisons which were designed to house only about 80,000 inmates. Detention facilities were so overstretched that mentally ill inmates were placed in cages the size of telephone booths (without toilets) while they wait for an appropriate bed or cell to free up.

The severe overcrowding also overwhelmed the prison staff, particularly the medical and mental health personnel, resulting in inmates being routinely denied basic medical and mental health care, which in some cases led to death or suicide.

In Coleman v. Brown, the Ninth Circuit Court of Appeals ruled that the state’s denial of care inflicted needless pain and suffering on the prisoners and amounted to “cruel and unusual punishment” in violation of the Eighth Amendment.

Notably, the court identified the persistent prison overcrowding as the underlying cause of California’s systematic constitutional violations and ordered the state to reduce its prison population from the then-195.5% to 137.5% of design capacity within 2 years and to improve its prison mental health system.

In May 2011, the U.S. Supreme Court upheld the three-judge panel’s order, and the state, after exhausting its legal appeals, finally began to alleviate the severe overcrowding in its 33 prisons through what is known as the “Public Safety Realignment.”



By shifting incarceration responsibilities of non-serious or non-violent felons to counties, the state was able reduce its prison population by 24,000 inmates between October 2011 and December 2012. By the end of last year, California’s prison population had shrunk to 119,327 inmates, amounting to 149.6% of design capacity. However, state officials have publicly acknowledged that California will not be able to reach the court-mandated 137.5% of design capacity benchmark by the June 27, 2013 deadline.


Brown argued that meeting the 137.5% design capacity benchmark is no longer necessary because the state has been able to remedy the problems plaguing the prison mental health system at the current population level.

“Our prisons are not overcrowded. I know there’s a design capacity but that’s a somewhat arbitrary figure,” said Brown.

Read more: ANALYSIS: “Profound” ethical violations undermine expert testimonies in California’s bid to lift federal oversight of prison system

The state contended in court filings that “the current prison population does not interfere with the state’s provision of quality health care.”

Not only is there no need for further reductions in the state prison population, Brown claimed that meeting the 137.5% benchmark would threaten public safety.

“I don’t believe it’s wise or sound public policy to release any more people out of our prison other than in accordance with our existing state law,” said Brown. “And that is the reason why we are going to court asking that the prison cap or limit be removed.”

At the court hearing on March 27th, Deputy Attorney General Patrick McKinney pointed out that the state has been spending $400 million a year on prison mental health.

(To put that figure in context, keep in mind that the total budget for the California Department of Corrections and Rehabilitation for fiscal year 2011-2012 was $10 billion, which means the prison mental health amount cited by McKinney accounted for less than 4% of what the state spends on incarceration.)

The state, according to court filings, has been constructing new health care facilities and adding more treatment spaces and beds to increase mental health care capacity even as the prison population was declining.

In addition, the state claimed that it now complies with all of the 6 court-mandated requirements to:

  • screen and evaluate inmates for mental health problems when they enter the prison system;
  • provide timely access to quality mental health treatment;
  • ensure sufficient staffing of “competent mental health professionals”;
  • maintain accurate, complete, and confidential mental health records;
  • ensure proper management of medications to inmates;
  • and establish a system to identify and treat inmates at risk of suicide.

“We’ve gone from serious constitutional problem to one of the finest prison systems in the United States,” said Brown. “Most of the people in prison get far better care for mental health problems or their physical well-being inside the prison than they’ll get once they’re released on the streets.”

Given that the state now has a “basic mental health system in place” and provides care that state-hired consultants say “far exceeds” what the constitution requires, McKinney argued that there is no need for continued federal oversight of California’s prison system.

“There is no current or ongoing violation of a federal right,” said McKinney. “Federal oversight should not continue unless there’s a violation of federal law.”

In court filings, the state emphasized that enforcing the 137.5% order and continuing federal oversight absent of systematic constitutional violations would be “unfair, unnecessary, and illegal.”


The Coleman class action, which represents thousands of prisoners seeking mental health care, countered that although Realignment has somewhat alleviated the severe overcrowding, the prison mental health system still provides inmates with care that falls well short of what the constitution requires.

Photo of California prisoners held in cages for group therapy. SOURCE: Court documents in Coleman v. Brown.

Photo of California prisoners held in cages for group therapy. SOURCE: Court documents in Coleman v. Brown.

Instead of using Realignment to improve the prison’s mental health system, the plaintiffs claimed that the state has exploited the prison population reduction to achieve budget savings and, in effect, “balance[d] the budget on the backs of the California prisoners with mental illness.”

“The Coleman class has to date experienced little to no benefit from Realignment,” the plaintiffs argued in their court filings. “Even as the population reduction of Realignment begin to kick in, [the state] prioritized, once again, budget savings over all else, squandering the opportunity to take major steps forward in remedying the ongoing violations.”

The plaintiffs also pointed out that California still has “one of the most overcrowded prison systems in the United States” even after Realignment.

As a result, California’s prison system still suffers from staff shortages, hindering the delivery of timely and adequate mental health care to prisoners.

“The current dangerous levels of clinical and custodial staffing shortages in CDCR…are a direct result of [the state’s] intentional and conscious decisions to maximize cost-savings by imposing a hiring freeze on all state public employee positions and managing Realignment mission changes to maximize budget savings,” according to the plaintiffs’ court filings.

Not only that, the state has not properly remedied the lack of treatment space for mentally ill inmates and continues to provide care in “punitive, non-confidential, and anti-therapeutic settings” such as telephone booth sized cages, small and barren cells in which inmates are forced to sleep on the floor, and individual therapy provided in shared spaces with other inmates.

These improper settings, particularly the use of shared spaces for therapy sessions, “discourage mental health patients from participating in treatment by forcing patients who access care to jeopardize their safety,” according to the plaintiffs’ court filings. “By talking about sensitive and personal information in front of other prisoners, CDCR erects dangerous barriers to mental health treatment.”

Another sign of overcrowding and shortages in treatment facilities is the state’s practice of holding mentally ill prisoners in solitary confinement – known as “administrative segregation units” (or “ad seg”) or “secure housing units” (or “SHU”) – while they wait for appropriate treatment beds and spaces to open up.

“[The state’s] segregation units continue to be extremely harsh, non-therapeutic places that drive innumerable mentally ill and vulnerable prisoners to mental health crisis and even suicide,” according to the plaintiffs’ court filings.

Michael Bien, one of the lead counsel for the Coleman class action lawsuit, told the court that serious problems with the prison mental health system remain and that the state has shown “deliberate indifference” by choosing to not follow through with its own plan to remedy those problems.

“The state has told the court ‘This is the plan to do the minimum of what we need to do’ – and then knowingly failing and consciously failing to follow through on those plans,” said Bien. “The decisions that they’re making to overcrowd certain prisons and choose to not fund certain construction – that’s evidence of deliberate indifference.”

Bien argued that to ensure the “current and ongoing constitutional violations” stemming from the still-overcrowded conditions are properly remedied, the federal court must continue its oversight of California’s prison system and compel the state to meet the 137.5% of design capacity benchmark.


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