California argues federal court cannot mandate “perfection” in prison mental health system

California Institute for Men's Administrative Segregation Unit (Palm Hall), Row of Cages Used to Hold Suicidal Prisoners until Custody Staff Is Available to Escort Prisoner to Mental Health Crisis Bed Unit. SOURCE: Coleman v. Brown declaration of Dr. Craig Haney for the plaintiffs.

One of the main issues in Coleman v. Brown is whether the state of California is meeting its obligation to provide a “constitutional” level of care to prisoners with mental health problems.

For decades, severe overcrowding in California’s prisons has overstretched staff and health care facilities to such an extent that inmates were routinely denied necessary medical and mental health care.

A federal court ruled that the state’s denial of care resulted in needless suffering and preventable deaths in violation of the Constitution’s Eighth Amendment prohibiting “cruel and unusual punishment.”

As a result, California’s prison system was placed under the oversight of a court-appointed “special master” and the state was ordered to reduce its inmate population from the then-195.5% to 137.5% of design bed capacity within 2 years and to improve the prisons mental health system.

California officials have argued that federal oversight and the court-mandated 137.5% benchmark are no longer necessary because the state’s revamped mental health system is providing inmates with care that “far exceeds” what the Constitution requires.

“What the constitution requires is that the state has a basic mental health system in place,” said Deputy Attorney General Patrick McKinney at the court hearing on March 27th. “The state is spending $400 million annually in prison mental health. Some recent construction projects have been completed. The year-to-year system getting better and better. [The California Department of Corrections and Rehabilitation] is continually self-improving and correcting issues that it identifies.”

Attorneys for the prisoners maintained that “serious problems” remain in California’s prison mental health system.

Michael Bien, one of the attorneys representing the Coleman plaintiffs, maintained that constitutional violations still persist due to staff shortages and lack of proper care facilities hindering the delivery of timely and adequate mental health care to prisoners.

McKinney countered that Bien’s claims are based on “one or two individual grievances” and pointed out that the state cannot be asked to achieve “perfection” in providing care to inmates.

“Clearly, the constitution doesn’t require perfection,” said U.S. District Court Judge Lawrence Karlton. “If perfection is not the standard, the question then becomes…if something less than perfect conditions will suffice for the constitution, then at what level must the court say, ‘Yes, it’s not perfect but it’s good enough for government work – good enough for the constitution’s definition of government work?'”

Karlton used the example of preventable suicides to illustrate the conundrum.

“What is the state’s position that if it did X, Y, and Z, [it] could have prevented two people from committing suicide? Would it be your argument that those two people must die because there would not be a constitutional requirement to prevent their suicides?” asked Karlton.

“It would depend on those two individual cases; it doesn’t address the system,” responded McKinney, who reiterated that the constitution only requires the state to have a basic health care system in place.

“So your answer is that the constitution will tolerate preventable suicide as long as we have a system in place?” Karlton pressed.

“If the question is are there zero suicide permitted in a systemic level, then that can’t be,” McKinney replied.

“Of course. You can’t prevent people who are determined to kill themselves. That’s impossible. That’s not the question,” Karlton said. “You’ve got a system in place but it doesn’t have X, Y, and Z in place to prevent suicide. Those two people died because we don’t require perfection. It’s as clear that you can’t prevent all suicides, but what standard applies to determine whether constitutional violations are continuing?”

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2 Comments on “California argues federal court cannot mandate “perfection” in prison mental health system

  1. Pingback: Spotlight: California prison mental health system | What The Folly?!

  2. Pingback: California places mentally ill prisoners in solitary confinement due to lack of treatment beds | What The Folly?!

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