Federal court denies California’s request to lift oversight of prison mental health system

SOURCE: Coleman v. Brown court filings

A federal judge has denied California’s request to lift the court’s oversight of the state’s prison mental health system, citing “ongoing constitutional violations”.

“Systemic failures persist in the form of inadequate suicide prevention measures, excessive administrative segregation of the mentally ill, lack of timely access to adequate care, insufficient treatment space and access to beds, and unmet staffing needs,” wrote U.S. District Court Judge Lawrence Karlton in his ruling in Coleman v. Brown.

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

Despite some progress made by California to improve its prison mental health system, Karlton expressed concern that the state has “failed to adequately implement and administer necessary components of their suicide prevention program and other critical parts of their remedial plan.” In other words, the state has not followed through on implementing its own plan to comply with the Constitution’s Eight Amendment and “deliver adequate mental health care to seriously mentally ill inmates.”

Karlton pointed out that the suicide rate in California’s prisons has not declined much since 2005 and that more than 70% of the inmate suicides were “foreseeable and preventable” and “involve significant inadequacies [in mental health care] about which the [state] have known for years”.

In fact, the state’s 2012 suicide rate is still more than 50% higher than the national average.

Not only has the state failed to fully implement its suicide prevention program, Karlton found an “ongoing pattern of repeating inadequacies” including failure to refer inmates for appropriate treatment, failure to evaluate and screen inmates for mental health problems, failure to carry out basic clinical procedures, and inadequate emergency responses.

“Despite the fact that current evidence shows that inmate suicides are occurring at virtually the same rate and with virtually the degree of inadequacies in assessment, treatment and intervention, defendants now seek termination of all relief in this action,” Karlton wrote.

The state also lacks the necessary facilities to house prisoners with serious mental health problems.

Karlton found that the state still does not have a sufficient number of mental health crisis beds for inmates who require 24-hour nursing care due to serious “impairment and dysfunction” or who pose danger to themselves and others.

The facility shortage meant that inmates seeking mental health treatment are still being placed in solitary confinement – known as “administrative segregation” – sometimes more than 90 days while they wait for an appropriate treatment bed to open up.

Read more: California places mentally ill prisoners in solitary confinement due to lack of treatment beds

“Mentally ill inmates in need of this care are held in conditions that defendants have now agreed should not be used to house inmates in need of crisis care. This aspect of the Eighth Amendment is ongoing,” wrote Karlton.

State officials pointed out that additional treatment facilities are under construction and would significantly increase the number of beds for inmates seeking care, but Karlton remains unconvinced, noting that the constructions for some of the facilities are in the “very preliminary stages.”

“Until all necessary projects are complete, the state’s prison system is operating with a constitutionally inadequate amount of treatment space and a constitutionally inadequate number of beds necessary for adequate care,” Karlton wrote.

Karlton also cited the staffing shortages of mental health professionals in state prisons as another reason why federal oversight should continue.

The state reported that the vacancy rate for prison mental health professionals – psychiatrists, psychologists, social workers, and et cetera – was 29% as November 2012, and even the state-hired experts found the high staffing vacancies “worrisome”.

“Chronic understaffing continues to hamper the delivery of constitutionally adequate medical care and is a central part of the ongoing constitutional violation in this action,” wrote Karlton.

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