Indiana’s confinement of mentally ill prisoners in solitary confinement is cruel and unusual under the Constitution’s Eighth Amendment, a federal judge ruled last week in one of just a handful of decisions on the severe treatment. In a sweeping class action ruling that affects all current and future mentally ill patients subject to segregated confinement in the state, U.S. District Judge Tanya Walton Pratt found that the “effect of segregation on mentally ill prisoners in Indiana is toxic to their welfare,” exacerbating their condition and severely limiting their chances for rehabilitation:
Tragically, a disproportionately high percentage of suicides are committed by prisoners in segregation compared with those in the general population of a prison system. This is true both within the IDOC and in correctional settings across the country. […]
[T]he severe conditions in the segregation units cause a predictable deterioration of the mental health of seriously mentally ill prisoners and the IDOC has explicitly observed, diagnosed and noted patient decompensation. Records from a prisoner who recently committed suicide disclose that there was only one correctional staff member for the entire area and the staff person was unable to visually supervise the prisoner. Records of another prisoner who committed suicide in late 2010 note that on one occasion shortly before his death he could not be brought to a mental health appointment because “custody unable to escort.” He was not seen for a week. He was scheduled to be seen again shortly before his suicide, but his medical records note that he “did not appear” for the appointment. He committed suicide within days of the missed appointment … [T]here is a difference between mental health monitoring and mental health treatment. The IDOC is performing the former in its segregation units, but very little of the latter.
The opinion describes confinement of as much as 22.5 hours per day, with most of it spent in small cells but for some limited recreation opportunities, medical appointments, and showers at least 3 times per week — in another small isolated space where prisoners are sometimes locked for extended periods of time. The average stays in isolation range from 1 to 3 years, depending on the reason for isolation. And mentally ill prisoners make up a disproportionate 22 percent of the state’s isolated prisoners.
Several journalists who have spent time in solitary confinement have recounted the extreme distress that sets in within days. Shane Bauer, one of the American hikers who was imprisoned in Iran, described the conditions of solitary confinement at Pelican Bay as at least as bad, or arguably worse, than those in Iran and called the experience of solitary confinement “a living death.” The ACLU, Physicians for Human Rights and The Center for Human Rights and Constitutional Law all call the practice torture and Human Rights Watch calls it at the very least cruel and inhuman treatment in violation of international law.
The impact of these conditions is compounded for vulnerable populations like the mentally ill and children as young as 13, who are also subject to solitary confinement in the U.S. A federal judge ruled in 1995 that the conditions at the Pelican Bay prison visited by Bauer were unconstitutional as applied at least to the mentally ill, and a Colorado judge ruled in September that at least some conditions of solitary confinement violated the Eighth Amendment. Other states have since agreed to limit solitary confinement for the mentally ill, but most of those cases have ended with settlements rather than decisions, according to an ACLU memo. Last week’s decision relied heavily on the U.S. Supreme Court’s 2011 ruling that conditions at California’s severely overcrowded prisons were cruel and unusual under the Eighth Amendment.
The court has not yet determined what the remedy will be for this constitutional violation, but USA Today reports that Indiana officials are already “scrambling for solutions,” including 30-day reviews, and removal from segregation of inmates who are observed to be deteriorating.