As several news reports have recently highlighted, prisons are increasingly serving as de facto asylums for the mentally ill. The country’s three biggest jails are now its largest mental health facilities. A Wall Street Journal survey found that Oregon estimates half of its prisoners suffer from mental illness. In New York City, about 34 percent are mentally ill. “Our jails and prisons are our main place now where you find mentally ill people,” psychiatrist E. Fuller Tory told 60 Minutes.
This has been attributed in part to a failed mental health system outside prison bars. But for some inmates already there for the long haul, getting treatment is thwarted by intransigence on the part of prison officials. Jonathan Francisco was “obsessively hoard[ing] his own feces and handling it,” and even ate it on occasion during the five years that his mother sought treatment for him. Francisco was described as mute, mostly keeping his face very close to his cell wall and staring. But according to reporting by the Atlantic’s Andrew Cohen, prison officials did little other than put sandbags around Francisco’s cell to reduce the scent of excrement. Only this week, facing an emergency motion for relief, did the government agree to transfer him to a mental health prison.
In 2010, Francisco’s mother wrote a letter to the judge that sentenced him to a ADX Florence, a “Supermax” prison in Colorado, imploring the prison to treat his obvious mental deterioration. When she later secured an attorney, the federal Bureau of Prisons refused even to provide the power of attorney to his mother as requested so that they could gain access to needed documents. The BOP finally surrendered the documents at the end of August, prompting the emergency motion for Francisco’s transfer. During Tuesday’s hearing on the motion, Department of Justice lawyers conceded Francisco’s mental issues and told the “grim-faced” federal judge that they had already filed paperwork for his removal to a mental health facility in Missouri.
This wasn’t an isolated incident for the prison. As the complaint explains:
These conditions would be cause for serious concern in any context, or at any time, but two recent events involving other prisoners with severe mental illness at ADX demonstrate that the medical and mental health staff at ADX are either unwilling or unable to detect impending mental health emergencies. In one recent case, the BOP allowed a psychotic prisoner named Richie Hill to develop severe malnutrition and systemic staph infections so severe that he was on the verge of death when the BOP finally evacuated him on an emergency basis to a medical facility in November 2012.
Like Francisco, Hill spent months in a feces-encrusted cell before the BOP finally addressed his serious medical needs. In a more recent case, the BOP ignored obvious signs of acute psychosis on the part of ADX prisoner Robert Knott, who hung himself in his cell at ADX on September 7, 2013, after languishing at ADX for years with only intermittent care for his schizophrenia. Both of these incidents occurred after this case was filed, when the BOP knew Plaintiffs and this Court were watching, and both resulted from inexcusable and unconstitutional neglect.
Francisco is part of a class challenge against the Supermax prison for improper treatment of many mentally ill inmates. Supermax facilities are intended to house the most dangerous of inmates, and they are subjected to severe isolation akin to the solitary confinement that has been deemed cruel and unusual for the mentally ill. As Cohen writes, “There aren’t supposed to be mentally ill prisoners at Supermax. But there are.” Across Colorado, confinement of the mentally ill is a problem and the subject of an ACLU lawsuit.
As Cohen has documented, Francisco is far from the only inmate whose loved ones have had to fight tooth and nail for mental health treatment in an appropriate facility. And given the growing rate of mental illness behind bars, there are likely many more who don’t have an advocate like Francisco’s mother to expose their struggle.