South Carolina Judge: Treatment of Mentally Ill Prisoners is Unconstitutional
By John Monk
The treatment given to S.C. prison inmates suffering serious mental illness is so substandard that it's unconstitutional and threatens the mental health of inmates, a state judge ruled Wednesday in a historic decision.
The S.C. Department of Corrections intends to appeal the decision, the agency said late Wednesday. Mental health is not just a corrections problem, it's a national problem that all sectors of society are working to address, the agency said through a spokesman.
But the judge said the agency is responsible for its conduct. "Evidence in this case has proved that inmates have died in the S.C. Department of Corrections for lack of basic mental health care," Judge Michael Baxley wrote in his 45-page order, filed around noon in the Richland County courthouse.
"Hundreds more remain substantially at risk for serious physical injury, mental decompensation, and profound, permanent mental illness," wrote Baxley. He cited numerous individual cases as evidence of "a system that is inherently flawed in many respects, understaffed, underfunded and inadequate."
Baxley, 57, of Hartsville, called the lawsuit "the most troubling" of the 70,000 cases he has handled in his 14 years on the bench. He found that evidence in the case showed that for more than 10 years, the Department of Corrections has known "its mental health program is systemically deficient and exposes seriously mentally ill inmates to a substantial risk of serious harm."
He gave the department -- the main defendant in the case -- 180 days to prepare a plan to remedy the situation. The plan must include additional staff and better-trained staff, the judge wrote. The other defendant, former prisons director William Byars, resigned last year.
Wednesday's ruling resulted from a class action lawsuit originally filed in 2005 in circuit court in Richland County. Several prison inmates identified only by their initials as well as a Columbia-based advocacy group -- Protection and Advocacy for People with Disabilities -- brought the lawsuit.
Baxley made it clear he hoped Corrections would not appeal. "We are now eight years into this litigation. Rather than accept the obvious at some point and come forward in a meaningful way to try and improve its mental healthy system, Defendants have fought this case tooth and nail -- on the facts, on the law, on the constitutional issues," Baxley wrote.
"The hundreds of thousands of tax dollars spent defending this lawsuit, at trial and most likely now on appeal, would be better expended to improve mental health services delivery at SCDC."
It could not be learned how much taxpayer money was spent fighting the lawsuit. Corrections hired the Columbia law firm of Davidson & Lindemann to defend the agency. Agency private lawyers had contended at trial that any abuses cited by the plaintiffs were extreme and that the court did not have the authority to tell Corrections what to do.
Of the 22,000 inmates in the state's prison system, an estimated 3,500 have serious mental illness, according to the judge's order, which was based on evidence presented during a 2012 nonjury trial in the case.
The lawsuit did not seek damages, but only to force Corrections to develop and fund a "reasonable and adequate system for the mental health care of inmates suffering from mental illness," according to a complaint in the case.
There were no immediate estimates on how much it would cost the state to upgrade treatment for seriously mentally ill inmates. The judge's order marks a clear turning point of a 11-year legal saga for prisoners and Protection and Advocacy for People With Disabilities, who brought the suit, as well as for Columbia's Nelson Mullins law firm, which has handled the case for free. "We're extraordinarily pleased -- the judge has validated concerns a lot of us have had for years, and he recognized it is time for change," said Gloria Prevost, executive director of Protection and Advocacy for People with Disabilities.
Prevost said many citizens mistakenly believe that it's no great matter not to give adequate treatment to the mentally ill who are behind bars. "They say, 'So what if they're ill?'" she said. "But the fact remains these inmates do need treatment -- and most of them will get out of prison, so it's a public safety factor, too." The case is apparently the most sweeping legal victory for inmates' rights in South Carolina since the case of inmate Gary Wayne Nelson vs. Leeke in the early 1980s.
At that time, Nelson's class action lawsuit in federal court forced the overcrowded state prison system to sharply upgrade conditions in sleeping areas, build new prisons, limit overcrowding, improve staffing and upgrade health services, fire safety and sanitation. Following that lawsuit, the state spent more than $200 million to build five prisons and make other substantial upgrades.
The state had long resisted improvements before the Nelson verdict. The mental illness case actually began in 2002, when Nelson Mullins lawyers were approached by the Protection and Advocacy group and the Death Penalty Resources Center, both of which had clients suffering from mental illness who were in the prison system. In 2005, Nelson Mullins filed suit on behalf of several inmates and the Protection and Advocacy group.
In 2012, the case went to trial. Over five weeks, some 15 inmates and three experts testified for the plaintiffs, and another dozen or so testified for the Department of Corrections.
Over the years, Nelson Mullins estimates, its lawyers and paralegals spent at least 43,000 hours on the case -- time that would have cost about $9 million.
Nelson Mullins attorney Stuart Andrews, who with attorney Don Westbrook, handled most of the case, said the judge basically found the department had such "deliberate indifference" to the seriously mentally ill inmates that it amounted to "cruel and unusual punishment" under the state constitution.
"He found the department had known of this risk of substantial harm since 1999," Andrews said.
The judge found:
- Severe understaffing in the mental health program.
- A disproportionate use of force and solitary confinement, the latter exposing mentally ill inmates to "substantial risk of serious harm by limiting their access to mental health counselors."
- That substandard mental health treatment "contributed to the deaths of multiple inmates in segregation, while placing other inmates and staff at risk.
- Inadequate records to accurately track inmates' treatment and progress. That administration of key psychotropic (powerful mood- and behavior-changing) medications is inadequately supervised.
- That suicide prevention and crisis intervention policies are inadequate and have resulted in loss of life among seriously mentally ill inmates.