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Crazy Punishment 

The state continues the dubious practice of placing mentally ill inmates in solitary confinement

It's commonly called "supermax," although Arizona corrections officials won't use that tough term. Nonetheless, this special form of solitary confinement--created for the worst and otherwise uncontrollable inmates--is being used to isolate the mentally ill in our state prisons.

According to one reform group, that is both counterproductive and inhumane.

"Solitary confinement makes crazy people crazier," says Caroline Isaacs, director of the Arizona American Friends Service Committee, which has its headquarters in Tucson. "Even healthy people will sometimes decompensate and start experiencing symptoms of mental illness if they're put in isolation for prolonged periods."

That also has ramifications for the rest of us, she says, since most inmates who spend time in these maximum-security sections--known as "special management units," or SMUs--eventually return to our communities.

In response, last year, the AFSC kicked off its StopMax Arizona Campaign, aimed at ending the use of solitary confinement across the state. The first stage of that effort targets the long-term isolation of mentally ill inmates.

Studies have shown that inmates with mental-health issues tend to have related behavioral problems, which can land them in maximum-security situations more often than other prisoners. That's certainly evident within Arizona's correctional system, says Isaacs. "There's clearly a high concentration of people with serious mental illness in the SMUs. They're only about 18 percent of the general population, compared with 26 percent in the SMU."

But prison officials dispute those numbers, stressing that the Arizona Department of Corrections doesn't indiscriminately dump mentally ill inmates into maximum-security isolation.

"We don't really have what I consider to be solitary confinement," says Dona Markley, ADC's deputy director. Still, she concedes that problem inmates are isolated, including those with mental-health issues. For example, a headcount at the end of August revealed 33 maximum-custody inmates with elevated mental-health scores. Of those, 28 were men, and five were women. "But since we regularly assess placement," she says, "the numbers do change."

In turn, an inmate's mental-health status is ranked on a scale from one to five; the lowest are prisoners needing no mental-health intervention, while a score of five mandates intensive psychiatric services. Those falling in the middle seem most likely to fall through the cracks. "It's the threes that we really can't agree on," says Isaacs.

According to Markley, the 28 men in maximum custody are awaiting transfer to a licensed ADC behavioral-health facility in Phoenix.

She adds that guidelines for determining where inmates are placed are codified in department policy. Among other things, the policy dictates that inmates receive a mental-health evaluation within 90 days of incarceration. It also directs how and why they're to be placed in maximum security. Circumstances could include mental-health emergencies, or instances when inmates display enough mental illness that they need to be in a "high-custody setting," but aren't deemed ill enough to require immediate placement in a psychiatric facility. They can also be put in maximum security if they've been released from a psychiatric facility, but continue to display aggressive or violent behavior.

Isaacs maintains that those inmates can be held in their cells, described as roughly the size of a bathroom, for up to 23 hours a day, and that five years is the average stay in special management units. She also claims that there are only nine mental-health professionals to serve all 1,600 inmates in maximum security. Often times, she says, those professionals only monitor inmates through a tiny window in the cell door.

But Markley says the time inmates spend in their cells each day varies, "according to what their needs are, and how many times they are coming out for treatment."

Does that mean inmates can be held nearly around the clock, as claimed by Isaacs? "I'm sure it's possible," Markley says, "but I don't know what the average is, because there is constant contact with other individuals who are monitoring them, and there is recreational time. It would vary as to the risk of the inmate, and his medical and mental-health needs."

However, Isaacs calls this a vicious circle, with people ending up in special management units simply because they're too mentally ill to follow the rules. "Then you get people going in there for other reasons who crack under those conditions. You have people who are developing mental illness inside the SMU."

Indeed, this level of confinement draws fire from a variety of quarters--including international bodies such as the United Nations Committee Against Torture, which has cited serious concerns with America's maximum-security prisons.

The situation is exacerbated by the sheer numbers: Nationally, prisons handle twice as many mentally ill people as do state mental hospitals. It's also an inherently deleterious situation. When the mentally ill are placed in small cells, their conditions often only worsen--which makes them more likely to exhibit "bad" behavior, leading to ever-harsher discipline. Human Rights Watch has also called prisons "dangerous and damaging places for mentally ill people." In an extensive 2003 report, the group cited "deep-rooted patterns of neglect, mistreatment and even cavalier disregard for the well-being of vulnerable and sick human beings."

Within the Arizona prison system, Isaacs and her group have been pressuring ADC director Dora Schriro to remove all mentally ill inmates from solitary confinement--a measure the director hasn't agreed to, says Isaacs. And while the department claims to have transferred several inmates with mental-health ratings of four or five from maximum-security into psychiatric-treatment units, she says this is impossible to verify.

But at the very least, "we want a verbal agreement in good faith that people with serious mental illness should not be in the supermax," Isaacs says.

So far, that demand is apparently getting little more than lip service from the Department of Corrections--and the AFSC is willing to go to court if necessary.

"The ADC is definitely vulnerable to a lawsuit. These kinds of suits have been very successful in other states," Isaacs says.

More by Tim Vanderpool

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