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Mental health and the SCDC

Posted: January 10, 2014 9:27 a.m.
Updated: January 13, 2014 5:00 a.m.

I am not a mental health expert, nor an expert on running corrections facilities, whether they be detention centers, like our county jail, or major institutions such as Wateree Correctional over the Sumter county line.

Nevertheless, I was intrigued by the recent news that a South Carolina Circuit Court judge ruled against the S.C. Department of Corrections (SCDC) in a 2005 lawsuit claiming the agency violated the Constitutional rights of mentally ill inmates.

The plaintiffs are listed as three detainees, by initials only; “similarly situated” inmates; and a group called Protection and Advocacy for People with Disabilities Inc.. They filed suit against the SCDC and Camden’s Bill Byars as the agency’s director.

Keep in mind, in 2005, Byars was busy heading up the S.C. Department of Juvenile Justice (DJJ). I suspect his name is on the lawsuit now only because he was the agency’s most current permanent director.

The action was a class action lawsuit brought on behalf of approximately 3,500 state inmates who met the definition of being mentally ill. That included inmates with diagnoses ranging from schizophrenia to some type of psychotic disorder, “or any other mental condition that results in significant functional impairment.” S.C. Circuit Court Judge Michael Baxley wrote that the evidence “has proved that inmates have died” in SCDC and that hundreds more remain at risk.

“As a society, and as citizen jurors and judges (who) make decisions that send people to prison, we have the reasonable expectation that those in prison -- even though it is prison -- will have their basic health needs met by the state that imprisons them. And this includes mental health,” Baxley wrote in his order.

I can’t disagree with that sentiment. Baxley concluded that expectation to be “misplaced in many instances.”

However, Baxley also noted that the country’s economic downturn likely led to more mentally ill people ending up in prison. Further, he wrote, “The Court recognizes that the Department is underfunded and understaffed in many particulars, not just mental health services delivery.” Baxley also wrote that the SCDC mental health system’s “inadequacy ... has not occurred by design, but instead by default,” but felt he still had to rule against the agency.

SCDC claimed its mentally ill population stood at 12.9 percent of the total inmate population. Baxley said evidence showed it closer to 17 percent. That’s significant and should be addressed in many ways -- and not just by SCDC. Even seeking treatment for mental health issues still carries a stigma in this country, although I believe things have been getting better in that regard in recent years.

To me, that means we as a society must find a way to reduce mentally ill people from ending up in prison in the first place. Depending on the nature of their criminal charges, prison may or may not be the best place for them.

Baxley’s ruling included six findings:

• That SCDC’s mental health program is severely understaffed.

• Seriously mentally ill inmates are exposed to a disproportionate use of force and segregation (solitary confinement) compared to other inmates.

• SCDC’s mental health services doesn’t maintain accurate and complete treatment records.

• SCDC’s screening and evaluation process is ineffective in identifying inmates with serious mental illness.

• SCDC’s administration of psychotropic medications is inadequately supervised and evaluated.

• SCDC’s current policies and practices concerning suicide prevention are inadequate and have led to loss of life.

SCDC put out a short statement saying it plans to appeal the ruling: “Mental health is not just a corrections problem, it’s a national problem that all sectors of society are working to address.”

That is certainly true, and I agree; that doesn’t necessarily mean that SCDC shouldn’t be working to improve how it handles mentally ill inmates. At the same time, the appeal places the findings back into the realm of allegation.

I’m not discounting those allegations, but I have to go back to Baxley’s own statements that SCDC’s “inadequacies” are “by default” and that it is severely understaffed and underfunded. The General Assembly should find a way to more adequately fund the agency to handle the population it ends up with as well as developing policies and programs to further reduce the overall prison population -- something Byars already had success with. And, as a I said a little earlier, the state (society) should work on ways to reduce that segment of the state’s population. As Baxley noted, the general population with mental illness is only 4 percent, not the 17 SCDC might have.

Baxley ordered that SCDC must submit a written plan to correct the deficiencies; must rely on factors and guidelines identified in the ruling to create the plan (which the court will approve or disapprove); and the court will appoint expert monitors and/or special master to oversee implementation of the plan.

It’s reminiscent of the oversight Byars inherited at DJJ due to problems that manifested under his predecessors. He successfully guided DJJ out from under that oversight. I can’t quite tell if Baxley’s ruling comes from an understanding of current conditions at SCDC as opposed to those in 2005 when the suit was filed. I’m willing to bet Byars already had staff deal with many of these things before he retired last year.

Hopefully, acting Director Bryan Stirling or his successor can do the same for SCDC while, hopefully, the state does a better job of providing him the resources to do so.

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