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Alabama DOC Settles Mental Health Class Action

The U.S. District Court for the Middle District of Alabama approved a settlement agreement between a class of prisoners, defined as "all acutely or severely mentally ill male inmates who are presently or will in the future be incarcerated in the Alabama Department of Corrections" (ADOC), and the defendant state prison officials. As a result, the case was dismissed without prejudice, and the defendant was ordered to pay the prisoners' attorneys $762,233 in costs and fees.

This case was commenced on January 15, 1992, when a group of ADOC prisoners filed suit challenging the adequacy of the mental health treatment being provided to those seriously mentally ill state prisoners by the ADOC. The prisoners were adroitly represented by Rhonda Brownstein of the Southern Poverty Law Center, and Gayle Gear, a private practitioner from Birmingham.

The litigation evolved from what one expert described as having "never witnessed more desperately mentally ill prisoners living under such horrendous physical conditions and subjected to such a low level of care." These mentally ill prisoners were reported have been "living in filth," and some were purportedly observed being "clubbed for failure to follow orders," while they were "having seizures." The delivery of mental health care within the ADOC was even characterized as "medieval."

The settlement is quite comprehensive, and it is set forth in two documents, the Settlement Agreement (SA), dated September 28, 2000, and the Agreement of Experts (AOE), dated August 8, 2000. The parties agreed to enforce the settlement only in state court, but the dismissal without prejudice allows for the commencement of a new federal action in the event of non-compliance.

The SA consists of nine principal sections that establish a schedule for implementing various improvements, such as comprehensive mental health policies, procedures, and program manuals; bed space increases and mental health facility renovations, staff increases and training; and a requirement of National Commission on Correctional Health Care (NCCHC) accreditation by April 2002. The SA also includes the appointment of Jane Haddad, Psy.D., to facilitate the implementation of the agreement, and to oversee its compliance. In addition, Suzanne Ducate, M.D. was tabbed for her expertise in psychiatry.

Beginning in October 2000, Dr. Haddad was to assist the ADOC with implementing the SA. From June 1, 2001, and to June 1, 2003, the SA requires Dr. Haddad to "tour up to five of the ADOC's major prisons four times per year." The objectives of these `tours' are clearly enunciated in the SA, and it includes strict reporting requirements by both the ADOC and Dr. Haddad.

By July 1, 2003, Dr. Haddad will also be required to issue a "final report detailing the ADOC's overall effort at achieving compliance with the terms of the Settlement Agreement." This final report must also include any recommendations that may be necessary for "the ADOC to achieve or maintain substantial compliance" with the SA.

The Agreement of Experts is a much more detailed, 12-page document, beginning with a list defining the terms serious mental illness, mental health profession, individual counseling, group programming, mental health rounds, and treatment plan. There is also a section outlining the various levels of mental health care, including crisis intervention services, intensive psychiatric stabilization, and inpatient, residential and outpatient treatment.

The AOE also enumerates the components of "adequate treatment," rather than simply mandating such treatment and leaving the actual standard of care delivered to the discretion of state clinicians and administrators. In addition, the AOE meticulously outlines the elements that are necessary for the implementation of policies and procedures that will be consistent with NCCHC standards. The AOE further establishes minimum staff training, psychiatric bed space, and staff/patient ratios. The latter should result in 75 to 80 new staff positions devoted to the treatment of the seriously mentally ill.

Following the settlement, a commentator in the Correctional Mental Health Reporter (Nov./Dec. 2000) observed that "this settlement is superimposed not on a marginally deficient system but on a desperately poor system which also decided to fight, delay, and obfuscate during the litigation." Nevertheless, it was noted that Dr. Haddad believes that, if the settlement reaches "fruition then ... Alabama will not only have a constitutional correctional mental health care system but one that provides acceptable care for inmates with serious mental illness." Given the history of the ADOC, this may be a substantial achievement. See: Bradley v. Haley, USDC no. 92-A-70-N (M-D. Ala. Sept. 28, 2000).

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Related legal case

Bradley v. Haley