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South Carolina’s Treatment of Mentally Ill Unconstitutional

by David M. Reutter

A South Carolina Court of Common Pleas found the South Carolina Department of Corrections’ (SCDC) “mental health system exposes seriously mentally ill inmates to a substantial risk of serious harm.”

The court began its order by stating that of the 70,000 cases that has come before it over 14years, “[t]his case, far above all others, is most troubling.”  The class action before it was “brought on behalf of approximately 3,500 state inmates who meet the definition of being seriously mentally ill.”

The court made six threshold findings.  First, the mental health program at SCDC is severely understaffed, particularly with respect to mental health professionals, to such a degree as to impede the proper administration of mental health services.  Second, seriously mentally ill prisoners are exposed to a disproportionate use of force and solitary confinement when compared with non-mentally Ill prisoners.

Third, mental health services at SCDC lack a sufficiently systematic program that maintains accurate and complete treatment records to chart overall treatment, progress or repression of prisoners with mental illness.  Fourth, SCDC’s screening and evaluation process is ineffective in identifying prisoners with serious mental illness and in providing those it does identify with timely treatment.

Fifth, SCDC’s administration of psychotropic medications is inadequately supervised and evaluated.  Finally, it found SCDC’s current policies and practices concerning suicide prevention and crisis intervention are inadequate and have resulted in unnecessary loss of life among seriously mentally ill prisoners.

SCDC argued at trial “that reference to an individual inmate and his/her particular situation was anecdotal and not indicative of the general administration of mental health services.”  The court rejected such situations as being only “outliers” that brought an unfortunate result.

The court’s order then goes on to make factual findings.  The first concerned the failures in screening and evaluation at intake, which fails to adequately identify and classify prisoners suffering from serious mental health.

It then found “SCDC places heavy reliance on segregation and physical force against seriously mentally ill inmates, as opposed to treatment.”  A mentally ill prisoner, the facts showed, “is twice as likely to be placed in segregation as a [non]-mentally ill prisoner.

They also are “more than three times likely to be assigned “to solitary confinement for indefinite periods.  While there, they “receive no group therapy and [no] sessions with both psychiatrists and counselors are seldom held in a confidential setting.”

The confinement cells “are both extremely cold and inordinately filthy”.  The court detailed the death of mentally ill prisoner Jerome Laudman on February 7, 2008.  As PLN reported , he was sprayed with “physical munitions and physically abused” by a guard while in Supermax.   He lay in a cell for a week before being found near death, and later died in a hospital.  The hospital found he had hypothermia upon arrival. 

SCDC guards “routinely gas inmates with OC spray in amounts that exceed manufacturer instructions and at distances closer than the manufacturer directs”.  One expert, Steve J. Martin, testified he had “never seen MK-9, a crowd control contaminate, so frequently used by a correctional force inappropriately.”

SCDC also inappropriately used restraint chairs, placing even seriously injured prisoners in them for hours.  They found “excessive uses of force have been largely unreported, uninvestigated, and unmanaged.”

The court also found over 100 placements of prisoners into alternative Crisis Intervention (CI) cells over a 27 month period.  All CI cells are on segregation rather than a medical setting.  In the 100 placements noted above, the alternative when CI cells are full is to place prisoners naked into “show stalls, ‘rec cages’, interview booths, and holding cells for hours and even days at a time.”

Seven mentally ill prisoners who died “from 2008-2011 were both foreseeable and preventable,” Dr. Raymond F. Patterson testified.  The court noted that two more deaths occurred during trial.  The court found there was a lack of constant observation of suicidal prisoners.  It also spent some time detailing the facts to show inadequate and unqualified staff existed.  It even detailed instances of psychiatrists not knowing what CI ir SMU (Special Management Unit) meant, who was responsible for creating treatment plans, and doctors who had never visited the units that house the mentally ill.

The court found SCDC was aware of these situations, and its decision “should not come as a shock to SCDC.”  Over the eight years of litigation, SCDC “fought this case tooth and nail.”

It spent “hundreds of thousands of tax dollars [ ] defending this lawsuit, at trial, and most likely now on appeal,” which “would be better expended to improve mental health services delivery in SCDC.  The court ordered SCDC to submit a remedial plan and entered judgment for the class.  

See: T.R. v. South Carolina Department of Corrections, South Carolina Fifth Circuit Court of Common Pleas, Case # 2005-CP-40-2925

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Related legal case

T.R. v. South Carolina Department of Corrections