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Hawaii Prison System Failing to Uphold Agreement on Mental Health Care

The suicides of three prisoners over a four-month period in mid-2017 brought new scrutiny to the Hawaii Department of Public Safety (DPS). Coming just two years after reaching a settlement with the U.S. Department of Justice (DOJ), the trio of suicides raises concerns that DPS officials are not following the plans that resolved the DOJ’s lawsuit over mental health care at the Oahu Community Correctional Center (OCCC).

Filed in 2008, the suit alleged that the DPS exhibited “deliberate indifference to the mental health needs” of prisoners at OCCC, where current DPS director Nolan Espinda was then the warden. After six years of wrangling, a settlement was reached in 2014 and the DPS agreed to a corrective action plan to bring mental health care up to constitutional standards. In June 2015, the DOJ found that OCCC was in compliance and settled the litigation.

However, OCCC medical director Dr. Lori Karan was fired the following month. Mental health services declined from 20 hours a week in June 2015 to just five hours a week, said Dr. Mark Mitchell, who created the corrective action plan approved by the DOJ.

Mitchell claimed he was terminated in retaliation after he complained about declining standards of care.

Since the federal lawsuit was settled, 25 of 61 budgeted positions in DPS’ mental health branch – 40 percent – became vacant as of November 2017. Of the 20 positions reserved for psychologists and other mental health staff at OCCC, 10 were vacant.

Eric Seitz, an attorney advocating for the families of the prisoners who committed suicide, called the treatment they received “atrocious.”

“[I]t amounted to punishment,” he added.

One of the prisoners who committed suicide was Joseph O’Malley, 28, who killed himself in his cell soon after guards released him from suicide watch. O’Malley’s father, who is an attorney, said there was “no excuse” for his son’s death.

“I would like to see meaningful reform of our prison system,” he stated.

Though O’Malley believes his son was denied access to mental health care while incarcerated, he was undecided whether he would join Seitz in a planned class-action suit.

Another prisoner, Jessica Fortson, hanged herself at WCCC in July 2017. The thirty-year-old, who suffered from bipolar disorder, was serving a five-year sentence for credit card fraud and identity theft. She was supposed to be released in January 2018. At the time of her death, Fortson was being held in solitary confinement for assaulting another prisoner. WCCC officials confirmed she was not on suicide watch.

Several DPS employees, who requested anonymity, said that “comprehensive treatment plans” are completed for only about half of mentally ill prisoners, rather than at least 90 percent as required by the DOJ settlement. The DPS created a simplified treatment form which one employee called “short and superficial – more like a checklist than a plan,” adding that it was “not meaningful.”

To address the therapeutic session requirements for mentally ill prisoners, Espinda said the DPS used a “color-crayon program” – individualized worksheet activities that, in an analysis of logs from August and September 2017, made up nearly two-thirds of the hours that were counted as therapeutic sessions in Module 1, which houses prisoners suffering from the most acute mental illnesses.

According to a memo from Gavin Tekenaka, the mental health branch’s acting administrator, “budget constraints” required a ban on overtime. As part of the resulting staff shortage, Tanenaka confirmed in emails that monitoring prisoners on suicide watch on weekends and holidays had to be conducted by employees who were not mental health professionals.

Despite the staff shortages, including Mitchell’s termination, Espinda did not renew the contracts of Victor Yee, who managed OCCC’s mental health section, and Jackie Lee, a nurse in Module 1. [See: PLN, Dec. 2017, p.33].

“You had the best minds in the country come in and spend years providing a blueprint for how to provide the care and, as soon as the settlement agreement expires, you throw it away,” said Russell Van Vleet. “These three people he let go – they were the only people who could provide the supervision necessary to comply with the settlement agreement.”

Van Vleet, who oversaw the settlement as one of several court-appointed monitors, said the DPS had simply abandoned any effort to maintain its end of the bargain it made as part of the agreement.

The three prisoner suicides last year occurred at the Kulani Correctional Facility, Halawa Correctional Facility and Women’s Community Correctional Center (WCCC). They were among a total of five since April 2014. Five other prisoner deaths during that time period were attributed to a pair of murders, an “accidental water intoxication” and two incidents in which prisoners died on work furlough.

On average, two DPS prisoners die each year due to “unnatural, non-illness-related causes.” The agency claimed the recent spike in suicides did not alter that average.

“We are confident that our practices are sound,” stated DPS spokeswoman Toni Schwartz.

However, the American Civil Liberties Union of Hawaii recently asked the DOJ to investigate inadequacies in medical and mental health care at DPS facilities.

“Very quickly ... conditions have deteriorated not just in terms of the general conditions but also for mental health services,” said ACLU legal director Mateo Caballero. 



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