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Florida DOC Agrees to Reform Prisoner Mental Health Care

Disability Rights Florida, the state’s Protection and Advocacy organization for people with disabilities, has reached a settlement agreement with the Florida Department of Corrections (FDOC) that includes widespread changes to mental health treatment for prisoners.

The agreement was filed in conjunction with the complaint in federal district court in January 2018, and approved the following month. The settlement was the culmination of a multiyear investigation by Disability Rights Florida into the care and treatment of FDOC prisoners with mental health issues. The parties engaged in a year-long series of mediation sessions and reached the agreement with the assistance of federal judge Harvey Schlesinger.

Florida has over 18,000 state prisoners diagnosed with a mental illness that requires treatment. The FDOC operates 10 inpatient mental health units in prisons that treat about 1,200 prisoners whose mental illness significantly impairs their ability to function in a general prison environment.

The complaint alleged the FDOC provided only “cookie-cutter” Individual Service Plans (ISPs) that rarely changed, and treatment typically lacked any meaningful content and had “little to no direct relationship” to the prisoner’s actual mental health condition or ISP. Rather than provide appropriate care, “assignment to an inpatient unit amounts to little more than prolonged isolation similar to disciplinary confinement or close management.” 

Further, the complaint cited a lack of qualified clinical staff and guards in the inpatient mental health units, and condemned the use of involuntary medication, restraints and punishment for behavior caused by prisoners’ mental illness. It also alleged the FDOC had “no system to identify and correct systematic deficiencies in the quality of care in the inpatient mental health units.”

The settlement addressed those issues. It requires the creation of ISPs that tailor treatment to the individual needs of the prisoner, and Multidisciplinary Services Teams were created that must meet and address each prisoner’s care needs at the initial stage and at regular and emergent intervals.

Evidence-based practices and measures will be implemented, which include ten hours per week of structured out-of-cell treatment and no less than ten hours of unstructured out-of-cell time that includes at least five hours of outdoor exercise. The FDOC agreed to train staff with respect to clinical orders, checking on patients and motivational interviews of prisoners who refuse mental health treatment.

Additionally, the agreement implements new policies to address the excessive isolation and use of restraints and disciplinary reports that were previously used to address behavioral problems related to a prisoner’s mental illness. The new policies specify that psychological staff provide counsel and advice before disciplinary action is taken.

“This settlement agreement represents significant changes in the way inmates with serious mental illness receive care and treatment while serving sentences in Florida’s prisons,” said Maryellen McDonald, then-executive director of Disability Rights Florida. “With the dramatic rise of individuals with serious mental illness entering our criminal justice system, it is no surprise that our state prisons sadly become the last stop for those most at risk of severe psychiatric crisis.” 

Attorneys from Disability Rights Florida, Florida Legal Services and the law firm of Holland & Knight represented Disability Rights Florida in the lawsuit; a settlement regarding attorney fees was reached in August 2018. See: Disability Rights Florida v. Jones, U.S.D.C. (M.D. Fla.), Case No. 3:18-cv-00179-HES-JRK.

Previously, a settlement in a similar lawsuit filed by Disability Rights Florida resulted in the FDOC agreeing to reforms to ensure prisoners with physical disabilities receive the services and accommodations they need. [See: PLN, Mar. 2018, p.44]. 

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Related legal case

Disability Rights Florida v. Jones