Mentally Ill Inmates: Patients, Not Just Prisoners

Ezekiel Edwards

Mentally Ill Inmates: Patients, Not Just Prisoners

On Sunday night, 60 Minutes aired a report on the outrageous prison death of Tim Souders, a 21-year-old man with a history of mental illness who died of dehydration amid 100-degree heat due entirely to the institutional negligence and medical ineptness of the Michigan Department of Corrections (click here to read a summary and/or watch the program). Specifically, Mr. Souders, incarcerated for shoplifting and threatening store employees with a knife, was shackled in "top of bed restraints" for up to 17 hours at a time over a period of four days, during which period he repeatedly urinated on himself, and despite his obvious severe mental illness, pleas for help, and increasingly urgent need for serious medical attention, was left to collapse onto the floor of a prison cell, dead.

I wrote about his story in greater detail a few months ago (see "Torture in American Prisons"), highlighting the withering decision by Federal District Court Judge Richard Alan Enslen in which he categorizes the treatment of Mr. Souders as "torture". Reading about the case was appalling; watching actual video footage of Mr. Souders' demise (he was kept under video surveillance the entire time), of him chained to a bed naked, of his actual death, was horrific and unbearable.

This case is alarming not just in and of itself, but because it is not an isolated occurrence and because we are in danger of seeing many more like it. It is the result of a nationally-overburdened prison system, over 2.3 million strong, which finds itself forced to treat 300,000 mentally ill patients - and failing. It is not just the Hadix facilities in Michigan where a tragedy so easily unavoidable could occur (which themselves were already under court supervision following a successful suit by its inmates in the 1980's regarding prison conditions), it could be repeated in the hundreds of similar facilities nationwide strewn like debris across our prison-littered landscape. 60 Minutes cited another example of an inmate who died of thirst in Michigan alone (and who, not surprisingly, was also mentally ill and in solitary confinement when he died).

Undoubtedly, mental illness can be excruciatingly difficult to treat. I had clients in the Bronx whose severe mental illness complicated their prison care, our ability to communicate about their health, needs, and case, and my ability to represent them. But the complexity of mental illness is all the more reason that poorly-trained (if at all) prison staff should not be left to care for mentally ill prisoners. Putting a state prison under a federal court's watch, while a helpful and often necessary step, is not enough. Resources need to be re-deployed to create more hospitals for the mentally ill, many of which have been closed over the past few decades, leaving prisons to fill the void. In cases where prisons must house people with mental illnesses, experts must be available around the clock to assess, diagnose, and treat them, not as prisoners, but as patients.

After all, wardens are not doctors. Corrections officers are not psychologists. Even many social workers are not always prepared to diagnose, let alone treat, serious mental illness. Moreover, many prison employees have been made cynical to the point of indifference by their difficult jobs, and prisoners in precarious predicaments cannot be left to the apathetic whims of bureaucracy.

The potential result of relying on prisons - whose primary purpose in our country is to punish, not rehabilitate - to handle mentally ill inmates is ignominiously illustrated by Tim Souders' case: leaving inmates to die of dehydration while chained to a slab; treatment not fit for an animal, let alone a human being.