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NAMI-New York
State would like to thank Senator Duane and Senator Montgomery,
along with all other members of the Senate Democratic
Task Force on Criminal Justice Reform for the opportunity
to testify at this hearing. NAMI-New York State, formerly
the Alliance for the Mentally Ill of New York State is
a grass roots, self help, support and advocacy organization
dedicated to improving the lives of all people who are
affected by mental illness. We strive to enable all persons
with a mental illness and their families to live the best
life possible. We are the largest not-for-profit membership
organization in New York State representing families of
persons with severe psychiatric disabilities.
Prison within a prison-----whether referred to as The
Box, SHU, punitive segregation or any other appellation----is
rightfully attracting increased scrutiny in New York State
in light of recent news articles, deaths in correctional
facilities, growing concerns by religious organizations,
lawsuits which won't go away, and NAMI's venture into
advocacy among families of persons with mental illness
who are incarcerated in the state's correctional system.
Of the state's
72,000 persons incarcerated, nearly 5700 are confined
to 23-hour lockdown in one of the state's special housing
units (SHUs) where inmates are sent for committing serious
rule infractions. In roughly one-third of the cases, the
persons committed to these units are sentenced to the
lockdown for one year or more.
Indeed, over
the last five years, well over 50% of the new capacity
added to the state correctional system has been cells
designed for punitive segregation.
Of special
concern to those of us advocating for improved treatment
and services for persons with mental illness is the number
of inmates with mental illness who are sentenced to SHU
because of rule infractions, often involving threatening
or assaultive behavior toward other inmates or staff.
It is estimated that approximately 10% of the DOCS population
are persons with mental illness. According to information
provided to NAMI, approximately 33% of inmates transferred
to the Central New York Psychiatric Facility for intensive
psychiatric treatment are inmates with mental illness
who have deteriorated badly while housed in one of the
state's special housing units. Ironically, after receiving
treatment at CNYPC, most are then returned to the isolation
of the SHU to complete their disciplinary sentence.
The March
26 Albany Times-Union special supplement entitled Lockdown:
the Hardest Time highlighted the increased use of punitive
segregation and questioned its impact on a person's psyche.
There is already considerable consensus, however, among
mental health professionals on the damaging effect of
enforced isolation on persons with mental illness. Dr.
Stuart Grassian, a Harvard Medical School professor and
practicing psychiatrist in Boston, wrote an extensive
follow-up report on the Attica SHU last fall as part of
Prisoners Legal Services' ongoing effort to improve conditions
in special housing units. In a Times-Union article, Dr.
Grassian states that "the psychiatric evaluation
and periodic monitoring of mentally ill Attica SHU inmates
are grossly inadequate; seriously mentally ill inmates
continue to be housed in SHU, and often psychiatrically
deteriorate as a result of the stringent conditions prevailing
there." Dr. Grassian continued that "they're
taking sick people and making them sicker". "Mentally
ill people need treatment, not disciplinary punishment,"
he said.
Following
an extensive tour of several SHUs last year, Bishop Howard
Hubbard of the Albany Roman Catholic Diocese said that
SHU "dehumanizes and demonizes the person. And that
loss of dignity and stress on a person's mental health
is a great cause of concern for me". The Catholic
Bishops of New York State and the Capital Region Ecumenical
Organization, of which Bishop Hubbard is a member, have
called for fundamental changes in how inmates are disciplined
for rule infractions.
Recently,
the State Commission of Correction and the Franklin County
Grand Jury released reports on the death of an inmate
with mental illness who died after an altercation with
correction officers in the Franklin Correctional Facility's
special housing unit. According to the Commission of Correction
death report, the Christmas day 1999 death of the inmate
resulted from "positional asphyxiation" suffered
when the inmate was forced to lie on his stomach while
at least one guard applied pressure--apparently enough
to fatally inhibit breathing--to the inmate's back. The
grand jury determined that officers were not criminally
responsible, but recommended strongly that the officers
be afforded increased training in the handling of emotionally
disturbed inmates. In addition to a similar finding on
cause of death, the Commission found that a psychiatrist
who discharged the inmate from the Clinton Satellite Unit
should be disciplined because of an inadequate assessment
and inappropriate discharge of the inmate three days before
his death. The Commission also cited a DOCS' nurse for
inadequate care and urged that she be disciplined by the
Department, as well as investigated by the Office of Professional
Conduct of the State Education Department. In a second
case involving the death of an inmate from positional
asphyxia who suffered from mental illness and who died
after a struggle with correction officers in November
1999--but who was not housed in a SHU--the Dutchess County
grand jury made a series of similar recommendations with
regard to staff training. The state Commission has not
yet released its report on the Dutchess County case. In
each case, a spokesman for the Corrections Department
indicated an openness to the recommendations made.
Finally, NAMI-NYS's
recent advocacy efforts in corrections have served to
reinforce the point of view that persons with mental illness
can not receive proper treatment while locked in the state's
SHUs, and, frankly, do not belong in punitive segregation.
I can tell
you of the young man from central New York who suffers
from a serious mental illness, who originally was admitted
to a local jail on a charge of violating an order of protection
who is scheduled to "max out" of DOCS after
serving all six years of two consecutive sentences. This
young man's illness was a major factor in a series of
altercations with correctional staffs in both the local
jail and state correctional facilities which resulted
in six years of incarceration spent largely in special
housing units. Now that he is close to release, he is
participating in a day treatment program run by OMH at
a downstate correctional facility. This young man will
be released to the streets, however, in March and after
six years of incarceration, we can look back on only a
smattering of treatment he has received. How ready is
this young man to resume a life on the outside and to
participate in working on his recovery?
I can tell
you of a second young man who suffered brain damage at
birth and who spent several years in group homes as a
youngster because this was the only way his mother could
hope to obtain treatment for him. At age 16, upon release
from the group home , the young man was convicted of a
serious sex offense and is now serving a sentence of 10
to 20 years. He has been in DOCS for nearly four years
and has spent most of that time in SHU and is scheduled
to remain in SHU for the next couple of years. He will
receive medication, but no real mental health treatment.
What do we think happens to a person like this?
Obviously,
I can go on with other stories like the above--of persons
with mental illness whose misbehavior in prison gets them
into trouble and they then wind up in SHU for extended
time periods. There is no "not guilty by reason of
mental disease or mental defect" defense in the DOCS
disciplinary system.
In fairness
to DOCS, the Department does not get to choose the persons
who are committed to its care and custody. When persons
with serious mental illness are committed to it, DOCS
attempts to provide care and custody within the resources
provided and within a correctional security system not
intended to meet the needs of persons with mental illness.
This should be the subject of another hearing at another
time.
As you know,
OMH provides all mental health services to DOCS inmates
who are determined to be in need of such services. Many
inmates with mental health problems are housed in Intermediate
Care Programs and Satellite Units where OMH staff are
based and where effective care can occur with some of
the population. OMH, in fact, has recently been authorized
to increase its staffing levels substantially in these
units.
Whatever efforts
OMH staff may undertake in SHUs to provide services, however,
these services must be carried out within the operational
rules of DOCS and other constraints imposed by DOCS. In
short, OMH's duties in special housing units are largely
limited to passing out medication and periodic monitoring
of inmates--observing inmates through cell doors. Obviously,
they are also called upon to make a determination when
the inmate suffers a serious decompensation and must be
transferred to the Central New York Psychiatric Center.
Such services and attention, however, do not begin to
make for mental health treatment.
The nut of
the problem seems to be that, with DOCS' emphasis on maintaining
safety and security, there results an inflexibility in
distinguishing between the misbehavior of persons with
serious mental illness and other inmates, e.g. gang members
who are convicted of rule violations. At the risk of oversimplifying
the case, the Department sees only "good inmates"
who conform to rules, and "bad inmates" who
violate rules and who must be punished. There is no room
in the DOCS' equation for "sick inmates" who
misbehave and should be dealt with in an alternative manner.
What we are,
therefore, calling for is the development of alternative,
treatment-oriented disciplinary housing units for inmates
with a serious mental illness who do not conform to the
rules and who can not remain in an intermediate care housing
unit or other appropriate housing area so designated for
persons with mental illness because of their behavior.
We recognize that there may be no easy models to replicate,
and that many of the persons with mental illness pose
genuine challenges in terms of treatment and management.
But we are even more sure that the current system of disciplining
persons with mental illness must be abandoned and cast
into the trash heap with the Willowbrooks of this world
and the dungeons and "holes" once used for punitive
segregation in our state correction facilities. It is
now time for legislation which bars the placement of persons
with serious mental illness in SHUs and which establishes
alternative, treatment -oriented disciplinary housing
units operated by the state Office of Mental Health.
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