Advances in Treatment for Inmates with Mental Illness

November 2007

After years of advocacy by the Correctional Association and the Mental Health Alternatives to Solitary Confinement (MHASC)—a coalition of mental health and prisoner advocates, formerly incarcerated individuals, and family members of inmates— New York is on the verge of enacting landmark legislation that will significantly improve treatment of the mentally ill in prison.

More than half of the 2.2 million inmates in the U.S. suffer from mental health problems, and yet many receive little treatment while incarcerated. Ending the practice of placing inmates with mental illness in solitary confinement has long been a cornerstone CA issue.

In Lockdown New York (2003) and Mental Health in the House of Corrections (2004), we reported that many mentally ill inmates in New York ’s prisons have a difficult time following orders and/or controlling their behavior. As a result, they wind up in “Special Housing Units” or “SHUs” in disproportionate numbers. There, they are isolated for 23 to 24 hours a day for weeks, months, sometimes years at a time, with minimal human contact. These isolated and harrowing conditions frequently make their illness worse, endangering both inmates and the prison staff.

In March, New York settled a lawsuit brought by Disability Advocates, Inc. (DAI), resulting in a requirement that mentally ill inmates receive two hours of therapy a day while in SHU and that the state create a Residential Mental Health Unit (RMHU)—a 100-bed unit for mentally ill inmates. The state also agreed to several other advances that secure better conditions and limit punitive measures for prisoners with mental illness.

While positive in many ways, the DAI settlement did not prohibit housing mentally ill people in SHUs. The CA and its allies sought to end this practice with a new piece of legislation that gained the support of Senator Michael Nozzolio, Chair of the Senate Crime Victims, Crime and Correction Committee; Assemblymember Jeffrion Aubry, Chair of the Assembly Committee on Correction; and of the union representing New York State correctional officers. This bill passed both the Assembly and Senate in June, but was stalled due to concerns raised by corrections and mental health agencies and by the Executive Branch.

During the intense negotiations that followed, the CA and MHASC were consulted about changes to the bill and had significant input into the final version, which was agreed to by all parties. The modified bill passed in the Senate in July. We anticipate it will pass the Assembly when it returns in December, and then be signed into law by Governor Spitzer. To be sure, the modified version involves compromises. However, it contains several components aimed at improving conditions for segregated inmates with mental illness, including requirements that:

• Nearly all inmates with serious mental illness facing 30 days in SHU be diverted or removed to an RMHU.
• RMHUs be therapeutic environments with four hours of daily therapy.
• DOCS only place mentally ill inmates on a restricted diet or return them to the SHU in extremely limited circumstances.
• All inmates in SHUs be regularly assessed by mental health clinicians to determine any adverse effects to their mental health.

While passage of this legislation would constitute a significant victory, our work will not be finished. Through prison visiting, the CA will continue to monitor implementation of the legislation and report on conditions in SHUs and in the RMHUs, once they are constructed. With continued support from allies, we will see to it that the better conditions promised for inmates with mental illness become a working reality in the state’s prisons.