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New York Promised Help for Mentally Ill Inmates – But Still Sticks Many in Solitary

In New York, inmates diagnosed with “serious” disorders should be protected from solitary confinement. But since that policy began, the number of inmates diagnosed with such disorders has dropped.

In New York, inmates diagnosed with “serious” disorders should be protected from solitary confinement. But since that policy began, the number of inmates diagnosed with such disorders has dropped. (©iStockphoto.com/Hélène Vallée)

This story was co-produced with WNYC.

When Amir Hall entered New York state prison for a parole violation in November 2009, he came with a long list of psychological problems. Hall arrived at the prison from a state psychiatric hospital, after he had tried to suffocate himself. Hospital staff diagnosed Hall with serious depression.

In Mid-State prison, Hall was in and out of solitary confinement for fighting with other inmates and other rule violations. After throwing Kool-Aid at an officer, he was sentenced to seven months in solitary at Great Meadow Correctional Facility, a maximum-security prison in upstate New York.

Hall did not want to be moved. When his mother and grandmother visited him that spring, Hall warned them: If he didn't get out of prison soon, he would not be coming home.

Amir Hall (Photo courtesy of Tiffany Adams)A grainy tape of Hall's transfer on June 18, 2010, shows prison guards spraying chemicals into his cell, forcing him to come out. He barely says a word as he is made to strip, shower, bend over and cough. His head drops, his shoulders slump. His face is blank and expressionless. He stares at his hands, except for a few furtive glances at the silent guards wearing gas masks and riot gear.

"There was somebody who looked defeated, like the life was beat out of him," said his sister Shaleah Hall. "I don't know who that person was. The person in that video was not my brother."

Multiple studies have shown that isolation can damage inmates' minds, particularly those already struggling with mental illness. In recent years, New York state has led the way in implementing policies to protect troubled inmates from the trauma of solitary confinement.

A 2007 federal court order required New York to provide inmates with "serious" mental illness more treatment while in solitary. And a follow-up law enacted in 2011 all but bans such inmates from being put there altogether.

But something odd has happened: Since protections were first added, the number of inmates diagnosed with severe mental illness has dropped. The number of inmates diagnosed with "serious" mental illness is down 33 percent since 2007, compared to a 13 percent decrease in the state's prison population.

A larger portion of inmates flagged for mental issues are now being given more modest diagnoses, such as adjustment disorders or minor mood disorders.

Shaleah Hall, Amir's sister, has  'In Loving Memory of Amir' tattooed in a curling ribbon on her right bicep. (Photo courtesy of Shaleah Hall) It's unclear what exactly is driving the drop in "serious" diagnoses. But "whenever you draw a magic line, and somebody gets all these rights above it and none below it," said Jack Beck, director of the Prison Visiting Project for the nonprofit Correctional Association of New York, "you create an incentive to push people below." The association was one of a coalition of organizations that called for the change in policy.

The New York Office of Mental Health says the decrease reflects improvements to the screening process. Efforts to base diagnoses on firmer evidence "has resulted in somewhat fewer, but better-substantiated diagnoses" of serious mental illness, said a spokesman for the office in an emailed statement.

In Hall's case, prison mental health staff never labeled his problems as "serious."

Instead, they repeatedly downgraded his diagnosis. After three months in solitary — during which Hall was put on suicide watch twice — they changed his status to a level for inmates who have experienced "at least six months of psychiatric stability."

Two weeks after his diagnosis was downgraded, and two days after he was transferred to solitary at Great Meadow, guards found Hall in his cell hanging from a bed sheet.

As part of a report issued on every inmate death, the Corrections Department's Medical Review Board found no documented reason behind the change in Hall's diagnosis.

A 2011 Poughkeepsie Journal investigation detailed a spike in inmate suicides in 2010, which disproportionately took place in solitary confinement. Death reports from the state's oversight committee obtained by the Journal suggest several inmates who have committed suicide in recent years may have been under-diagnosed.

Hall's family is suing the Corrections Department and the Office of Mental Health, among other defendants, for failing to treat his mental illness and instead locking him in solitary.

Sonya Hall, Amir's aunt, wonders why her nephew was locked up in solitary confinement if he was dealing with a mental illness. (Shannon DeCelle for ProPublica)"If someone knew anything, had any inkling that there was that going on, why was he put there?" asked his aunt Sonya Hall.

New York State's Office of Mental Health, which is in charge of inmates' mental health care, declined to comment on Hall's case, citing the litigation.

Amir Hall (or Mir, as his family calls him) was originally arrested in October 2007, for the unarmed robbery of a Verizon store. He made off with $86. Released on parole, he lived with his sister Shaleah Hall and her two sons while working at a local Holiday Inn and studying to become a nurse.

"Sometimes I sit there thinking that he's going to walk through the door and make everybody laugh," said Shaleah, who has "In Loving Memory of Amir" tattooed in a curling ribbon on her right bicep. "He was the life of the party. If you met him, you would just love him."

But Hall's mood could shift in an instant, Shaleah said. He was often paranoid, worried that people judged him for being gay. He would snap, then apologize repeatedly for it afterward.

"You had to walk on eggshells sometimes, because you never knew if he was going to be happy or sad that day," Shaleah said. "It was like this ever since we were kids."

One of those outbursts landed Hall back in prison for violating parole, after he got into a fight with Shaleah's friend.

Knowing her brother's history of mental illness, Shaleah said solitary confinement must have "drove him crazy."

"I feel like they treated him like an animal," she said. "They just locked him away and forgot about him."

The lawsuit over Hall's death claims mental health and prison staff ignored recommendations that he receive more treatment, and that staff members failed to properly assess his mental health when he arrived at Great Meadow.

In a response to the state oversight committee's assessment of Hall's case, the Office of Mental Health said they were retraining staff on screening for suicide risk. The Corrections Department said they were working to improve communication when inmates are transferred to new facilities.

Sarah Kerr, a staff attorney with the Prisoners' Rights Project of the Legal Aid Society, noted Hall's case during a Senate hearing on solitary confinement. "The repeated punitive responses to [Hall] as he psychiatrically deteriorated in solitary confinement exemplify the importance of vigilance and monitoring, and the need for diversion from harmful solitary confinement," she wrote.

Kerr points out that significant improvements have been made for inmates diagnosed above the "serious" mental illness line. The new mental health units provide at least four hours of out-of-cell treatment a day, and speed up an inmate's return to the general population.

"I don't think those improvements should be taken lightly," said Kerr. "In terms of mental health policy, we're way ahead of the country."

But when it comes to solitary confinement, "New York is among the worst states," said Taylor Pendergrass of the New York Civil Liberties Union, which is suing the state over its use of isolation. "Even if you're totally sane and you go into solitary, it's incredibly hard to deal with the psychological toll of that," he said.

Solitary confinement is used in jails and prisons across the country, though there's no reliable data to compare its prevalence among states. Experts say New York stands out for sentencing inmates to solitary for infractions as minor as having too many postage stamps or a messy cell. A report from the NYCLU found that five out of six solitary sentences in New York prisons were for "non-violent misbehavior."

Under the state's new law, all inmates housed in solitary — known in New York as Special Housing Units, or SHU — receive regular check-ins from mental health staff. The screenings are meant to catch inmates not originally diagnosed with a disorder who develop problems in isolation.

But Jennifer Parish, director of criminal justice advocacy at the Urban Justice Center, said she thinks many staff members still view inmates' symptoms as attempts to avoid punishment. "If you don't believe that being in solitary can have detrimental effects to a person's mental health, you're going to see someone who just says, 'I want to get out of here,'" she said.

Beck has seen the same skepticism in conversations with some prison staff. "There's a bias in the system that looks at the incarcerated population as anti-social, malingerers, manipulators," Beck said. "I hear that all the time."

When inmates ask to see mental health staff, "we have found far too often that it appears security staff really resent people asking for these interventions," Beck said. "We have in a few facilities what I think are credible stories of individuals being beaten up when they want to go to the crisis center."

As Sarah Kerr sees it, "if mental health staff are overly concerned that people are feigning illness, that they're conning their way out of special housing ... that will lead to tragedies."

The Corrections Department says any unusual behavior by inmates or attempts to hurt themselves are reported to mental health staff. A spokesman for the Office of Mental Health said "inmates reporting psychiatric symptoms are taken seriously and assessed carefully."

Donna Currao said prison staff ignored her and her husband, Tommy Currao, when he attempted suicide at least 10 times over the course of 10 months in solitary confinement. According to his wife, Currao had been sent to solitary after testing positive for heroin.

Currao's first suicide attempt in solitary was in July 2012, when he tried to overdose on heroin. That October, guards found him attempting to hang himself in his cell. While on suicide watch after he tried again to overdose, Currao broke open his hearing aid and used the metal inside to cut his wrists. (He received a bill of $500 for "destruction of state property," Donna said.)

Both the Corrections Department and the Office of Mental Health declined to comment on Currao's case.

According to the Corrections Department, an inmate can be returned to solitary confinement after being on suicide watch if they're cleared by the Office of Mental Health. In 2011, 14 percent of the 8,242 inmates released from New York's mental health crisis units were sent to solitary confinement.

After just three weeks in isolation, Donna noticed a dramatic change in her husband. He "was withdrawn, all he would do is apologize," Donna said. He was no longer laughing with her, playing cards or chatting with other inmates. She watched him drop from 240 pounds to 160.

Currao stopped writing the almost daily letters he'd sent for 13 years. When Donna persuaded him to start again, as a way to escape, he talked of an overwhelming sadness.

Donna says she repeatedly called the prison. She faxed them copies of Currao's suicidal letters. But he remained in isolation.

"I don't know if they don't want to spend the money, or think it's a joke," she said. "They still thought he wanted out of solitary. He wanted out of the picture is what he wanted."

A survey by the state's independent oversight committee found many family members who said prison officials didn't listen to concerns about inmates' psychological wellbeing. None of the mental health files reviewed by the oversight committee contained information from family members about a prisoner's psychiatric history.

The Office of Mental Health says it's working on creating new procedures to "insure that the call is responded to promptly and in a manner that addresses the family member's concern as best as possible."

Prisoner rights advocates are also working on a new legislative proposal to ensure that mentally ill inmates get the treatment they need. A coalition of groups is drafting a new bill, which would expand protections from solitary for inmates with mental illness, and put a limit on solitary confinement sentences for any prisoner, whether or not they're diagnosed with a disorder.

"Even though there's a law that says you can't do this for people with serious mental illness, it hasn't stopped [Corrections] from using solitary," said Parish. "I think they just replaced it with lower-level tickets instead of some of the most serious ones."

In May, Donna's persistence in trying to get her husband treatment finally saw results. Currao met with a psychologist, and was diagnosed with "serious" anti-social personality disorder and dysthymic disorder. He was moved out of solitary confinement and into one of the 170 Residential Mental Health Treatment beds created under the recent law.

Currao "seems to be 1,000 times better" since entering treatment, Donna said. He talks about wanting to become a counselor when he's released.

But Donna wonders why it took so many suicide attempts and nearly a year of pressure to get her husband a proper diagnosis and the treatment he was legally owed. "They are not enforcing this law," she said. "Why do we have to fight so hard to get them evaluated?"

Hall's family is left with the same questions as they search for answers about his death. "How many more people have to die?" Shaleah asked. "They need help. Locking them away is hurting them more."

I love propublica, but this is exactly why the left is losing politically.

Unfortunately, when you have the intersection of two marginalized populations, the political motivation to help them is pretty slim.

I mean, we are talking about an area (and I live here, so I get to poke) where Stop-and-Frisk totally isn’t racial profiling, even if a disproportionate number of minorities do get approached, and they should be profiling even more!  If nobody calls Bloomberg and Kelly on their crap, openly and loudly, where does one expect the support to come from, here?

The entire criminal justice system needs to be fixed, because it has never been about justice.  Justice would be rehabilitation, not punishment or handwavy exile.  Hurting someone because they’ve hurt is generally considered revenge, not justice.

And the results are going to be feuds, essentially.  Do we have any statistics on the families of these mentally ill inmates who themselves end up turning to crime?  I’d like to think I wouldn’t, if in that situation, but I imagine that I’d be sorely tempted.  Why support law and order when order means no interest in helping people yet actively hurting the most vulnerable?

Meeka Johnakin

Aug. 15, 2013, 3:25 p.m.

I’ve heard all sorts of horror stories of what goes on behind prison bars, but never with the people who suffer from mental disorders. I think anyone can place themselves in another shoes of how solitary confinement can make you go crazy, so to already be experiencing an mental illness and be thrown into solitary confinement, I am unable to wrap my head around that. What’s most hurtful is that this hits home for me. Amir Hall was my cousin, and his life was taken away way too soon, especially before he even had the chance to become comfortable to accept and love himself for who he was. He had time to get him self together. Speaking as a nurse with 19 years of experience, with the correct medical team, psych treatment/therapy, support groups, medication, and a chosen spiritual faith/religion to be grounded into, the sky would have been the limit for Mir! R.I.P. baby your are forever in my heart !

Sameialika Tarver

Aug. 15, 2013, 4:32 p.m.

This hurts me, on so many levels. I knew Amir since he was born and grew up with his Mom and Dad. He was a good soul and I never knew he suffered from depression. I know, personally, how much depression hurts and how difficult it is to deal with. Depression can easily go undetected (or underestimated) by relatives /friends….and too often, it does. I lost my baby brother to suicide (by hanging) 16 months ago and neither me nor my family would have ever predicted that could happen. Even after suffering from depression myself and witnessing the effects of it on my grandmother, I didn’t suspect my brother was suffering too.

I urge everyone to take mental illness very seriously; especially that of those who are incarcerated or otherwise isolated. My heart goes out to Nicole, Shaleah, Ms. Peggy and the rest of Amir’s family.

Yes because we need to politicize the people who are truly suffering and then let them die in a cell by themselves for fun.  Now that’s right or left winged I don’t care, that sounds like a sick person who does this kind of stuff.

I’m reading the comments from the families of Amir, your loss is terrible and my heart also goes out. What happened to him was an injustice. Dealing with the courts is hard, and usually best avoided, but sometimes, like in times like yours, it’s the right thing, it’s necessary. Good luck to you.

This is a country full of cold people.  They mainly claim to be “Christians” but finding a “Christ-like” one is nearly impossible.

People in jail?  No sympathy
People with mental illness?  No sympathy
Minorities?!  Now you’ve hit the trifecta of “white people don’t care”...

I’m white and know most whites don’t care about any of these issues because they think it doesn’t apply to them.  Christ would weep…

My son is mentally ill, diagnosed with a border-line personality disorder and a mood disorder and incarcerated at the prison Amir was at first..Mid-State. He has a history of also being MICA.  Within three months of his arrival, the nurse practitioner took him off his meds! I have advocated for him as he has fought with the Mental Health department to get these returned to him and reopen his mental health case. It was closed after they took him off his meds. When I called to advocate for my son, I was told by the Unit Chief that he knows the MICA inmates better than the outside psychiatrists who often misdiagnose them! Hmmm, the Unit chief is not a doctor but a social worker. He also said most of these inmates are only drug seekers, they don’t actually need medications! Unbelievable! It’s common sense to know that people seek drugs to self-medicate when they aren’t getting the relief they need from the medications prescribed by their doctors! After he threatened suicide, I demanded they help him and he was taken for observation and offered services. He’s been there since 2009. Why does it take this much pushing to get mental help assistance to individuals who are incarcerated? Well they are understaffed..my son was told counseling sessions occur once a month for 15 minutes!  They don’t have enough help to treat people with mental illnesses. My heart goes out to Amir’s family. I’m lucky that my son didn’t try to hurt himself and that I live close to my son so I can advocate for him. I pray for those who have no one to speak for them!

Prayers .... How sad…. The mental health industry & prison industry is abusive in my opinion. Psychiatry has labeled normal human challenges as mental illness. Seems this person was insecure. We have all been insecure, at times. With help that didn’t label him as mentally ill & didn’t treat him inhumanely he would have been a success. Psychiatrists in prison & other places will deliberately taunt a person they think is weak to provoke a mentally unstable response so that they can diagnose a mental illness to get paid. Prayers the prison where he was learns from this young man’s story. No one deserves the treatment he got. Hugs to his family. all rights reserved

@Galileo

You said “I love propublica, but this is exactly why the left is losing politically. “

If you are suggesting that the left is losing due to our defense of those who have been marginalized then I would suggest that you never really belonged on the left.

Some of what “we” do is done only because it is the right thing to do. We should not adjust our opinions based on their popularity. When the left abandons those whom society has abandoned I will abandon the left.

is a big problem: illness - the persons are condmned without concret proves;

the puzzle start with a chemical weapon, psycho torture and mass manipulation and after remain only mass manipulation= suicide cases

i can receive 1 billion dollars , an assassinate is an assassinate; a murder is a murder

i want to see a real story or stories with all the persons who suffered or suffer into a paychologicaly puzzlle of torture to death in mass manipulation. illness cover the psychological torture and maintain the author in freedom

It is the most insane thing in the world to believe you can put someone into power over you, entrust them with authority to use force and domination, and then expect them to be righteous.

Power corrupts. You can put all the laws you want on the books, but, if anyone maintains power over a fellow human being, you are going to have corruption in the power holders practices. That goes all the way from the top to the bottom of the system.

POWER SHOULD BE MADE ILLEGAL!

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