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In US Prisons, Psychiatric Disability Is Often Met by Brute Force

By Kanya D’Almeida | Truthout | July 18, 2015

They called it the “shoe leather treatment” because that was exactly what it was: 10 or 11 guards, sometimes more, would form a circle around the patient and kick him unconscious. Then they’d drag him across the room, strip him naked and throw him in a tiny room with just one window to allow in the snow, and leave him there to freeze.

That was in 1961 in Pennsylvania’s Farview State Hospital for the Criminally Insane.

Twenty years later, the routine abuse that took place there became the subject of a memoir by Bill Thomas who survived 10 years in that institution before breaking out and eventually testifying before a Special State Senate Committee Inquiry on the practices of administrators, guards and even doctors at Farview State Hospital.

The facility has since been closed down, as were thousands of others like it during the wave of “deinstitutionalization” in the 1960s and ’70s. Some state mental hospitals remain, but they are much less prevalent than they once were.

However, the shoe leather treatment lives on in jails and prisons around the country, which have become surrogate institutions for people with mental illnesses and where violence, neglect and abuse of prisoners labeled with psychiatric disabilities is on the rise.

Callous and Cruel

There is no hard data nationwide on the use of force against people diagnosed with mental illness, but a new report by Human Rights Watch (HRW) released at the end of May documents, for the first time, the extent of the problem across the approximately 5,100 jails and prisons in the United States.

“We have no data to make any kind of statistical assertion on the issue,” Jamie Fellner, senior adviser to the US program at HRW and author of the report, explained to Truthout, “but it is fair to assume that it happens in every state, and that it exists in small and large jails, and in small and large prison systems.”

Entitled “Callous and Cruel,” the research confirms what news items, court cases and personal anecdotes have been suggesting for years: that corrections officers nationwide systematically assault prisoners living with psychiatric disabilities with chemical sprays, strap them down for days on end, shock them with electric stun devices, fling them into isolation and leave them with burned skin, broken bones or damaged organs from beatings.

In their very architecture, prisons are highly regimented places; the inability of prisoners with psychiatric disorders to immediately and unquestioningly respond to the endless orders and routines that dictate prison life means they are frequently at the receiving end of excessive force.

HRW estimates that 58 percent of state prisoners nationwide with a diagnosed mental illness have been charged with rule violations, compared to 43 percent of prisoners who were not diagnosed with mental disabilities.

These “violations” usually involve issues related to their disabilities or altered states of consciousness: paranoia, self-harm, hallucinations or delusions. Prison records document mentally ill prisoners screaming incessantly to drown out the voices in their heads, inserting sharp objects into their penises and smearing feces on the walls.

A serious dearth of comprehensive policies guiding the use of force in thousands of institutions that comprise the US prison archipelago means that guards with no psychiatric experience are free to exert extreme punishment for even the most minor offense.

The case studies are endless, though some prove more instructive than others.

Take Christopher Lopez, a 35-year-old Colorado man living with schizophrenia, whose last hours in the San Carlos Correctional Facility, caught on videotape, reveal the most extreme consequences of incarcerating people in places that are at best indifferent to their state of mind – and at worst deadly.

Lopez was serving his second stint at San Carlos, spending 22 to 24 hours each day in solitary confinement. In the early hours of March 17, 2013, he was found lying facedown on the floor of his cell in a vegetative state. Unable to respond to commands, he was shackled, forced to wear a spit mask and tied to a restraint chair by officers in riot gear.

Over the next several hours, CCTV footage shows Lopez having two seizures, neither of which prompt the staff to take or call for medical action. At 9:10 am, he appears to stop breathing, but the nurse on duty merely shouts at him through the food slot and appears to carry on laughing with her coworkers.

It is not until 20 minutes later when staff members enter the holding cell that they call for backup. By then, it is too late.

As Fellner points out in an interview with Truthout, it is “difficult to make generalizations based on one single case.” What she does concede is that Lopez’s tragic death showed “an astonishing level of callousness and disregard for a human being.”

Recently, at the Vienna Crime Commission on May 22, the United Nations passed a resolution cosponsored by the United States on the basic minimum standards for treatment of prisoners.

The so-called Mandela Rules contain a clause that deals explicitly with mental illness, stating: “Persons who are … diagnosed with severe mental disabilities … for whom staying in prison would mean an exacerbation of their condition, shall not be detained in prisons, and arrangements shall be made to transfer them to mental health facilities as soon as possible.”

The resolution reiterates commitments made decades ago to uphold the human rights of all prisoners, but at the time of writing, the United States could not be further from the realization of these obligations.

Far from holding the country accountable, the agency tasked with overseeing fair and effective criminal legal systems worldwide, the UN Office on Drugs and Crime (UNODC), has made no mention of numerous reports alleging serious rights violations of mentally ill prisoners in the United States.

Asked specifically about the comprehensive research conducted by groups like HRW and others, David Dadge, spokesperson for the executive director of UNODC, told Truthout in an email, “We would not normally comment on a report of another organization, especially where we are not aware of the nature of the report or the methodology used.”

Read the rest of the report, originally published by Truthout, here.