The Real Cost of Prisons Weblog

There were nine suicides in the system last year, and five so far this year. From 1997 to 2003, the annual average was 3.6. Clearly, something is going on.

The latest suicide, last Sunday, was particularly tragic. It involved a 17-year-old inmate at the Manson Youth Institution in Cheshire, who used a bedsheet to hang himself - the method used in the vast majority of inmate suicides.

Prison suicides are prone to spike on occasion, but Connecticut's rash - now in its second year - suggests it is no anomaly. Instead, it likely reflects the system's struggle to deal with its fastest-growing population of inmates: those who suffer from mental illness. The share of mentally ill inmates in Connecticut's 18 prisons rose from 5 percent in 1991 to 20 percent currently, or nearly 3,600 inmates. The youth who died Sunday reportedly suffered from bipolar and attention-deficit/hyperactivity disorder.

Connecticut is taking concrete steps to address its mentally ill population, thanks to an enlightened administration that has recognized the need to act and a lawsuit that helped push the effort along. The lawsuit, filed in August 2003 and settled in March 2004, contended that mentally ill inmates were given "systematically inadequate" mental health care and were subjected to conditions in solitary confinement that "approach the limits of human endurance."

Under the settlement, the state has consolidated and increased care of its most seriously mentally ill inmates at Garner Correctional Institution, a 600-inmate facility in Newtown that once housed gang members. The state also now excludes seriously mentally ill inmates from "supermax" confinement at Northern Correctional Institution in Somers because of its harmful effects. Connecticut is one of only four states nationwide with such a policy.

These are good developments but they are not enough. Beyond Garner's walls are 3,000 mentally ill inmates in 17 other facilities; many are unsentenced people in jails, where the risk of suicide is greater.

Officers need more training in handling ill inmates, and they need more help in monitoring and caring for them. Understaffing is a chronic problem, forcing officers to work overtime and precluding their ability to conduct rounds often enough to intervene in suicide attempts.

In two suicides last year, officers at Bridgeport and New Haven were fired for failing to make scheduled rounds, and a New Haven lieutenant was disciplined. More broadly, the fault extends beyond the front lines. A lawsuit filed in connection with the death in 2002 of an inmate at MacDougall-Walker contends that mental health evaluations before the inmate's death lasted less than a minute and were conducted through his cell door. This is a common practice in prisons that do not have enough staff to serve sick inmates, and it should stop.

The system's inability to handle sick inmates has been tragic and expensive - not only in the case of suicides. In two lawsuits settled in 2002, the state paid $4 million to the families of inmates who died when guards attempted to restrain them. Both had long histories of mental illness that should have altered their course of care while incarcerated.

One died when he was sent to a Virginia prison to relieve overcrowding; mentally ill inmates were supposed to be excluded from transfer. The other died at Hartford Correctional Center - where three of the 2004 suicides occurred - when he suffocated after being held face down with his hands behind his back. Although that case occurred in 1999, another restraint death, involving an inmate with a history of mental illness, occurred at Garner in May 2004. And in three other cases since 2002, the state paid a total of $1.3 million to settle lawsuits filed after inmate suicides.

Connecticut is not alone in struggling with this population. In Iowa, four inmates killed themselves in a recent 21-month period in a unit for mentally ill inmates designed, ironically, to keep inmates safe. Ohio's prisons saw more suicides last year - 11 - than in any previous year, including two in a 24-hour period. Nationwide, 16 percent of jail and prison inmates are or have been mentally ill.

The Connecticut Department of Correction has taken steps to prevent inmate suicide, such as removal of shoelaces and wall hooks, better mental health evaluation at admission and stepped-up observation of inmates at risk. Officers receive a wallet card of suicide warning signs with their paychecks. More than a year ago, the department assured the public that it was "employing the highest level of preventative measures." Yet the problem persists.

Connecticut set the stage for this crisis by starving community mental health care in the 1990s while closing two of its psychiatric hospitals, Norwich Hospital and Fairfield Hills Hospital. Making matters worse, when budget problems hit in 2003, 15 percent of state mental health staff was cut.

Prison expenditures, meanwhile, have tripled in Connecticut since 1991 to more than a half-billion dollars a year.

Lacking decent housing and support in the community, mentally ill people often land behind bars because that's the only bed available.

Connecticut is trying to change course. It was one of few states that saw its prison population decline last year, part of a concerted effort to divert mentally ill people from the criminal justice system and provide alternatives to jail. But the toll of inmate suicides should serve as an urgent reminder that the state's work has just begun - that far more must be done to keep this vulnerable population out of prison and care for those that are there.

Mary Beth Pfeiffer of Stone Ridge, N.Y., a former editor at the Poughkeepsie Journal, was a 2004 Soros Justice Media Fellow. She is writing a book about the mentally ill in prison.
Copyright 2005, Hartford Courant
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