Tuesday, February 4, 2014

The Gap Between Policy and Practice at the D.C. Jail: A Discussion of the Shortcomings of Mental Health Treatment and Suicide Risk Prevention

On November 7, 2013 Virginia Willis, a D.C. resident, testified before the Committee on the Judiciary and Public Safety at a Public Oversight Hearing regarding her fiancé’s suicide at the D.C. Jail in June of 2013.  Mrs. Willis came before the committee with many unanswered questions: what is in the cells that can be used for inmates to hang themselves and what is being done to change that?  What measures are put in place if an inmate comes in with a mental illness?  Is old paperwork being pulled up?  Unfortunately, besides naming a specialized task force and referring to an expert’s report on the current state of the D.C. Jail, Chairperson Tommy Wells found himself apologetic and unable to answer such imperative questions.

Though Mrs. Willis’s questions are critical to answer, “[r]eforming legal treatment of individuals with mental illness has been a topic that periodically resurfaces only to be quickly replaced by the next emergent public policy issue . . . decisions are generally made in a reactionary fashion.”[1]  This is exactly the manner in which the Committee on the Judiciary and Public Safety is handling the exasperation of three suicides in the year 2013 and 165 suicide attempts since the year 2011.  The following text will detail the current state of the D.C. Jail, review its policies and regulations, and provide potential solutions for the D.C. Jail—not as a reactionary response, but rather as a preventative measure—to improve the overall quality of mental health treatment at the D.C. Jail.

With regard to the most recent suicide at the D.C. Jail, Chairperson Wells’ asked: “[i]s this a case of faulty practice or did this one fall through this cracks?”  Dr. Diana Lapp, Deputy Chief Medical Officer and Interim Medical Director at the Department of Corrections, answered, “[t]his one fell through the cracks.  Further, Dr. Lapp noted that although the D.C. Jail had prior information of “the high risk [mental health] indicators” for this individual, she was unaware of this information until she read it in the Washington Post. 

There is a huge gap between the D.C. Jail’s policies and what actually occurs in practice.  In response to the many suicides at the D.C. Jail, Thomas Faust, Director of D.C.’s Department of Corrections consulted Lindsay Hayes, a nationally recognized expert in the field of suicide prevention within prisons and jails.  Mr. Hayes’ preliminary assertion best illustrates the drastic gap between the current policies at the D.C. Jail and their practices:

Despite the policy requirements from the D.C. Department of Corrections and Unity Health Care, current practices reflect a different training schedule and focus.  For example, this writer was informed that correctional officers that are assigned to the mental health unit (South 3) in the Central Detention Facility do not receive any specialized mental health and/or suicide prevention training (either on a pre-service or annual basis).  In practice, the totality of suicide prevention training to all employees is a 39-slide PowerPoint presentation entitled ‘Suicide Prevention (Module 16).’

In 1999 Joseph Heard, a deaf, mute, and mentally disabled[2] man, found himself in the D.C. criminal justice system for “trespassing” onto George Washington University’s campus.[3]  Mr. Heard was first ordered to Saint Elizabeth’s Hospital for a competency evaluation and the trial court eventually dismissed the charge.  Instead of being released from Saint Elizabeth’s Hospital, however, Mr. Heard was mistakenly sent to the D.C. Jail where he remained for two years.[4] 

Although a D.C. Jail official discovered this glitch in the computer system stating Mr. Heard had a “pending misdemeanor” on Mr. Heard’s first day at the jail, the officer failed to address the problem and instead left work for the day.  Throughout Mr. Heard’s unlawful time at the D.C. Jail, he repeatedly sent notes to correction officers, social workers, and other D.C. Jail officials stating his innocence and his wrongful placement at the jail.[5]  These employees responded either by laughing or throwing away the notes.  Mr. Heard was “never once provided with an interpreter, [an] attorney, or a court date.”[6] 

Because of Mr. Heard’s mental disability, he was housed in the Mental Health Unit (“MHU”) where he was isolated, unable to communicate, and repeatedly beaten by other inmates.  There, he was placed on suicide watch, diagnosed with major depression, and involuntarily medicated numerous times.[7]  Eventually when all inmates from the Mental Health Unit were transferred to other prisons, there was one individual left: Mr. Heard.  It was at this time when the jail staff finally acknowledged his wrongful imprisonment.  Years later, through a civil suit, Mr. Heard received eleven million dollars for this unforgiveable civil rights violation.

Since Mr. Heard’s lawsuit surfaced, numerous preventable oversights have occurred.  Early in February 2013, William Pierce, also a deaf individual who was housed at the D.C. Jail filed an action alleging a disability-based discrimination.  Mr. Pierce was denied medical care, held in solitary confinement, kept from communicating, and denied access to his prescribed HIV medication.  In an interview, Mr. Pierce communicated through a videophone: “I can’t verbally speak . . . I had asked for an interpreter and I kept asking for it.  They told me to shut up.

Despite such appalling public media attention, the inhumane treatment of mentally ill and mentally disabled inmates continued.  In 2008, a Superior Court judge sentenced twenty-seven year old quadriplegic, Jonathan Magbie, to ten days in jail for his first offense of misdemeanor possession of marijuana.  The D.C. Jail was “incompetent to meet [Mr. Magbie’s] special needs, [which included] dependence on a ventilator.  Within four days, Mr. Magbie passed away at the D.C. Jail.

With the array of dysfunction surrounding the practices used by the D.C. Jail in a feeble attempt to provide appropriate mental health care and suicide prevention comes many solutions.  The key, however, appears to lie in holding each individual accountable for the respective roles.
Gretchen Sund, a Reentry Advocate for the D.C. Jail and Prisoner Advocacy Project testified regarding the implementation of a “trauma-informed care” system.  Essentially, trauma-informed care assumes that the person (in this case, the inmate) is “injured”[8] in some way.  For example, something could have happened to an inmate as early as two or three years old that is still manifesting when the person is in his fifties.  Thus, the person has simply been “injured” and has not been “fully healed.”[9]  It is basically a “no harm, no foul” approach that allows staff members to appropriately respond to certain trauma experienced by inmates.

Another approach offered by multiple individuals at the Public Oversight hearing was the opportunity to hire a paid librarian at the D.C. Jail.  Tara Libert from the Free Minds Book Club and Writing Workshop, emphasized the importance of having books to which inmates can relate.  Though many individuals and organizations throughout the city donate a substantial number of books, they are often of no use when an inmate cannot relate to the book.  For example, most inmates have experienced being on “lock down,” they have seen people being killed in front of them, and they often have a history of violence in their past.  Because of this, books related to trauma and grief can often provide as much support as a therapist.  Additionally, Mrs. Libert mentioned the possibility—which occurs in many other states—of jails partnering with local libraries. 

The People Empowering Each other to Realize Success “PEERS” Coalition is another mechanism of support that can be provided to inmates.  At New Beginnings, the juvenile detention facility in D.C., there are many programs that pair an inmate up with a mentor.  This is something that can and should also be considered.  Such a program would also help increase awareness regarding the severe mental illnesses and intellectual disabilities inmates face on a daily basis with minimal, if any, support at all.

Overall, a major overhaul of the mental health system at the D.C. Jail needs to be conducted.  Despite abhorrent incidents dating as far back as the late 1990’s, nothing has been accomplished to reduce the inhumane treatment and deplorable conditions that continue within the walls of the D.C. Jail.  Perhaps a third suicide in a year’s timeframe was the untimely travesty that the D.C. Committee on the Judiciary and Public Safety needed to conduct their Public Oversight Roundtable.

Megan Petry
Editor-in-Chief, Criminal Law Practitioner 

[1]  Joseph W. Cormier, Note: Providing Those with Mental Illness Full and Fair Treatment: Legislative Considerations in the Post-Clark Era, 47 Am. Crim. L. Rev. 129, 129 (2010).
[2]  Mr. Heard suffered from schizophrenia and mild mental retardation.
[3]  See Armen H. Merjian, Lonesome Agony: Heard v. the District of Columbia and the Struggle Against Disability Discrimination in the D.C. Penal System, 47 Am. Crim. L. Rev. 1491, 1493 (2010) (noting the unclear nature of whether Mr. Heard was actually able to understand he was not allowed on GW’s premises).
[4]  See Heard v. District of Columbia, Civ. No. 02-296, 2006 U.S. Dist. LEXIS 62912, at *1 (D.D.C. Sept. 5, 2006); see also id. supra n. 6.
[5]  See Merjian supra n. 6 at 1500.
[6]  Id. at 1493 (stating Mr. Heard was also never informed through an interpreter the rules of the D.C. Jail).
[7]  See id. at 1500.
[8]  The term “injured” refers to a range of negative experiences and adverse outcomes one may encounter throughout their life.
[9]  See generally Commentary of Chairperson Tommy Wells.

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