Gov. Jerry Brown’s latest effort to end federal supervision of mental health services available to state prisoners received a harsh rebuke by judges who said the state’s behavior in supporting the mental health needs of its prisoners was “unprofessional and unethical.”
In a motion filed April 5, United States District Court judge Lawrence K. Karlton expressed concern over two state reports about ending oversight of the mental health procedures and concluded that the mental health care in California prisons is sub-par.
“For years the mental health care provided by California’s prisons has fallen short of minimum constitutional requirements and has failed to meet prisoners’ basic health needs,” the court wrote. “Needless suffering and death have been well-documented.”
Yet, state officials contend that they have provided timely access to mental health care and are not “deliberately indifferent to the serious needs” of prisoners in need of mental health care.
The court said it was disturbed by the state’s action in hiring experts who conducted interviews with prisoners and used the information “gleaned from them” to bolster the claim oversight was unnecessary. More disturbing, the court said, was that interviews were conducted outside the presence of the prisoners’ lawyers.
Despite the state’s descriptions that the interviews were “simply occasional” and “unintended by-products of the inspections,” the court found prisoners were interviewed with serious mental disorders to gather supportive evidence for the state’s cases.
The court evaluated mental health services delivered to prisoners from May through mid-September 2012. A court-appointed monitor visited 23 prisons and assessed the mental health services. Document-based reviews were conducted of the other 10 prisons in California.
Among other deficiencies, the court found that the state’s mental health care delivery system did not re-evaluate and update suicide prevention policies and practices, and officials failed to ensure that seriously mentally ill prisoners were properly identified, referred, and transferred to receive higher levels of care.
For more than a decade, a disproportionately high number of prisoners have committed suicide in California’s prison system, the court found.
“Inadequate staffing has plagued the delivery of mental health care”
The suicide rate in state prisons in 2006 was about 80 percent higher than the national average for prison populations, and about 72 percent of suicides could have been prevented because they involved some degree of inadequate assessment, treatment or intervention, according to the court finding.
A previous report, conducted in 2011 by the court-appointed monitor, found that most prisoners who later committed suicide were not referred to higher levels of care when deemed clinically appropriate, were not evaluated or examined in a timely manner, or did not receive adequate emergency responses, among other findings.
According to the court-appointed monitor’s most recent report, because prison officials have not yet fully implemented a remedial suicide prevention program, an ongoing constitutional violation remains.
Additionally, the court reported in the motion that mental health staff were managing too large of caseloads to be effective. A prison psychiatrist reported they were “doing about 50 percent of what we should be doing to be effective [for individual prisoners].”
“Inadequate staffing has plagued the delivery of mental health care,” the court said in its finding.
The chronic understaffing and high job vacancy rates in mental health staff positions are also evidence of ongoing violations, according to the court. By the end of November 2012, the state’s prison mental healthcare program had a 29 percent staffing vacancy.
