A mentally ill prisoner at the Broward County Jail in Florida used a razor to commit an act of self-mutilation, according to the American Civil Liberties Union (ACLU).

“I have a real medical emergency,” the prisoner, who goes by the initials J.I., told an officer. “I just cut off my penis and flushed it down the toilet. I have no need for it anymore.”

J.I. was sent to solitary confinement for yelling at staff and had been there for 112 days prior to the incident. Even before his placement in solitary confinement he exhibited abnormal behavior — he refused to eat or take his medication and had public masturbation episodes.

These behaviors were red flags that the doctors overseeing J.I’s care failed to notice. J.I.’s medical files contained little information about his status and, as his mental state declined, his treatment plan was not updated. Prisoners in solitary are isolated in a cell roughly the size of a parking space. These conditions are often consequential for an individual’s mental health, which should be assessed and monitored before placement in solitary. J.I. was not assessed before his placement in solitary, according to the ACLU.

J.I.’s self-mutilation was only one case involving prisoners with mental health issues at the Broward County Jail. One prisoner diagnosed with schizophrenia and bipolar disorder starved himself to death. Months before, another prisoner starved to death— standing six- foot-two-inches tall and weighing 240 pounds at his arrest, he weighed a mere 120 pounds at his death.

Prior to J.I.’s mutilation, a court-appointed expert issued a report finding life- threatening shortcomings with the jail’s mental health program, citing a failure to exclude patients with serious mental illness from solitary confinement. The expert concluded that the mistreatment and neglect of those with mental illness at the jail was “absolutely inhumane.” The ACLU has filed a civil rights lawsuit on behalf of the prisoners at Broward County Jail.

A comprehensive plan to remedy the problems has been crafted but must be approved by a federal judge before it is implemented. Once approved, those with serious mental health issues will be excluded from solitary, treatment plans will be developed, and patients will be placed in psychiatric hospitals rather than being housed at the county jail.