In­mate sui­cide shaped a court or­der on Alabama prison care

Psy­chi­atric care for in­mates ‘hor­ren­dously in­ad­e­quate’

Kuwait Times - - HEALTH & SCIENCE -

If any one wit­ness led to a sweep­ing court or­der de­mand­ing that Alabama im­prove psy­chi­atric care in state prisons, it was Jamie Wal­lace. Di­ag­nosed with bipo­lar dis­or­der and schizophre­nia and im­pris­oned in Alabama for killing his mother, Michelle Franklin Wal­lace, the in­mate said he some­times heard the voice of the dead woman and oth­ers telling him to harm him­self. He did, with fa­tal con­se­quences, just 10 days af­ter tes­ti­fy­ing as the first wit­ness in a trial over men­tal health care in state prisons.

The story of Wal­lace’s hang­ing while in state cus­tody served as the back­drop for a fed­eral judge’s rul­ing on Tues­day that Alabama’s psy­chi­atric care for in­mates is “hor­ren­dously in­ad­e­quate” and vi­o­lates con­sti­tu­tional stan­dards. US District My­ron Thomp­son, in a 302-page de­ci­sion out­lin­ing mul­ti­ple de­fi­cien­cies in the state sys­tem, wrote of be­ing “ex­tremely con­cerned” af­ter Wal­lace showed him scars from past sui­cide at­tempts and tes­ti­fied about a lack of psy­chi­atric treat­ment while in state cus­tody.

“With­out ques­tion, Wal­lace’s tes­ti­mony and the tragic event that fol­lowed darkly draped all the sub­se­quent tes­ti­mony like a pall,” said the judge, who re­peat­edly cited Wal­lace’s treat­ment to de­pict a sys­tem that locks away trou­bled in­mates with only spo­radic psy­chi­atric care. It’s un­clear ex­actly what sort of changes will oc­cur be­cause of the de­ci­sion: Rather than man­dat­ing spe­cific ac­tions, Thomp­son or­dered the state to meet with in­mates’ lawyers to work on re­forms. A spe­cial leg­isla­tive ses­sion, ad­di­tional fund­ing and more hir­ing are pos­si­ble. What­ever the so­lu­tion, Thomp­son made clear he doesn’t want a re­peat of what hap­pened to the 24-year-old Wal­lace.

Al­ready suf­fer­ing from psy­chi­atric prob­lems as a teenager, Wal­lace was re­leased from a men­tal fa­cil­ity only weeks be­fore shoot­ing his mother and try­ing to kill his grand­fa­ther in 2009. He pleaded guilty in 2011, re­ject­ing a de­fense lawyer’s sug­ges­tions that he plead not guilty by rea­son of men­tal ill­ness. Sen­tenced to 25 years, Wal­lace en­tered an Alabama De­part­ment of Cor­rec­tions wracked by long­stand­ing prob­lems of in­mate over­crowd­ing, un­der­staffing and fund­ing that crit­ics say is in­ad­e­quate. Wal­lace talked about be­ing sui­ci­dal and made mul­ti­ple at­tempts on his life, the judge said, but re­ceived in­con­sis­tent, in­suf­fi­cient care in prison.

In De­cem­ber, Thomp­son be­gan a non-jury trial to air claims in a class ac­tion filed by in­mates who say the state’s men­tal health care is so bad, it’s un­con­sti­tu­tional. State at­tor­neys didn’t deny prob­lems, but said the trou­bles weren’t bad enough to vi­o­late the Con­sti­tu­tion. Wal­lace took the stand as the first wit­ness. Less than two months ear­lier, Thomp­son’s or­der said, the state had ig­nored rec­om­men­da­tions from prison psy­chi­atric con­trac­tors to trans­fer Wal­lace to a hospi­tal.

Rather than re­ceive treat­ment, some­times Wal­lace was pun­ished for sui­cide at­tempts by be­ing placed in a sparse, one-per­son cell, Thomp­son said. Wal­lace tes­ti­fied that voices in his head told him to kill him­self, and he be­came so ag­i­tated the judge re­cessed tem­po­rar­ily and let him con­tinue in a quiet cham­bers li­brary af­ter Wal­lace was coaxed, “as if he were a fear­ful child,” Thomp­son wrote. Wal­lace’s con­di­tion re­mained poor af­ter his court ap­pear­ance, the judge said, yet he was al­lowed to lan­guish with lit­tle care.

“His med­i­cal records for his fi­nal 10 days re­flected no group ac­tiv­i­ties, one cell-side treat­ment plan note, and two psy­chi­atric progress notes,” Thomp­son wrote. Five days be­fore the sui­cide, a worker wrote that Wal­lace was us­ing threats “to get what he wants,” the judge noted. The Bul­lock County prison where Wal­lace was in­car­cer­ated has sui­cide pre­ven­tion cells called “sta­bi­liza­tion units,” ev­i­dence showed, but Thomp­son said the rooms had sprin­kler heads di­rectly above sinks and toi­lets that make it easy for a sui­ci­dal pris­oner to climb atop a fix­ture and hang him­self. “In fact, that is how Jamie Wal­lace com­mit­ted sui­cide,” the judge said. Wal­lace died on Dec 15.

With nearly 20,000 state in­mates, about 3,400 of whom are sup­posed to be re­ceiv­ing men­tal care, Alabama now faces a court or­der to pro­vide bet­ter psy­chi­atric care in its prisons. The state agreed to some new sui­cide pre­ven­tion mea­sures dur­ing the trial af­ter Wal­lace’s death, in­clud­ing ad­di­tional med­i­cal staff and more ob­ser­va­tion of trou­bled in­mates, but Thomp­son said sweep­ing re­forms are re­quired. “The case of Jamie Wal­lace is pow­er­ful ev­i­dence of the real, con­crete and ter­ri­bly per­ma­nent harms that woe­fully in­ad­e­quate men­tal-health care in­flicts on men­tally ill prison­ers in Alabama,” Thomp­son wrote.— AP

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