EVEN BEING MENTALLY ILL, YOU WILL GET NO BREAK IN HAWAII UNLESS YOUR FORCED TO. BUT YOU CAN COUNT OF THE ACLU, BUT NOT IF YOU'RE NOT MENTALLY ILL AND DISCOVER THE CROYNISM THAT AND PREJUDICE THAT IS ENDEMIC.

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Posted on: Sunday, January 14, 2007
Prison probe hints politics at play

• Mentally ill prisoners receiving shoddy care


By Rob Perez
Advertiser Staff Writer



Three expert psychiatrists assisting in a federal investigation of O'ahu Community Correctional Center found major problems with the prison's treatment of mentally ill inmates more than a year ago, but the Justice Department has yet to force the state to correct the problems.

Instead, it deviated from its usual practice and gave the state an advance copy of the experts' report in July, saying it hoped that would allow the state to begin focusing resources on Justice's concerns.

Critics say the unusual way the federal government has handled the investigation smacks of politics. Normally, a demand letter detailing deficiencies and demanding corrective action within a specific time frame is issued, and the experts' report is included with that letter.

Alvin Bronstein, director emeritus of the American Civil Liberties Union's National Prison Project, said he suspects the Justice Department deviated from its usual practice so a demand letter would not come out during an election year.

Had a demand letter come out, it would have been a public document, and the federal agency even puts some letters on its Web site.

Critics have accused Bush's Justice Department of allowing politics to enter into investigations by the agency's Civil Rights Division. That's the division overseeing the OCCC case.

Bronstein said a significant number of lawyers have quit the division. "They feel politics is coloring a lot of what's going on."

Asked whether politics has affected the Hawai'i case, a Justice spokeswoman would not comment, citing the general policy of not discussing pending investigations. She said, however, that the department has in the past provided advance copies of experts' reports to jurisdictions, particularly when they are cooperative.

A spokesman for Gov. Linda Lingle didn't respond to requests for comment.

The state Department of Public Safety, which runs the prison system, said it immediately began addressing Justice concerns after meeting with the experts following their inspection in October 2005. The agency said it is continuing to pursue improvements, not waiting for the official findings from the federal agency.

The report by the three private psychiatrists is only part of the information the Justice Department considers before deciding what step to take next. It also has its own investigators' work to consider.

Lois Perrin, the ACLU's legal director in Hawai'i, said nothing appears to be happening with the federal probe and suspects it has stalled. If that's the case, her group may file a lawsuit against the state on behalf of OCCC inmates, she said.

Bronstein said it was unusual that a demand letter hasn't been issued more than a year after an experts' report, which found serious deficiencies, was issued.

But the Justice spokeswoman said investigations tend to be lengthy.

The OCCC investigation began in June 2005, more than 18 months ago. When Justice investigated OCCC and the Women's Community Correctional Center in the mid-1980s, it took about a year, even though the scope was broader and involved two facilities.

Reach Rob Perez at rperez@honoluluadvertiser.com.




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12:03 PM
Vernon said...
A HISTORY OF PROBLEMS

1984: The American Civil Liberties Union files a class-action lawsuit on behalf of prisoners at O'ahu Community Correctional Center in Kalihi and the Women's Community Correctional Center in Kailua, alleging the two prisons were overcrowded, lacked medical care for inmates, were unsanitary and had a host of other problems. The ACLU's lead attorney described mental-health services at OCCC as grossly inadequate.

1985: The federal government notifies the state of the results of its one-year investigation of OCCC, alleging that unconstitutional conditions existed because of inadequate medical, dental and psychiatric care.

1985: On the eve of trial in the ACLU case, the state concedes that major problems exist at both prisons and signs a consent decree agreeing to fix them. The changes would be monitored by a panel of experts, who gave their findings to the court.

1998: Conditions at the women's prison improved to the point that it was removed from the lawsuit.

1999: The ACLU agreed to end the lawsuit after determining OCCC was in compliance with the consent decree. The court dismissed the case.

June 2005: The Justice Department notifies Gov. Linda Lingle that it is investigating OCCC's mental-health services to determine whether inmates' civil rights were being violated.

November 2005: Three medical experts who inspected the prison issue an internal report for the Justice Department detailing numerous deficiencies in the prison's mental-health care.

July 2006: Departing from its usual practice, the Justice Department gives a copy of the experts' report to the state without issuing its official findings letter.

January 2007: A Justice spokeswoman says the OCCC investigation is still pending.



EXPERTS FIND OCCC CARE DEFICIENT

Three medical experts who inspected treatment of mentally ill prisoners at O'ahu Community Correctional Center in late 2005 found numerous deficiencies. The inspection was part of an ongoing federal investigation into the prison's mental-health services, but the Justice Department has not issued official findings yet. Here are some of the findings of the three psychiatrists and how the state has responded:


No designated person was in charge of mental-health services, the organizational structure was confusing and inconsistent, policies and procedures were outdated and often not followed, and a quality improvement process essentially did not exist.

Significant deficiencies existed in treatment programs for men and women. Mental-health care was primarily limited to medication. Treatment planning mostly wasn't done.

Inmates were placed in therapeutic lockdowns that lasted days to weeks and were not allowed any privileges. No discernable treatment was provided except for psychotropic medications, and the inmates weren't monitored adequately. The lockdowns frequently exacerbated symptoms.

Suicide watches resulted in significant isolation, deprivation and general discomfort, all of which likely worsened the psychotic symptoms. Clinical monitoring was inadequate.
"They are locked in with no reading materials, are only allowed to wear their undershorts and allowed a special suicide blanket. They are generally not allowed an eating utensil, may have no facility to wash during the day, have minimal exercise outside of the cell and uniformly report they were cold. Detainees also reported that cells were often not cleaned between detainees cell moves."


Individual counseling was an exception rather than the rule.

There was inadequate access to or use of psychiatric hospitalization for those needing such care.

Restraints were used for agitated women detainees without documentation showing range of motion, monitoring of vital signs or clear guidelines for release from restraints.

With few exceptions, discharge services were not provided to those leaving the prison.

The prison lacked sufficient numbers of trained mental-health professionals.

Documentation problems were found throughout the programs.
The Department of Public Safety's response:


"The department has taken significant steps to address the various concerns identified through the DOJ's investigative process, choosing not to wait for the DOJ to issue its findings and recommendations. All necessary changes cannot realistically take place instantaneously. The department, however, is confident that all changes that could be made immediately have been made, that the appropriate review and planning for future changes are well under way and that it has in place the basic structure for a successful mental-health program."

Hired five mental-health professionals, including a program administrator, and one medical records technician.

Meeting weekly to develop master treatment plans for inmates with identified needs.

Working toward providing each OCCC inmate in the therapeutic housing units with face-to-face treatment time and 20 hours of mental-health programming per week.

Revising policies, including changing its therapeutic lockdown one, emphasizing intervention and rehabilitation. Since then, inmate behavior has improved.

Doing discharge planning to link OCCC inmates with community mental-health programs.

Training workers on a revised suicide prevention manual. The number and duration of suicide watches has since declined considerably.

Using a more timely process for transferring inmates to the Hawai'i State Hospital.
Sources: Federal experts report, Department of Public Safety



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