After four suicides and multiple self-mutilations occurred at the Wabash Valley Correctional Facility within a two-year span, the ACLU of Indiana filed a complaint in February 2005 challenging the constitutionality of housing mentally ill inmates in long-term solitary confinement units.
The Secure Housing Units (SHU) are used to house prisoners in disciplinary or administrative segregation for prolonged periods. Prisoners in SHU are forced into solitary confinement for 23 hours a day, allowed only an hour for showers and recreation, if weather permits.
Contact with the outside world is kept to a minimum. And personal items allowed in cells, such as photographs, letters, and reading materials, are limited.
"It's a steel box," said Rev. Bill Breeden of the Unitarian Universalist Church of Bloomington and an eight-year volunteer at the Wabash prison. "Those cells are inhumane."
The case closed last month when the Indiana Department of Correction (IDOC) signed an agreement with the ACLU.
"We agree that some of them (mentally-ill inmates) do deteriorate if they are subjected to long-term confinement," Dr. William Elliott, director of Mental Health and Behavioral Management for IDOC, said in a phone interview. "... If this means preventing mental illness from getting worse, it's a good move."
Rather than serving time in the SHU at the Wabash Valley prison in Sullivan County just south of Terre Haute, mentally ill prisoners will now be transferred to other prisons around the state, said Elliott.
The Department has established a state Residential Treatment Unit (RTU) at the prison in Michigan City. At this facility mentally ill inmates can receive long-term treatment that helps them gradually work their way back into society, he said.
New Castle Correctional Facility is another option for inmates who require mental health care. Mentally ill prisoners have and will continue to be sent to New Castle, which has inpatient help to acute mental health care, said Elliott. And some will be sent to general population units at other prisons.
Although none will be transferred to state asylums or mental health clinics, Wabash's mentally ill prisoners will receive treatment, Elliot said.
"Regardless of where the offender is housed, he or she will have access to medication prescribed by psychiatrist and/or psychotherapy provided by license psychologist or mental health counselors," he said.
The ACLU-IDOC settlement follows the latest report released by The Commission on Safety and Abuse in America's Prisons. The council stressed the need for a stronger commitment toward caring for and protecting mentally ill inmates. It notes that correction administrators struggle to meet the needs of mentally ill inmates.
So even though the department works to make the proper adjustments to better accommodate its mentally ill prisoners, it may take years before these inmates feel the impact.
While psychiatrists and mental health care providers are available, these professionals are often overwhelmed by the numbers needing their attention. Medication, too, is available, but for some, it is just not enough.
Breeden said these methods are fairly ineffective. He does not fault the staff's ability. He argues that it is just not big enough.
"The Reagan era gutted the money for mental hospitals," he said. "We lost funding for mental health care and have paid the price for a long time."
The Michigan City RTU Elliott described may successfully treat mentally-ill prisoners, but it only houses 106 patients. And the New Castle Correctional Facility does aid prisoners, but only those with minor mental health issues.
With approximately 2,500 inmates deemed mentally ill, these two prisons and a handful of providers cannot possibly reach all of these prisoners.
And while long-term solitary confinement in the SHU is banned, mentally-ill prisoners will still be subjected to short-term disciplinary segregation, meaning six months or less in solitary confinement.
But experts agree that prisoners with mentally illnesses of any kind, acute or severe, are poor candidates for segregation.
SHU use of any kind is unacceptable, said Breeden.
"It's amazing how quickly the SHU gets to you," Breeden said.
He himself spent one night in the SHU after being arrested for his political activism and recalled thinking that he was being gassed and that people were against him within hours of confinement.
"I was going crazy," he said.
The lawsuit was meant to further treatment for the mentally ill in prisons. But, progress may not be possible if society does not demand the help these prisoners deserve.
"As a society we don't care for the mentally ill," Breeden said. "...It (prison) is the wrong solution."
Erica Ballard can be reached at elballar@indiana.edu.