12-15-2014 Rhode Island:
CRANSTON — To reach D-mod, a specialized unit at the High Security Center of the Adult Correctional Institutions, you must pass through a series of steel doors manned by guards inside fortified control booths. You must be escorted by at least one correctional officer — on this day, William Galligan, a lieutenant. Louis A. Cerbo, the Department of Corrections’ clinical director, joins him on a tour.
Each of D-mod’s 12 cells holds a single prisoner. Each cell has cinder-block walls, a high ceiling, one fluorescent light, a camera, a tiny window facing outside, a larger window facing in, and a bunk and steel toilet/sink fixture, both bolted to the concrete floor. The metal mirror, warped by age, distorts your reflection. The total floor space of each cell is 76 square feet. There are no radios, televisions, or computers. It is eerily quiet, except when someone is in crisis.
A small number of D-mod inmates, diagnosed with severe mental illness, spend most of their days alone in these cells.
During the hour or sometimes more that they are out, they take outdoor “recreation” in steel cages, watch a group TV, visit the library or classroom, or receive counseling and related services. When they shower, liquid soap is poured into their palms, since a bar could be used to attempt self-asphyxiation, or, wrapped and swung in a towel, used as a weapon.
These men on D-mod, home of the Observation and Stabilization Unit, are among the sickest people at the ACI.
Galligan says their care has improved since Cerbo was hired in late 2011: correctional officers have undergone training and they belong to mental-health teams created by the clinical director. Galligan says his job these days includes what he calls “a social-worker aspect.”
“We don’t throw them in a cell and forget them,” he says. “We try to make it a little bit better, rather than exacerbate the situation. We get them medicated, we get them compliant, we get them stabilized.”
“We work together,” Cerbo says. “We have to understand their perspective and they have to understand ours.”
The same approach, says Cerbo, is used elsewhere at the ACI, including in High Security’s other modules. According to department spokeswoman Susan Lamkins, 17 of High Security’s 94 inmates, as of last Monday, were classified as “high risk” — men diagnosed with schizophrenia, post-traumatic stress disorder and other severe disorders who have exhibited unruly, self-injurious or suicidal behaviors. Another 31 were classified as “moderate to low-risk mentally ill offenders.”
Treatment teams include doctors, social workers, and education and discharge-planning specialists, according to Cerbo. ..Continued.. by G. WAYNE MILLER, JOURNAL STAFF WRITER
December 15, 2014
R.I. prison system lacks resources to care for mentally ill inmates
May 18, 2008
MI- Courts, prisons fail in treatment, intervention for mentally disordered
5-18-2008 Michigan:
IONIA -- Terry Casha's fate, the path that led him to a prison cell in Ionia, likely was determined before he was born.
He came into the world weighing a little more than 2 pounds and was not expected to live. His twin sister died a few months later with extensive brain damage.
He went from the hospital to foster care, then was adopted by parents who nurtured him and loved him the same as they did their six biological children. But whatever care they gave him was not enough to overcome the burden inflicted on him by his birth mother, an alcoholic who drank throughout her pregnancy.
Other Michigan inmates, such as Chad Childers, whose medicine to control paranoid schizophrenia was taken away, represent persistent claims that mental illnesses do not get proper treatment in prison. Terry Casha's story, however, shows other parts of the justice system also can be blind to the disorders.
For his first 18 years, Casha stayed out of trouble, followed the rules. Only after he graduated and went out on his own did the trouble begin. He couldn't hold a job. He lost his apartment and ended up living in the missions and on the streets of Grand Rapids. He had minor brushes with the law -- driving on a suspended license, urinating in public -- then the major one that landed him in prison.
He has been told he has fetal alcohol spectrum disorder, the umbrella term for a range of disabilities, but he can't describe how it affects him.
"I just am what I am," he said, sitting in a small room in the Bellamy Creek Correctional Facility, while a couple of guards watched from beyond two thick panes of glass. "From what I'm understanding about the disease, it is bad. It's kind of hard for me to describe it. It's just something I got to live with, basically."
He's 32 but has the emotional development of a person perhaps half his age. Those who suffer from the disorder need supervision and structure, a routine, to keep them from getting in trouble, experts say.
No one knows how many of the 51,000 inmates in Michigan's prisons suffered brain damage due to prenatal alcohol exposure, but a University of Washington study found half of those with the disorder end up in prisons or mental institutions.
Yet few states recognize fetal alcohol as a mitigating factor in criminal cases, and Michigan's prisons offer no programs to treat it.
That's why Kathryn Kelly recently came to Grand Rapids. She is a project director in the University of Washington's Fetal Alcohol and Drug Unit, the only program in the country that tries to help people with fetal alcohol disorders stay out of trouble.
She met with Kent County District Court officials to discuss creating a similar program in Grand Rapids.
A downward spiral
Terry Casha did not begin speaking until he was nearly 4 years old. He attended special education classes in St. Clair Shores, where the family lived. As a teen, he came to live with his brother Jerry in Wyoming, attended Wyoming Park High School, then graduated from Allendale High School.
Jerry taught him welding, hired him to work in his shop, but fired him for continually failing to show up for work, a pattern that repeated itself as his life began a downward spiral of lost jobs and minor scrapes with the law.
"I don't think he understands the consequences for what he's doing," Jerry said recently. "I could never explain to him, 'Terry, you can't go out and drive if you don't have a driver's license.' He doesn't understand it. He thinks for the moment."
With no income, Terry was evicted from his apartment and ended up living in the Guiding Light and Mel Trotter missions in Grand Rapids.
In 2003, in a mosh pit at a concert in Rosa Parks Circle, he touched a young woman's breast. When a police officer tried to arrest him, Terry ran. He was tackled and charged with criminal sexual conduct and assault for resisting arrest.
He pleaded guilty to fourth-degree criminal sexual conduct, a misdemeanor, and was placed on the state's sex offender list. When the people at Mel Trotter learned he was on the list, they kicked him out, since under state law, no registered sex offenders may live within 1,000 feet of a school. With Catholic Central High in the neighborhood, the Guiding Light also was off limits.
So he lived on the streets, then moved in with a friend -- or a man he thought was a friend -- at a house in Cascade Township. His housemate once dumped an ashtray in his mouth while he slept, poured urine in his ear and pushed him down the stairs, but Casha never fought back.
At a party in that neighborhood, he met a girl, and a few days later, April 1, 2006, they walked together to a store to buy liquor and cigarettes. What happened next is in dispute. She said he raped her. He said she seduced him.
When her parents found out, they came to the house, dragged Casha onto the porch and beat him. The police arrested him, charging him with first-degree criminal sexual conduct. Casha admitted he had sex with the girl, but he insisted it was consensual.
Legally, it was irrelevant whether she consented or was forcibly raped. The fact she was two months short of her 16th birthday made it a crime. Casha insisted he thought she was much older, and five people signed affidavits saying the girl was sexually promiscuous with older men and often lied about her age.
A plea for leniency
Despite that, Casha pleaded guilty to third-degree criminal sexual conduct -- having sex with a minor -- and thought he'd get off with a short jail term. At his sentencing last October, his attorney pleaded for leniency and submitted a report by a psychologist who warned that Casha could be easily victimized in prison.
"A very high level adult foster care situation may, in fact, be appropriate for Terry," the psychologist wrote. But Kent County Circuit Judge Donald Johnston sentenced him to 7-15 years.
"If fetal alcohol syndrome causes Mr. Casha to commit crimes of this sort, then, clearly, he needs to be institutionalized," he said. "If he's out and about under his own power, then he has to be held responsible by the same standards as anyone else."
Some months later, Johnston said state law gave him no choice, and Michigan has no facility for people with the disorder.
"Unfortunately, the only structured environment we have is the Michigan Department of Corrections," he said, but added: "Between you and me and the lamp post, I don't know too many people who get better in prison."
A mother's anguish
Anna Casha never thought she'd visit one of her children in prison. At 81, she dreaded it, but came anyway from her home in Bloomfield Hills to Bellamy Creek.
Inside the prison, she and two of her other sons, Jim and Jerry, were patted down and removed their shoes and socks to prove they were not smuggling in drugs. After a long wait, they sat across from Terry in a room filled with other visitors and inmates.
"It tears me apart," Anna said, especially the children who come to visit their fathers. "They're all in the same boat."
Her anguish is multiplied by two. Anna and her husband raised their six biological children and took in 15 foster kids, adopting two of them. Her biological children all have stable lives and careers. Her two adopted sons, Terry and Billy, both went to prison. She knows less about Billy's prenatal care, but suspects he, too, has fetal alcohol spectrum disorder. He has done two terms for stealing and domestic abuse.
"I worry a lot," Anna Casha said. "I pray when I open my eyes in the morning and when I go to bed at night. The thing is, they're not bad kids. They are good kids. They are sick. I never stopped loving them, and I will love them until the day I close my eyes, because they are mine."
A hope for freedom
For Jim Casha, a civil engineer who lives in Virginia, winning Terry's freedom is an obsession. He writes letters, makes phone calls, sends faxes and e-mails to anyone he believes can help.
When Terry was 3 or 4 years old, he fell into the family's backyard pool. Jim, then in his early 20s, dived in and saved him. When Jim was 25, he promised their mother he'd always look after Terry.
For a while, Terry lived with Jim and his wife, but, when Terry's drinking caused tension in the family, they asked him to leave.
"My God, what have I done?" Jim said, the day before visiting his brother in prison.
"Why didn't I help him? I knew he could not handle his own affairs. I should have been more diligent in making sure he had what he needed. He needs a group home, someone to manage his affairs"
Terry said he appreciates his family's concern, but he expects he will spend many more years in prison. He won't have his first parole hearing for five years. He has heard the parole board doesn't release most sex offenders until they have served the maximum.
"I'm gonna do 15 years," he said. "When I get out, I gotta worry about my neighbors, because I'm a sex offender. They can burn down my house, and I can't even have a gun to protect myself.
"Who's gonna hire me? Who's gonna rent me a house? Who?" ..more.. by Pat Shellenbarger | The Grand Rapids Press
MI- District court considers program to prevent repeat offenses by those with fetal-alcohol syndrome
5-18-2008 Michigan:
GRAND RAPIDS -- A court in Seattle was the first in the country to create a program aimed at helping fetal alcohol children avoid repeated violations of the law.
A court in Grand Rapids might become the second.
Kathryn Kelly, a project director at the University of Washington's Fetal Alcohol and Drug Unit, met with Kent County District Court officials last month about setting up a program modeled after Seattle's.
The Seattle program -- involving judges, defense attorneys, prosecutors, social workers and others -- recognizes the disability as a form of brain damage that makes its sufferers more likely to end up in court and in prison.
"Incarceration is not a cure," Kent County 61st District Judge Patrick Bowler said. "Hopefully, with the kind of community-based resources that we have, perhaps it will open the door to treatment and break the cycle of crime."
The program would be like drug court or sobriety court, offering counseling and social services for defendants diagnosed with or suspected of having a fetal alcohol disorder, aimed at helping them avoid a repeat of their crimes.
One of every 100 babies is born with brain damage because the mother drank during pregnancy, Kelly said. In the most severe cases, the children have visible abnormalities, including a flattish face, thin upper lip, small eye openings and no groove between the mouth and nose.
Most others exhibit no outward physical signs, but CAT scans show brain damage, which can impede memory and cause them to act impulsively without considering the consequences. Many have trouble keeping appointments, holding jobs or functioning in socially acceptable ways.
"When you're looking at someone with fetal alcohol syndrome disorder," Bowler said, "you're looking at someone who is a victim themselves."
Kelly, a former state and federal probation officer in California, said: "I was amazed by the lack of knowledge in the criminal justice system about this disability. These aren't career criminals. They aren't career anything. They simply can't manage their lives. They need help, and that's to the community's benefit, too. It's a lot cheaper than paying for prisons."
Kent County was chosen as a possible location for the program, she said, in part because Spectrum Health has a prenatal alcohol exposure clinic. If a New York-based foundation comes through with start-up money, the program could be up and running by this fall, Kelly said.
Because people with a fetal alcohol disorder are impulsive and easily led astray by others, they have difficulty connecting the punishment with the crime and, therefore, are more apt to repeat it, said Barbara Wybrecht, a fetal alcohol specialist at Spectrum Health.
Early diagnosis and intervention can help them avoid future problems, she said.
"You can punish them forever to death, and they're not going to get it," Wybrecht said. "The whole idea of people with cognitive disorders being held to the letter of the law is ludicrous." ..more.. by Pat Shellenbarger | The Grand Rapids Press
MI- Mother fights system that undid years of work on son's mental illness
5-18-2008 Michigan:
As he headed for prison just over a year ago, Chad Childers feared the doctors there would take away the prescription drugs that silenced the voices in his head and kept his depression at bay.
"Chad, I'm not going to let that happen," his mother promised.
But it did, even though Diana Childers:
• Made certain his pre-sentence report included a detailed record of his mental illness, including a diagnosis of paranoid schizophrenia.
• Got a 30-day supply of the three drugs that controlled it and delivered them to the Lapeer County jail before he was taken to prison.
• Obtained new prescriptions for refills.
• Wrote a letter to the judge, describing Chad's long battle with mental illness.
Despite all that, on March 28, 2007, when Chad arrived at the Michigan Corrections Department's Charles Egeler Reception and Guidance Center in Jackson, a prison psychiatrist took away his medication, sending him into a psychotic break of depression and paranoid delusions.
More than a year later, he still has not fully recovered, his mother said.
"I don't want Chad to be given special treatment," she said. "I just want him to be treated as a human being with a chemical imbalance. He is not a monster."
Not an isolated case
Attorneys in a long-running federal lawsuit over conditions in the Jackson prison complex say what happened to Chad Childers has happened to many others.
In a hearing before U.S. District Judge Robert Jonker last month, American Civil Liberties Union attorney Elizabeth Alexander claimed the prison violates the Eighth Amendment's prohibition against cruel and unusual punishment.
Mentally ill prisoners routinely are misdiagnosed, she said, and the prison psychiatrists and psychologists often undiagnose those who were being treated before arriving. Some take away psychotropic medications, warning inmates a diagnosis of mental illness could hurt their chances of getting into certain programs and being paroled, the attorneys claim.
In a letter to his mother, Chad Childers, 26, of Columbiaville in Lapeer County, said a prison psychiatrist told him his medication could make him impotent.
Chad began showing signs of mental illness in his late teens, Diana Childers said. He was admitted to mental hospitals six times, sometimes voluntarily, sometimes by court order after arrests for stealing and breaking and entering.
When he was 21, his doctors diagnosed him with paranoid schizophrenia and settled on a combination of three drugs to control it.
"It took us years to get him on those medications where he was symptom-free," his mother said.
'What medications?'
In November 2006, distraught over problems with a girlfriend, Chad stole a neighbor's car, intending to drive to see her. He pleaded guilty, and a Lapeer County judge sentenced him to 1 1/2-7 1/2 years.
The day after he arrived in Jackson, he wrote his mother a letter, saying the psychiatrist had taken away his medications. She worried he might attempt suicide, particularly since he was placed on the cellblock's fourth tier.
A prison official assured her -- incorrectly, it turned out -- her son was still on his meds. Chad's letters told her otherwise. By his third letter, she could tell he was deteriorating mentally.
"It made me feel like I had let my son down through all the efforts I had made," she said.
She began calling corrections officials in Jackson and Lansing, demanding they resume Chad's medication. An administrator in Lansing promised to help, then stopped returning her calls after Chad's grandmother wrote a letter to U.S. District Judge Richard Enslen.
A month after he entered prison, Chad was admitted to Duane Waters hospital in the Jackson complex. His mother assumed it was because he had suffered a mental breakdown, but she later learned he was being treated for cellulitis, a potentially fatal skin infection she believes he contracted due to unsanitary conditions in his cell.
She called and asked a nurse if Chad was receiving his psychotropic medications. "She said, 'What medications?'" Diana recalled.
Chad's medical records had not followed him the short distance to the prison hospital.
Last May 17, Diana finally was allowed to visit her son. His legs were swollen and peeling from the infection, but of more concern was his mental condition. He pulled away when she tried to hug him, claiming she was not his real mother. He reverted to childhood, talking about long-past neighbors.
"He looked bad," his mother said, the worst she had seen him in years. "I cried all the way home."
The next day, he was transferred to the Huron Valley Complex in Ypsilanti, where the state sends many of its mentally ill inmates, and locked in a small cell, his home for the next 135 days.
"They called it observation," Diana said. "I call it solitary confinement. He didn't have a pencil, a Bible, a book, a television, a radio, anything to occupy his mind."
He continued deteriorating, became angry, "like a madman," she said. He cried and smeared feces on himself.
A partial solution
This past February, after placing countless phone calls, after writing two letters to Gov. Jennifer Granholm, Diana Childers met with corrections officials and an assistant attorney general in Lansing. As a result of her persistence, they told her, the Corrections Department had changed its policy, issuing an order that any inmate who arrives with a prescription for psychotropic drugs should continue receiving them for at least 10 days.
Didn't that make her feel better? an assistant attorney general asked. It didn't. Why did it take a mother's persistence to change policy, she wondered, and what happens to inmates who don't have an advocate?
Last fall, Chad was transferred to a prison near Ionia. He is receiving drugs for his mental illness, she said, although not the ones he was taking before entering prison. He has recovered some, but still has a way to go, she said.
By this fall, he will be eligible for parole, but his mother vowed to continue her fight.
"I believe the way we're treating these prisoners is inhumane," she said. "I believe we don't treat our prisoners of war this bad. I hope not. If they let him out of there tomorrow, I would not stop advocating for the mentally ill in prison. Somebody has to." ..more.. by Pat Shellenbarger | The Grand Rapids Press
