A Prisoner’s Right to Mental Health Treatment

In Florida between 1996 and 2014, the percentage of prisoners with mental health illnesses grew 153%.[1] Though the US prison system has always housed mentally ill inmates, by the 1990s, the rate of inmates with mental illness dramatically increased. The dramatic increase of mentally ill inmates has not, in all cases, been accompanied with proper treatment, and is associated with a far greater likelihood of maltreatment and even abuse from correctional officers.

According to the Mayo Clinic, “Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior.”[2] In Title 42 Chapter 26 of the US Code, a disability qualifies as “with respect to an individual— a physical or mental impairment that substantially limits one or more major life activities of such individual.”[3] In this regard, mental illness can qualify as a disability in many cases.

In 1976, the US Supreme Court, in the ruling of Estelle v. Gamble, established that a prison must provide adequate support for an inmate’s medical needs. Justice Marshall wrote in the opinion, “An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met.”[4] The justices also upheld the notion that the deliberate indifference by prison staff regarding the serious illness of a inmate constitutes cruel and unusual punishment in violation with the Eighth Amendment. The Americans with Disabilities Act of 1990 (ADA) states that “the purpose of the law is to make sure that people with disabilities have the same rights and opportunities as everyone else.”[5] In 1998, the Supreme Court stated in Pennsylvania Department of Corrections v. Yeskey that the ADA applies to both prisons and jails. The distinction is that jails are run by local enforcement and exclusively hold people that are awaiting trial, while prisons are federally run and hold those who will be incarcerated for a long period of time.

In 2017, an organization named Disability Rights Florida filed a lawsuit against the Florida Correctional Office for their systematic denial of federal rights for inmates with disabilities.[6] The case concerned the story of a man named Martos, a deaf inmate that was systematically denied equal access and treatment due to his disability. Martos was not provided with properly fitted hearing aids, was deliberately separated from inmates who spoke American Sign Language, and was even denied a mental health, alcohol, and drug evaluation.[7] Unfortunately, stories like Martos’s are far too common, reflecting a larger pattern of injustice regarding access to medical treatments and resources.

In Clark v. California, a case brought before the Supreme Court in 1983, developmentally disabled prisoners were punished for rules they did not understand. The prison’s disregard for the prisoners’ disabilities was a clear example of unlawful discrimination, violating the Due Process Clause of the Fourteenth Amendment. In Clark v. California, it is stated that “Due process protections attach to state actions that (1) affect a prisoner's sentence in an unexpected manner, or (2) impose an ‘atypical and significant hardship on the inmate in relation to the ordinary incidents of prison life.”’[8] By this definition, state correctional facilities have a legal obligation and must be held accountable for providing appropriate accommodations to their inmates.

If it has been established in the courts and in the constitution that a prisoner’s right to appropriate treatment and accommodations for mental health illnesses and disabilities must be upheld, then why are mentally-ill prisoners at such a high risk of mistreatment? One rationale is to look at these issues on the state level. The ADA regulates the standard of services provided by the state and local governments, regardless of the whether or not whether or not that entity receives federal funding,[9] but it is ultimately the responsibility of each individual state to ensure that their correctional facilities uphold the ADA standards, such as adequate medical care, equal access to programs, and appropriate living facilities.[10]

According to the US Department of Justice, Restrictive Housing Units (which usually entail solitary confinement) are commonly used to house mentally ill inmates, yet they only increase the severity of the inmates’ illnesses.[11] Accommodations, not punishments, should be made for those with mental disabilities. Disabled and able inmates must have access to similar types of programs. People in every role of the criminal justice system, like police officers, judges, and correctional officers, should be required to participate in training to better equip them to support mentally ill inmates. The state of California has 40 mental health courts in 27 counties to help appropriate address mentally-ill offenders before they even enter the prison system.[12] Through these forms of actions on the local, state, and federal level, hopefully the treatment of those suffering from mental illness in the criminal justice system will improve and prisons will change to accommodate the needs of all, not just the few.

[1] Press, Eyal. “Madness,” The New Yorker (2 May 2016). Accessed 15 March 2018, https://www.newyorker.com/ magazine/2016/05/02/the-torturing-of-mentally-ill-prisoners.

[2] Mayo Clinic Staff, “Mental Illness-Symptoms and Causes,” Mayo Clinic (2015). Accessed 15 March 2018, https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968.

[3] Legal Information Institute Staff, “Disability Law,” Legal Information Institute. Accessed 15 March 2018, https://www.law.cornell.edu/wex/disability_law.

[4] Estelle v. Gamble, 429 U.S. 97 (U.S. Supreme Court, 1976).

[5] “What is the American Disabilities Act,” ADA.org. Accessed 15 March 2018, https://adata.org/learnabout-ada.

[6] “DRF files Lawsuit against Miami-Dade DOC,” Disability Rights Florida (3 May 2016). Accessed 15 March 2018, http://www.disabilityrightsflorida.org/newsroom/story/ drf_files_lawsuit_against_miami_dade_doc.

[7] Martos et al. v. Miami-Dade County Department of Corrections and Rehabilitation, 1:16- cv-21501-JEM (US District Court 2016).

[8] Clark v. California, 464 U.S. 1304, 5 (US Supreme Court, 1983).

[9] “Know Your Rights - Legal Rights of Disabled Prisoners,” American Civil Liberties Union (updated 2015). Accessed 15 March 2018, https://www.aclu.org/files/images/ asset_upload_file735_25737.pdf.

[10] Ibid, 9.

[11] Steinberg, D., Mills, D., Romano, M., “When did prisons become acceptable mental healthcare facilities,” Stanford Law School Three Strikes Project (19 February 2015). Accessed 15 March 2018, https://law.stanford.edu/publications/when-did-prisons-become-acceptable-mental-healthcarefacilities-2/.

[12] Ibid, 11.