Reports Condemn Health Care and Solitary Confinement in Arizona State Prisons

The American Civil Liberties Union (ACLU), along with California-based Prison Law Office and their co-counsel in federal class action lawsuit Parsons v. Ryan, has released a series of 26 reports alleging extensive problems with the Arizona Department of Corrections’ (ADC) healthcare program and its use of solitary confinement.

Prison Law Office director Don Specter stated the groups requested the reports from national experts in prison healthcare as part of a lawsuit against the ADC. The reports, which were released ahead of next month’s federal class action trial against the ADC, assert that medical, dental and mental healthcare in Arizona State prisons has declined to unsafe levels and that solitary confinement is excessive, with prisons placing people in isolation because prison beds elsewhere are full.

In 2012, the ACLU, the ACLU of Arizona and the Prison Law Office filed a lawsuit seeking competent medical, dental and mental healthcare for prisoners and challenging the use of solitary confinement in Arizona State prisons. The suit includes 33,000 people held in 10 Arizona State prisons. The federal class-action lawsuit is set to go to trial October 21, 2014.

A September 9, 2014, press release issued by the ACLU states:

To show the dangerous inadequacies of health care and other conditions in Arizona’s state prisons, the American Civil Liberties Union, the Prison Law Office, and their co-counsel in Parsons v. Ryan filed reports yesterday with the U.S. District Court from seven experts in medicine, psychiatry, dentistry, and related fields. These experts toured the prisons on multiple occasions. They found incidents of illnesses and injuries so neglected by prison staff that they caused extreme suffering, permanent damage, and even death. The reports also detail significant harm caused by the Arizona Department of Corrections’ use of solitary confinement.

According to a recent press release by the Prison Law Office:

“[T]he chronic shortage of mental health staff, delays in providing or outright failure to provide mental health treatment, the gross inadequacies in the provision of psychiatric medications, and the other deficiencies identified in this report are statewide systemic problems, and prisoners who need mental health care have already experienced, and will experience, a serious risk of injury to their health if these problems are not addressed,” wrote Dr. Pablo Stewart, another expert hired by plaintiffs’ counsel to tour ADC’s prisons and review prisoners’ medical records… (11/8/13 report, page 10).

Dr. [Pablo] Stewart, a psychiatry professor with expertise in prison mental health care, uncovered numerous preventable suicides by prisoners, lengthy and serious delays in care, insufficient and unlicensed staff and inadequate medication protocols. One prisoner hanged himself after ADC neglected to give him his prescribed mood stabilizing drugs for more than three weeks, Dr. Stewart found (11/8/13 report, pages 21-23).

The release also touches on “significant, dangerous problems with the ADC’s use of solitary confinement,” stating that people are placed in solitary “simply because other beds are full” and that people with mental illness are often placed in isolation because the ADC does not have “treatment alternatives.”

According to the Arizona Public Media:

The reports, “Come to the unanimous conclusion that the Arizona healthcare system is…an abysmal failure,” [Specter] said.

Arizona’s correctional system puts prisoners at serious risk of sickness and death because of a lack of access to adequate healthcare, he added.

Specter said the use of solitary confinement is also a large problem in state prisons.

The reports pointed out that mentally ill prisoners are often put into isolation units, where limited human contact can cause their mental condition to significantly worsen.

Of the ACLU’s 26 expert reports, eight focus on the ADC’s use of solitary confinement.

One expert commissioned by the ACLU, Mr. Eldon Vail, is a “former corrections administrator with nearly thirty-five years experience working in and administering adult institutions” whose experience “included responsibility for… the mentally ill population and their custody, housing, and treatment.” Vail spent five days inspecting three Arizona State prisons, during which time he interviewed over 100 people held in solitary confinement. According to his expert opinion:

In the name of safety and security, the ADC engages in multiple practices that are counterproductive to its states aims and harmful to the prisoners in its custody. Overreliance on isolation as a primary means of control results in a harmful environment for all inmates, and especially those with mental illness. Moreover, the actual operations of those units—extreme levels of isolation and idleness, frequent use of pepper spray, and unstable, infrequent, and incoherent “programming”—results in a correctional environment that exacerbates the already grave risks presented by ADC’s over-use of isolation. A predictable and stable custody environment that would help mentally ill prisoners feel safe is essential to prepare inmates to be ready to engage in treatment. That environment does not currently exist within ADC.

Another expert called on by the ACLU to provide his opinion of the ADC’s use of solitary confinement was Dr. Craig Haney, Ph.D, J.D., Professor of Psychology at the University of California at Santa Cruz. The following are excerpts from Haney’s report:

My inspections of the ADC isolation units, my substantial cell front and on-on-one confidential interviews, and the extensive documents that I have reviewed pertaining to the policies, procedures, and conditions that are in operation in ADC’s isolation units confirm that they do indeed impose “solitary confinement” on Arizona prisoners. These are precisely the kinds of isolated and isolating conditions that have been identified and described in the scientific literature as producing adverse effects. Indeed, in my experience, they represent an extremely harsh version of the kind of isolation that has been studied by researchers and condemned my human rights and professional organizations…

Based on my experience studying these kinds of environments and their psychological effects for nearly four decades. . . I can offer the strongly held opinion that the range of egregious conditions, practices, and policies and practices that I have described . . . can be remedied through system-wide relief that is ordered by the courts.

The ACLU commissioned yet another expert, Dr. Brie Williams, a licensed and practicing physician in the state of California who is board certified in Internal Medicine, Hospice and Palliative Medicine, and Geriatrics, to prepare an expert report on conditions of confinement in isolation units at three ADC prisons. Williams interviewed prisoners, inspected housing units and other areas to which prisoners have access and reviewed medical files. The following have been excerpted from Williams’ report:

Prisoners of older age, with chronic medical conditions, and/or with physical disabilities are at high risk of immediate and future harm from isolated confinement as practiced in ADC. In addition, some of these prisoners are receiving dangerously inadequate medical care…

Loneliness, both actual and perceived social isolation, is an important risk factor for the development and/or worsening of many serious medical conditions. . . [S]tudies show that social isolation has a significant adverse effect on physical and mental health, immune responses, functional ability, and important health behaviors capable of hastening the onset and course of medical illness…

Williams goes on to cite other health problems that can be brought on by or exacerbated by isolated confinement as practiced by the ADC, including memory impairment, osteoarthritis, hypertension, and hearing impairment, insomnia and type 2 diabetes mellitus. After detailing her visits at the prisons, Williams concludes:

For all of the reasons set forth in this report, it is my opinion that isolated confinement as practiced in ADC poses a substantial risk of serious harm, including increased morbidity and mortality, to prisoners of older age, with chronic medical conditions and/or physical disabilities.

Corrections officials have disputed the reports, which were made public earlier this month after the ACLU won a federal court hearing to have them unsealed. The Arizona Daily Star reports:

State prison officials declined to comment in detail on the case and the recent release of the ACLU reports because the matter remains in the courts. But a spokesman did provide a brief statement disputing the ACLU’s claims.

“While the plaintiffs have sought to try their case in the media, the ADC will present its evidence and arguments in Court, where it will offer its own expert opinions that paint an accurate and realistic picture of inmate health care and conditions of confinement,” ADC spokesman Doug Nick said.