By Adam Geller
AP National Writer
Day or night, the lights inside cell 135C of central New Mexico’s Valencia County Detention Center were always on.
Locked inside, alone, for a total of eight months, Jan Green says she heard the constant drip of water from a broken showerhead, pitting the concrete floor where she curled up on a sleeping pad.
When she was awake, Green — a 52-year-old computer technician diagnosed with schizophrenia and bipolar disorder — rocked back and forth on a three-foot bench, hour after hour, confiding in an imaginary companion.
“I didn’t have a calendar or a pencil. I didn’t have anything. So ... I pretended I had a friend in there with me,” says Green. “I would talk and hold conversations just in my little crazy world, I guess you would say, just to keep me company.”
Though locked in solitary, Green was, in a sense, far from alone. In jails around the country, inmates with serious mental illnesses are kept isolated in small cells — some no wider than a man’s arm span — for 23 hours a day or more, often with little or no treatment or human interaction.
Lawmakers and activists in some states have worked to curb the widespread use of long-term “solitary confinement” in prisons, where research shows it can drive those with mental illnesses further over the edge. But there has been little attention to the use of isolation in the country’s 3,300 local jails, increasingly the biggest mental health treatment centers in many communities.
Partly, that is because so many independent jurisdictions run jails.
In June, Colorado banned its state prisons from long-term solitary confinement of inmates with serious mental illnesses. But the new law left out county jails despite reports spotlighting isolation of inmates with mental illness. Texas legislators voted last year to form a task force to study inmate segregation, but dropped a provision including jails for scrutiny when county officials objected — and then did not fund the study at all.
Unlike prisons, jails hold those awaiting trial or serving shorter sentences, limiting the time inmates spend in lockdown. But inmates with serious mental illnesses are much more likely than others to break jail rules and to stay jailed longer than other inmates, increasing the chances of weeks or months in isolation that risks inflicting additional psychological damage.
The Associated Press obtained a report last fall showing that mentally ill inmates at New York City’s jails were disproportionately put in lockdown, some for thousands of days, a practice that coincides with increased violence inside the jail. Inmates who spent time in isolation were far more likely to harm themselves — and for those with serious mental illnesses, the odds of inflicting potentially fatal self-harm are particularly high, according to a second report by staff of the city’s health department.
“At many jails and prisons around the country, solitary confinement has become kind of the default placement for the mentally ill,” says Dr. James Gilligan, a New York University psychiatrist and lead author of the first study, who has worked in the Massachusetts prison system and San Francisco’s jail and has consulted in cases involving detention centers around the U.S.
Jails use isolation to punish inmates, but it also is frequently used to separate those with serious mental illnesses because officials worry they may be victimized by fellow inmates or because they are considered dangerous. Many inmates in lockdown end up there because of behavior linked to mental illnesses that experts say can be highly disruptive to jail routines.
Small jails often lack specialized housing units or care for inmates with mental illness. Large ones often manage populations that include hundreds of mentally ill prisoners. It can take months to secure an opening for the most seriously ill inmates in the few remaining state psychiatric hospitals, so some jailers decide that isolation is the only suitable place to put them.
Jail operators say critics mischaracterize their treatment of inmates in isolation. While activists routinely target “solitary confinement,” jails use a number of terms for the isolation of inmates, including administrative or punitive segregation, restrictive housing, or special housing. Privileges granted to inmates and the conditions in which they’re held in different types of isolation cells can vary
significantly.
But jail operators acknowledge that lockdown is the subject of growing debate in the corrections industry, in particular its use for inmates with serious mental illnesses at jails not built to house them.
Experts have pointed to rising numbers of inmates with mental illnesses at both jails and prisons since the 1970s, when states began closing psychiatric hospitals — without following through on promises to create and sustain comprehensive community treatment programs.
But as the number of those with mental illnesses has climbed or surpassed 20 percent in some jails, many have struggled to keep up, sometimes putting inmates in jeopardy. The task is complicated by the churn of inmates through jails. U.S. jails hold less than half the number of inmates as prisons — about 731,000 — but each year process more than 19 times as many new inmates as prisons do.
There’s been little research about the impact of lockdown on inmates in jails, where time in isolation is typically more limited than in prisons.
One of the only studies, examining 244,000 incarcerations in New York City’s jails from 2010 to early 2013, found that inmates who harmed themselves were seven times as likely to have spent time
in lockdown. Inmates who inflicted the most serious, life-threatening injuries were 10 times as likely to be both seriously mentally ill and have spent time in isolation. Many of those incidents occurred among inmates who harmed themselves in the days just before being put in isolation, in what appeared to be attempts to avoid it.
The report found that the time inmates — particularly those with mental illnesses — spent in lockdown stretched on because of additional violations of rules committed once they got there. Last year, one mentally ill adolescent inmate accrued 1,002 extra days of punishment beyond the 374 days of time owed, according to an investigation by the Justice Department, released in August.
Green, the former New Mexico inmate, says her months in lockdown left her with deep psychological scars. She was arrested twice in 2009, charged with assaulting her husband. For much of 2010 and 2011 — the county’s and Green’s lawyers disagree on how long and records are missing — she was held alone in a small segregation cell used for female inmates, off a corridor near the jail’s booking area. Both sides agree that the symptoms of her mental illnesses were obvious to jail administrators and inmates.
Nearly three years later, Green, who now lives in Minnesota, says her mental health is stabilized by treatment. She speaks clearly, if haltingly, about her experience. But she says she has been diagnosed with post-traumatic stress disorder that “causes me to fear things that I really shouldn’t fear in everyday life.”
The PTSD causes flashbacks and dreams about the jail, triggered by the sight of people in uniforms or the sound of locking doors, Green says.
“She’s definitely not the same woman she was going in,” says her daughter Jessalyn Middendorf. “She’s my mom, but she’s not my mom. She’s not the mother that I knew, that I grew up with, that I was raised by.”
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