The first annual report of a federally-appointed monitor regarding the Illinois Department of Corrections’ (IDOC) treatment of mentally ill prisoners was released to the public. It confirms the complaints prisoners and their lawyers have made regarding the care provided to prisoners with mental illness. The 113-page report characterizes the psychiatric care as “grossly insufficient” and “extremely poor” in quality. Shortcomings found by the monitor include:

• insufficient psychiatric staff
• problems with the continuation of medications upon entry into prison
• failure to follow up on powerful psychiatric medication and monitor side effects
• a lack of necessary mental health treatment for prisoners in crisis cells
• deterioration of mentally ill prisoners in solitary confinement

When Illinois prisoners are suicidal, officials put them in “crisis watch”—a barren cell with no books, radio, TV, paper, or blankets. The prisoner is kept naked, except for a “suicide smock.” The light is on 24 hours a day while a guard watches through Plexiglas. Typically, prisoners are kept here until they claim they are no longer suicidal. One seriously mentally ill woman at Logan Correctional Center, “Melinda,” continually finds ways to self-harm, including cutting her arms on razor wire on the prison yard fence. Prison doctors refuse to use anesthesia when stitching up her self-inflicted wounds. Most recently, “Melinda” broke a light bulb in her cell and ate it, then was denied proper medical care and written a ticket for destruction of state property. When acting out due to her mental illness, she was pepper sprayed, then charged for the cost of the pepper spray. The author of the report, Pablo Stewart, MD, was federally appointed as the result of the settlement of Rasho v. Walker, a class action lawsuit brought by Uptown People’s Law Center, Equip for Equality, Mayer Brown, and Dentons on behalf of all prisoners with mental illness in Illinois. “I am well aware that such a major shift in addressing the needs of the mentally ill offenders for an institution as large as IDOC can take time. For issues such as suicide prevention, medication management, use of force, confidentiality, discipline and preventing mentally ill offenders from deteriorating while in segregation, however, the time is now,” Stewart said in the report. IDOC estimates there are 12,000 prisoners with mental illness in the system; however, many experts think the actual number is much higher.