Death Row Inmates and Mental Health

Facts of the Case

Willie Russell, a death row prisoner, brought suit against officials of the MDOC on behalf of himself and others similarly situated on death row, Unit 32-C, at Parchman. Mr. Russell alleged that inmates were knowingly and deliberately subjected to conditions that violated the Eighth Amendment’s prohibition against cruel and unusual punishment. These conditions included unsanitary conditions, insect infestations, high temperatures, insufficient mental health care, and exposure to the noise of psychotic inmates.

In May 2003, a magistrate judge found that the conditions violated the Eighth Amendment and entered 10 injunctions for MDOC to address the conditions. When MDOC appealed the district court’s decision, the Fifth Circuit Court of Appeals granted a stay of the injunctive order, pending appeal by the MDOC, which argued that the trial court’s finding of facts was clearly erroneous.

Ruling and Reasoning

The court vacated three injunctions in their entirety, as they were found not to be justified by conditions that violated the Eighth Amendment. The remaining seven injunctions were affirmed, although some were affirmed only as they applied to Unit 32-C (death row inmates), as opposed to all of Unit 32. The injunction regarding requirements to alleviate problems stemming from allegedly inadequate mental health care afforded to inmates on death row was affirmed.

In reviewing the question of whether the conditions on death row violated the Eighth Amendment, the court first reviewed the Eighth Amendment Standard and observed: The Constitution does not mandate comfortable prisons, but neither does it permit inhumane ones [citation omitted]. Prison officials must provide humane conditions of confinement; they must ensure that inmates receive adequate food, clothing, shelter, and medical care and must take reasonable measure to ensure the safety of the inmates [citation omitted]. This circuit has worded the test as requiring extreme deprivation of any “minimal civilized measure of life’s necessities” [citation omitted]. Further, mental health needs are no less serious than physical needs (at 332).

In addition, the court reviewed the standard for Eighth Amendment violations by a prison official, as enumerated by Farmer v. Brennan, 511 U.S. 825 (1994): subjective deliberate indifference to conditions posing substantial risk of serious harm. Additive effects of deprivations and the interaction of such deprivations over extended lengths of time were noted to create conditions that might meet the level of an Eighth Amendment violation.

The court addressed the MDOC’s challenge to each of the 10 injunctions. Injunctions 1 and 2 related to the sanitary conditions of the cells of Unit 32-C. Because the unsanitary conditions were not atypical and were easily observable, they rose to the level of deliberate indifference on the part of MDOC officials. These injunctions were affirmed. Injunctions 3, 8, and 10 were vacated. They related to a requirement that the MDOC produce a written preventative-maintenance program, to circumstances surrounding the inmates’ laundry, and to conditions of inmates’ exercise, respectively. The court found that, although changes in theses areas would be desirable, they did not meet a standard of violation of the Eighth Amendment.

Injunctions 4 and 5 related to high temperatures and limited ventilation during the months of May through September and pest control in Unit 32. The court noted that Mr. Russell did not need to show that death or serious illness had yet occurred to obtain relief and that the conditions of high heat rose to the level of deliberate indifference by MDOC officials. The injunctions were affirmed. The extension of the injunctions to non-death row inmates who were not represented by Mr. Russell was found to exceed the scope of the litigation and therefore to be invalid.

Injunction 6 related to plumbing problems in Unit 32 resulting in “ping-pong toilets,” where waste flushed down one toilet would reappear in the toilet in the adjoining cell. The court found that the MDOC officials had been warned of the problem for more than 10 years and that this met the level of deliberate indifference, despite any attempts at corrective action. In addition, Mr. Russell had proven substantial risk of serious harm. This injunction was also affirmed.

Injunction 7 related to dim lighting in the cells. The court found that MDOC’s assertions that they were in the process of remedying the problem were insufficient to moot the issue. This injunction was supported by injunctions 1, 2 (that adequate lighting was necessary for hygiene), and 9 (that adequate lighting was necessary for mental health). The injunction was affirmed as it related to Unit 32-C.

Injunction 9 related to mental health services. The injunction ordered compliance with correctional medical and mental health standards. The injunction also required annual comprehensive mental health examinations in a private setting for all death row inmates. The MDOC was ordered to house separately inmates with psychosis and other severe mental illnesses and to monitor psychotropic medications according to medical standards. Although MDOC argued that it was already in compliance with American Correctional Association (ACA) standards, the court found that the testimony from the trial court provided ample evidence that the environment of death row was “toxic” to the mental health of the inmates. The injunction was affirmed.

The court reaffirmed mental health parity (“[M]ental health needs are no less serious than physical needs.” [at 328]) and cited two previous decisions by the Fifth Circuit on the issue. The court did not require evidence that harm had already occurred, only that “the substantial risk of serious harm” existed.

Discussion

This case illustrates the importance of mental health treatment for prisoners and the false reassurance an institution may have in meeting the standard of a correctional accrediting agency. The court found that absence of regular and private mental health evaluations and exposure to psychotic inmates constitute cruel and unusual punishment. Poor hygiene, isolation, sleep deprivation, high temperatures, and dim lighting were all considered to be contributing factors to the risk of mental health deterioration. Compliance with ACA standards was found to be “incongruous,” since the mental health conditions on death row were “grossly inadequate.” A 1994 report by Amnesty International (“Conditions of Death Row Prisoners in H-Unit, Oklahoma State Penitentiary,” May 1994) also questions whether the ACA standards are adequate.

Although the court in this case affirmed the injunction related to mental health, the feasibility of the injunction’s terms may be questionable. Regarding the injunction that MDOC must provide annual mental health evaluations and follow-up in a private setting, the feasibility of privacy in correctional facilities in general is questionable if they were not designed with accessible, soundproof interview rooms. The feasibility of housing death row inmates with psychosis separately from other inmates is also questionable. Perhaps this case, with others in which prisoners file suit to improve living conditions, will have an impact on the design of correctional facilities and raise the standards of the ACA, thereby facilitating the role of the correctional psychiatrist.