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| Montana Deals with Mandate for Change in Prison System |
| By Montana Forum |
| Published: 07/16/2003 |
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Walker's case is complicated. Before he was imprisoned in Montana - for violating the terms of his probation on forgery charges - he spent almost a year at a prison in Colorado. There, he was diagnosed with bipolar disorder and was put on lithium, a powerful drug designed to even out his mood swings. But Montana's prison psychiatrist, Dr. David Schaefer, concluded that Walker was not mentally ill. His disruptive behavior was not the result of mental illness, he said, but of an antisocial personality, not a rarity among a prison population. Walker challenged his treatment in prison, and his lawyers hired two independent psychiatrists to review Walker's file and examine him. Both concluded that Walker was ill. The decisions by prison mental health staff bordered on malpractice, they testified at trial in the fall of 2000 in Great Falls. When Walker arrived at Montana State Prison in February 1999, he complained that his lithium upset his stomach. 'They gave me a package of saltine crackers,' said Walker in a telephone interview from Minnesota, where he now runs a balloon dart game at a carnival. 'They said just put it in your cell.' The sergeant on duty, however, wasn't told about the crackers in advance and 'made a big stink out of it,' Walker said. In the end, Walker lost his saltines, and he quit taking his lithium. (After extensive investigation, it remains unclear whether stopping the medication was Walker's action or a staff decision or some combination of both.) What happened next could have been expected, said Terry Kupers, a psychiatrist, professor and author of 'Prison Madness,' a book about prison mental health. Kupers was one of the experts who examined Walker and testified as his initial trial. Walker would holler in his cell for hours. One prison officer testified at Walker's trial that Walker screamed every moment of his eight-hour shift. Another said Walker was the most unruly inmate he had ever seen in five years of working at the prison. He tried to kill himself three times. He spat on correctional officers and smeared ketchup, mustard and mayonnaise from his food tray on the walls of his cell. Walker also pulled two of the most unwelcome stunts at Montana State Prison: he flooded his cellblock by over-flushing his toilet and he put his mattress over the narrow window on his cell door to prevent officers from seeing inside. In response to this behavior, Walker was transferred to the prison's maximum security unit, or Max - an unusual security classification, perhaps, for a man serving time for forging his brother's name on checks. He was also subject to five special punishments - called behavior management plans - which are designed to teach inmates to follow the prison rules. It was for these punishments, along with the overall living conditions in Max, that the justices reserved their harshest words, calling them an 'affront to the inviolable right of human dignity.' Their ruling barred the prison from ever subjecting another mentally ill inmate to such treatment. Behavior management plans usually work like this, said Drew Schoening, the prison's head of psychological services: An inmate commits a violation, say by covering his cell window with a mattress. The prison's mental health staff, along with correctional officials, come up with a plan designed to discourage the inmate from breaking the rule again. When on a behavior plan, an inmate will be denied certain items, but he can earn them back by behaving appropriately for a prescribed amount of time. The point, said Schaefer, is to formalize the prison's process of disciplining unruly inmates and to stop restraining prisoners by strapping down their arms and legs. The practice of 'four-point-restraints,' Schaefer said, is more dangerous than behavior management plans, especially for the prisoner. Many behavior management plans seem innocuous. An inmate who repeatedly blocks his window with his mattress will have his mattress taken away for a few days and must sleep on the concrete berth standard to prison cells. In October 1999, Walker tried to hang himself with a sheet, swallowed a staple and tried to block his cell window. Two days later, he broke off a piece of his plastic food tray and cut himself with it; he spent a few days in the prison infirmary. Later, he tried to hang himself with his overalls. After all this, prison authorities put him naked in his cell, took his mattress, bedding and pillow and turned off the water to his sink and toilet. He was naked for four days. Prison officials said this month that there were two reasons for that action. It was designed to prevent Walker from hurting himself and to encourage him not to act up again. Since he was known to flood his cell, officers turned off the water to his sink and toilet, although, they said, officers also bring drinking water to each cell several times a day. One of his last plans, and most strict, started New Year's Day of 2000, after Walker wrote a threatening letter to prison staff. He was stripped naked, denied his mattress, pillow and water and given only 'finger foods,' like lunch meat, cheese and bread. Walker's clothes were not returned to him for 15 days. In his stint at Deer Lodge, Walker received more than 100 major disciplinary write-ups. Walker said his bad behavior was part of a game he played with the correctional officers. They would take from him and he would defy - using the only resources at his disposal - his meals, his toilet, his mattress, and ultimately, his voice. 'It became, 'Let's get this guy,' 'Walker said. 'I spent a lot of time on that bunk depressed. You kind of had to stand up for yourself. They took it all away and I thought, 'You've got it all now, what more can you take away?' Nothing.' So he would scream. Schaefer, the prison psychiatrist, said he believes Walker's behavior, which often agitated entire cell blocks, was designed to frustrate the prison officers, to get attention and disrupt the orderly prison routine. Kupers said Walker's behavior exhibited classic bipolar disorder in a prison system that was quick to label Walker 'bad' instead of 'sick.' 'Someone might be manipulating if they stayed up all night hollering at the top of their lungs - once,' Kupers said. 'But someone doing that night after night is probably manic. Look at the testimony of prisoners near him. They were angry at him and then they noticed that this man was off his rocker. They felt sorry for him.' The Supreme Court, in its decision, quoted prison officers saying that Walker's behavior didn't seem to improve after the punishments. They also said Walker's behavior worsened after he was off lithium. Great Falls District Judge Kenneth Neill tried Walker's suit in 2000 trial and concluded that the prison did nothing wrong. Neill said Walker continued get in trouble even when he was on lithium, and said the assertion that Walker's undoing started when he got off lithium was 'questionable.' Neill took no side in the debate over Walker's mental health, saying only that both the doctors in the prison and the outside experts who examined Walker later were credible. When the Supreme Court heard the appeal, however, the justices accepted Walker's mental illness as fact. 'Prison officials chose to label Walker as a bad person, rather than treat the mental health problems that were apparent to inmates and staff,' the decision reads. 'We cannot sanction correctional practices that ignore and exacerbate the plight of mentally ill inmates like Walker.' Diana L. Koch, the Department of Corrections' top lawyer, said the court's assertions undermine the ability of the prison to operate independently and rely on its own psychiatric staff for direction. 'We can't have people looking over our shoulders,' she said. 'Our experts worked with this inmate day in and day out and knew this inmate. They did not have the opinion that he was mentally ill.' Koch said the Supreme Court never explained why it believed outside experts over the state's own psychiatrist, giving the Department of Corrections no clear message about how to improve its mental health care. Eric Olson, the chief public defender of Cascade County and one of Walker's lawyers, said the Supreme Court heard both sides and made its own decision, just as it is supposed to. 'The proof was there in the Walker case about what is mental illness and what are degrading conditions,' Olson said. 'My sense is the Supreme Court resoundingly rejected (the prison's argument). The larger issue is the conditions that exist. Those conditions shouldn't exist in any event.' Kupers said the facts speak for themselves: 'Having someone lying naked on a cement slab is way over the top. Discipline has to be constitutionally sound.' Corrections officials said they are disappointed with the ruling, especially since the behavior management plans the court found fault with were the product of extensive work with outside prison monitors as a result of a suit growing out of a prison riot in 1991 in which five inmates were killed by other inmates. But they will follow the Supreme Court's order, which for the time being means discontinuing all use of behavior management plans. 'So far, things have been fairly calm,' Schaefer said. |
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