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Data set is updated monthly. The constitutional law governing conditions of confinement for inmates has two sources. With respect to inmates who have been convicted of criminal offenses, the Eighth Amendment's ban on cruel and unusual punishment governs all aspects of conditions discussed here. The Eighth Amendment "imposes duties on [prison] officials, who must provide humane conditions of confinement; prison officials must ensure that inmates receive adequate food, clothing, shelter, and medical care, including mental health care, and must 'take reasonable measures to guarantee the safety of the inmates.
Brennan , U. Palmer , U. Pretrial detainees "retain at least those constitutional rights. With respect to pretrial detainees, the Fourteenth Amendment prohibits conditions or practices not reasonably related to the legitimate governmental objectives of safety, order and security. Bell v. Wolfish , U. Pretrial detainees have not been convicted of anything and therefore they may not be punished. Conditions of confinement in the first floor booking and reception area violate an inmate's right to safe and humane conditions of confinement.
The booking and reception area has seventeen separate holding rooms where inmates are housed for their first several days in the facility. The cells range in size from single and double occupancy to multiple occupancy rooms of over 20 inmates. Most cells are equipped with benches and all rooms have toilet facilities. These cells are distant from the central booking area and direct sight and sound supervision of the majority of the cells is not possible. None of the cells is equipped with audible two-way communication capability. These isolated settings make it difficult to monitor suicidal behavior or inmate-on-inmate violence.
Moreover, the holding cells are extremely crowded and unsanitary. During our site visit, the holding area housed inmates. Many of the rooms were so crowded that there was little visible floor space and inmates lay underneath the benches in the room. Facility records indicate that these booking areas are frequently crowded with as many as inmates.
Detainees sometimes may not even shower because the shower area is used as a staging area for moving detainees in and out of the facility. Due to the overcrowding, routine visual checks required by security personnel are ineffective. There are too many people to see if anything is happening in the holding cells. We reviewed the housing cards posted outside the rooms and noted that inmates have been held in such conditions for up to three days.
Many of the inmates confined in the rooms claim not to have received any shower, bedding, or hygiene articles in excess of 24 hours. The stench in the housing cells is overpowering. In one of the holding cells there was human excrement on the walls and the toilet was filthy and unsanitary.
The overcrowding causes the temperature in the holding areas to reach excessive levels and the lighting is inadequate. The conditions in the holding area have caused serious harm and death to the detainees. Fights over space and for other reasons are frequent, occurring more often than in most areas of the jail, as do officer applications of force. Jail staff know that the conditions in the crowded large cells are anxiety producing and especially difficult for inmates who are particularly vulnerable for various reasons.
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One frequent response is to move inmates who "get in trouble" in the large cells to smaller, less crowded ones. These rooms are not appropriately designed for high risk populations. In particular, they have a partition separating the toilet from the rest of the cell that obscures sight surveillance into the cell and creates a protuberance for suicide by hanging. Furthermore, as discussed later, suicide screening upon booking and mental health care in the holding cells is inadequate. Inadequate suicide screening, inadequate supervision of the holding areas, and failure to provide mental health care in the holding area combine to create an especially dangerous inmate suicide risk.
In , there were two completed suicides in the holding area. In each instance, the inmate had been moved to a small holding cell, with few cell mates, and hanged himself from the partition.
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Another inmate in one of these cells attempted to hang himself from the partition in July of but the inmate's cell mate was able to summon officers to intervene. The two completed suicides in the holding area highlight the dangerous features of current operations at the jail.
The first suicide took place in February The day before it happened, the inmate had been the victim of a fight in a large holding cell. He was treated at the nursing station, and the facility doctor ordered him housed in the medical unit for observation.
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However, there was no available housing in the medical unit, so he was placed in a small holding cell to await a bed. Late in the day, a nurse observed him and wrote that the inmate had told her that "He is just giving up; you're not giving medications correctly; his life is not worth anything; just leave him alone. He was discovered hanging from the partition that night.
The second holding area suicide took place in October In that case, the inmate had asked an officer to see the sergeant "before something happened and I snap" and because he was "going crazy. No timed observation was done. He hanged himself less than one hour after the move. Inmates in the holding area are given a medical and mental health screen by a nurse, but they do not receive the opportunity for sick call.
Deputies hand out Tylenol and Maalox, but requests for other medical attention very frequently go unanswered. Where staff know that inmates are in a medical crisis, efforts are made to move them to the medical section of the facility. But because of the lack of supervision, some inmates' emergency medical needs go unobserved and unmet.
For example, one inmate was discovered dead in the late evening in one of the small holding cells. Staff concluded that he died from a "possible drug related overdose. Another detainee was moved from the holding area to the medical floor where an officer removed a nylon rope that had been wrapped around the detainee's ankles. Thirty minutes after reaching the medical floor, the detainee required emergency life-saving medical treatment.
He was transported to a local hospital where he was pronounced dead shortly after arrival. The Officer's Report did not explain or note why the detainee had a rope around his ankles or why he had been transported to the medical floor. In addition, inmates in the holding areas typically do not receive needed psychotropic medications because the detention center will not fill even verified psychiatric prescriptions without an independent evaluation by the facility's psychiatrist, which usually cannot be done for several days due to inadequate staffing.
Many mental health crises are precipitated by the lengthy stays and conditions in the holding area and by the failure to provide timely medication. In sum, operation of the holding area violates inmates' right to adequate safety and protection from harm, adequate medical care, and, as described more fully below, adequate mental health care.
Suicide screening in the booking and holding area is inadequate. Nursing staff who conduct the screening are insufficiently trained to perform the brief mental health status examination needed to identify mentally ill inmates. Moreover, they fail to conduct this examination in a setting as private as possible given legitimate penological considerations.
This lack of privacy greatly undermines any effort to obtain sensitive information from inmates. The result of inadequate screening is that inmates with mental health problems slip through the booking process and remain unidentified and untreated until their mental health problems often escalate to the point where security staff must later call mental health personnel.
For example, one inmate was given a negative mental health screening at intake and four days later was placed on suicide watch by an officer because of his bizarre behavior. After being placed on suicide watch, he had a mental health evaluation that revealed a history of depression and substance abuse along with an extensive history of hospitalization. In another example, our expert observed one female inmate who had been in holding for an hour and was complaining of claustrophobia and extreme anxiety bordering on panic.
The other inmates in the holding cell indicated that she was pacing around banging her head on the door. She stated that she felt a nervous breakdown coming on. A review of her initial medical screening later that day showed that the nurse had failed to refer her to the mental health unit even though she had a history of mental hospitalization and was extremely vocal concerning her anxiety.
In many cases, inmates who are mentally ill go unrecognized and untreated in general population units, as well, despite obvious signs of mental health problems. The officers in general population units are not adequately trained to recognize and refer mentally ill inmates to the mental health professionals at the Detention Center. A study completed by our expert of suicide attempts from January through February revealed that officers missed important and obvious precursor behavior to suicide attempts.
Officers recorded inmates "acting strange" and mutilating themselves but did not refer such inmates to the mental health unit and in several instances the inmates subsequently attempted suicide. Supervision of potentially suicidal inmates is inadequate not only in the holding area but also in the mental health unit Unit 2 and the administrative segregation unit Unit 5 where aggressive mentally ill inmates are sometimes housed.
In particular, jail records show that numerous inmates already on suicide watch -- and occasionally already in restraints -- have been able to attempt suicide.