By Alan Prendergast
By Michael Roberts
By Michael Roberts
By Amber Taufen
By Patricia Calhoun
By William Breathes
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By Melanie Asmar
Mentally ill inmates present significant problems when they're funneled into the general population at state prisons, notes Parmenter. "Other inmates target them for harassment and abuse, and they might try to get them to act out," she says. "They'll say, 'Go break into that candy machine,' and the [inmate] will do it." And the mentally ill can be victimizers as well as victims. Sometimes they assault other inmates. Sometimes their illness causes them to be combative.
In the past, the most a disturbed inmate might have received within DOC was minimal care--if he received any treatment at all. And Colorado's handling of the mentally ill wasn't all that different from what was happening in prisons across the United States.
Conditions in the country's prisons eventually reached the point that lawsuits over the treatment of mentally ill inmates became the norm. State or federal courts in at least twenty states ultimately intervened to require that mental-health services be expanded or improved.
In Colorado the pivotal case was Ramos v. Lamm, in which Fidel Ramos, a stick-up artist with a bad drug habit, and other inmates at the "Old Max" prison in Canon City banded together to complain of severe overcrowding, filth, and a general lack of services for those in need of medical and mental-health care.
U.S. District Judge John Kane asked Jeffrey Metzner and others to take a hard look at the prison system's psychiatric program. What they found was appalling. "Pre-Ramos," Metzner says, "there were three full-time staff psychologists in the department and one part-time psychiatrist [for roughly 4,000 inmates]. Even if the staff were the most wonderful in the world, it would not have been enough bodies to cope with the workload."
Because the treatment was inadequate, Metzner says, many of the prisoners suffering from mental illness were acting out. "People would throw fecal matter and urine," Metzner says. "They'd get in fights and cut themselves a lot."
Often when an inmate became psychotic, he or she would be placed in an "administrative segregation" cell and locked down 23 hours a day. "You won't get anyone to say that the treatment for seriously mentally ill patients is to lock them down 23 hours a day," Metzner says. "It only makes them worse. We'd get inmates who would cut their wrists so that they could go to the infirmary. So there were rashes of cuttings. It was a very stressful place."
Judge Kane agreed, and in 1979 declared that the prisons were in such poor shape that they violated the Constitution's ban on cruel and unusual punishment. Metzner and others were charged with getting the psychiatric care up to constitutional standards. Today, Metzner observes, "prisons are the only place in the country where there is a constitutional right to treatment."
Although Kane's sweeping ruling eventually led to the construction of twelve new prisons and the complete rehabilitation of Old Max, change was slow in coming to Colorado. State officials began discussions about building a special facility for chronically mentally ill inmates in about 1990, says the DOC's Michaud, but finding the money and a suitable site for the facility were stumbling blocks. As a stopgap measure until San Carlos could be built, the DOC set up two "special needs units" in August 1991. The more seriously mentally ill were housed in a unit at the Centennial prison in Canon City. The more stable were housed at the Arkansas Valley prison near Ordway.
When it was decided to build San Carlos on the grounds of the state hospital in Pueblo, workers soon stumbled across a grim reminder of the state's past treatment of the mentally ill. Construction had to be halted for several weeks in 1992 when crews preparing to lay the foundation began unearthing human skeletons with their backhoes in a vacant field behind the hospital power plant. An investigation was launched by the county coroner, whose best guess was that the remains marked a forgotten graveyard that had been used to dispose of state hospital patients between 1890 and 1915. The state hadn't bothered to put up tombstones--or even to keep records indicating the identity of the patients whose bodies had been laid to rest in neat rows outside what was then known as the Colorado State Insane Asylum.
San Carlos was subsequently reconfigured, primarily for financial reasons. The prison now sits across the street from the site of the old graveyard, whose residents, still unknown, have since been reburied elsewhere on the hospital grounds.
When San Carlos opened in August last year, the inmates from the pilot programs at Arkansas Valley and Centennial were the first to be admitted. Over the next few months, another 150 prisoners were handpicked from prisons around the state. Together the residents of San Carlos represent the most seriously mentally ill of all the inmates in the Department of Corrections.
Those inmates who had been management problems--who fought, threw feces or were suicidal--easily made the cut. But plenty of inmates whose crimes were seemingly the result of deranged minds weren't considered ill enough to be admitted to San Carlos.
For example, Gregory Clifford, whose lawyers claimed that he murdered and dismembered a woman at his Edgewater apartment during an alcohol-induced hallucination, is not living at San Carlos. Neither are brothers Vernon and Joseph Turley, whose two-state string of sadistic kidnap/rape cases landed them in prison six years ago.