By Paul Kiefer
A new report from Washington’s Office of the Corrections Ombuds (OCO) raises concerns with the consequences of a shortage of mental health staff and treatment options in the state’s prison system, including the increased risk of suicide, self-harm, or placement in solitary confinement for inmates with unmet mental health needs.
The report, which the OCO released on Wednesday, is based on a review of roughly 335 complaints about alleged shortcomings in the state Department of Corrections’ (DOC) handling of mental health care, as well as interviews with incarcerated people and DOC staff and administrators.
In its review of mental health care options at state prisons, the OCO found that many problems hinged on the dearth of treatment providers available to the roughly 15,000 people in DOC custody. Facing overwhelming demand for mental health treatment and screenings, the DOC’s current providers handle overwhelming daily caseloads, sometimes without a designated work space to offer privacy to their patients. For people in custody, the shortage of treatment providers translates into long wait times for therapy appointments. Residents of the state’s 12 work release facilities, as well as inmates in some smaller prisons, have even fewer options for mental health care—in fact, the DOC doesn’t offer mental health treatment to work-release inmates at all.
But the report also outlined other problems in the DOC’s response to the mental health needs of incarcerated people, including multiple instances in which prison staff did not properly document inmates’ risk of self-harm or suicide. The OCO has highlighted the same problems in earlier reports, including an April 2021 review of two deaths by suicide in DOC facilities last year that connected mishandled mental health screenings as a to both deaths.
The OCO’s review also raised concerns that prison staff rarely consider inmates’ mental health when punishing them for breaking rules. The investigators were particularly concerned about the use of so-called Intensive Management Units—solitary confinement—as a punishment for inmates with diagnosed mental health conditions, pointing out that placing those people in isolation can lead to “destructive or self-harming behaviors, often resulting in infractions and sanctions, causing time in solitary confinement to be repeatedly extended or increasingly harsh.”
In her response to the report, Melena Thompson, the DOC’s executive policy director, acknowledged the department’s ongoing struggles to respond to inmates’ mental health needs and pointed to ongoing efforts by the DOC to improve the department’s response to inmates’ mental health needs. They include a pilot program at the Washington Corrections Center for Women in Gig Harbor that allows an incarcerated person facing possible sanctions to have their therapist review their behavior; if the therapist believes the person’s mental health condition contributed to their behavior or would prevent them from participating in a disciplinary hearing, the DOC will dismiss the case.
Meanwhile, the DOC has gradually scaled down its use of solitary confinement over the past decade—the number of people in solitary confinement has fallen by a third since 2012, though 420 people remained in segregated units as of June. Over the same period, the number of suicide attempts and incidents of self-harm by those in solitary confinement fell by 45 percent.
At the recommendation of the OCO, the DOC is also developing a program with outside mental health care providers to offer treatment to people in work release facilities; according to Thompson, the department expects to get the program off the ground by November.
But staffing shortages remain a a challenge, and meeting the demand for mental health care providers will be an uphill battle for the department. As the OCO emphasized in earlier reports, the department is simultaneously trying to fill a deficit in medical staff. According to Thompson, the DOC is preparing to approach the state legislature to add funding for two new psychologists to Washington’s 2022 supplemental budget.