Despite progress made in complying with a 2013 settlement agreement, the V.I. Bureau of Corrections continues to struggle to find ways to get adequate care for mentally ill inmates and detainees at St. Thomas’s Criminal Justice Complex.
The case to which the agreement belongs began more than 20 years ago when inmates at the CJC, represented by the American Civil Liberties Union, filed a lawsuit in 1994 over poor conditions at the jail.
At a quarterly evidentiary hearing in District Court on Thursday, Corrections employees and an independent mental health expert told Judge Curtis V. Gomez that a plan to find long-term psychiatric care and hospitalization for mentally ill persons held at the jail had not yet been fully implemented.
Implementing such a plan was one of five quarterly compliance goals set for the bureau, and the only one it did not meet prior to Thursday’s hearing.
The bureau did complete goals involving staff training on suicide policy and restraints and seclusion policy this quarter. It was also successful in creating a new “use of force” reporting form and developing audit tools to better monitor administrative directives.
Gomez said that the progress made on compliance over the last few quarters was a marked improvement over the “dismal” situation in years past, when Corrections was held multiple times in contempt of the settlement agreement and few changes were made at the jail.
He added, however, that the area where the bureau fell short of its goals – psychiatric care – remains “the foremost issue” of the case.
According to reports written by Kathryn Burns, the mental health expert selected during the settlement agreement, mentally ill inmates have in some cases been locked up at CJC for months or years without access to the kinds of care they needed. These inmates included individuals found “not guilty by reason of insanity” who remained in jail or returned there long after their verdicts were received.
Although abuse and imprisonment of the mentally ill is a recognized problem in many jurisdictions beyond the Virgin Islands, Burns’ initial report in 2014 brought St. Thomas’s jail national media attention as a particularly egregious example of a widespread problem.
A second report in 2015 found little improvement.
Vernita Charles, Corrections’ health services administrator, testified that over the past quarter six individuals housed at the jail were determined to be in need of transfer to a hospital or mental health facility for long-term care.
She said the bureau was in various stages of discussions with facilities in California, Washington, D.C., Massachusetts and South Carolina to transfer the inmates out of the territory, a complex and expensive process.
The Eldra Shulterbrandt facility, the territory’s long-term mental health care facility, is not prepared to accept any residents from the jail in the short or long term, Corrections Director Rick Mullgrav said when asked about transfer possibilities closer to home. Another nearby facility in Puerto Rico, he added, does not treat violent patients, which many of CJC’s mentally-ill inmates are considered to be.
Burns and Mullgrav both said that finding long-term hospitalization and treatment for mentally ill persons housed in the territory’s jails is ultimately a job better suited to the Department of Health than Corrections. The bureau’s responsibility is the rehabilitation and detainment of people who are guilty of crimes, not the medical treatment of people who are not guilty by nature of their illnesses.
According to Mullgrav, Health officials are in agreement with this argument, although they have expressed pessimism about finding the funding to take on an additional task.
Burns’ most recent report found that although Corrections had been diligent in seeking out off-island facilities for possible transfers, no incoming detainee had been sent to the Schneider Regional Medical Center for acute care over the last quarter. In some cases, she said, it was clear that should have happened.
As an example, she referred to a July incident in which a woman with manic symptoms was placed in seclusion in the jail’s attorney visit room for seven hours upon her arrival at the jail.
Under an existing policy and memorandum of understanding with SRMC, the woman, who had been incarcerated six times over the course of the summer, should have been brought to hospital for psychiatric evaluation and possibly admission, Burns said. But in the written record of the incident, there is no explanation for why that didn’t occur.
At the end of Thursday’s hearing, Gomez proposed that it may be time to consider a court-ordered fund to help Corrections reach compliance, as has been done in other consent decree cases.
