A federal court in Montgomery ruled Monday that the Alabama Department of Corrections has failed to make court-ordered changes to improve mental health care in the state’s prisons. “ADOC does not have enough correctional staff to provide constitutionally adequate mental-health care to prisoners who need it,” the court wrote.
The court ruled in 2017 that Alabama was failing to provide constitutionally adequate mental health care to people in state prisons, finding that mental health services are “horrendously inadequate” and have led to a “skyrocketing suicide rate” among incarcerated people.
The court ordered multiple reforms to improve mental health care. Hiring more correctional officers was a critically needed change, the court wrote, because “staffing shortages, combined with persistent and significant overcrowding, contribute to serious systemic deficiencies in the delivery of mental-health care.”
But in its 600-page opinion, the court found this week that staffing has barely increased in the last three years. ADOC has filled less than half of the required 3,826 full-time-equivalent officer positions. As a result, the court found that its February 20, 2022, target is now “out of reach.”
“What was true four years ago is no less true today,” the court wrote. “The absence of security staff prevents people who need treatment from accessing it, stops those whose mental health is deteriorating from being caught before they lapse into psychosis or suicidality, and fosters an environment of danger, anxiety, and violence that constantly assaults the psychological stability of people with mental illness in ADOC custody.”
The deadline for the state to fill all mandatory and essential posts was extended to July 1, 2025, and the court added yearly benchmarks to measure ADOC’s progress, underscoring that “[t]hese steps cannot wait.” The court wrote:
So long as ADOC’s current staffing levels persist, people with serious mental-health needs are not safe in Alabama’s prisons, but are at daily serious risk of deprivation, decompensation, and death.
At least 27 more people have died by suicide in Alabama’s prisons in the four years since the court’s ruling, while ADOC has “persistently failed” to implement reforms.
For example, the court found, “ADOC has done nothing” to ensure that people in restrictive housing units “receive the out-of-cell time they need.” One man rarely received the required five hours per week out of his restrictive housing cell in the seven months before he died by suicide.
Audits found less than 20% compliance with the required 30-minute security checks in restrictive housing. It took staff 12 minutes to start resuscitation attempts after a man was found hanging in his cell, and another man, Casey Murphree, was not found until hours after his death, when rigor mortis had set in.
The “absence of correctional staff and resulting violence and stress among ADOC inmates resulted in decompensation and suicidality,” the court explained. Before he died by suicide, one man reported that he was the victim of “frequent, pervasive sexual and physical violence” and told his mental health provider he was being “trafficked by a gang and forced to perform sex acts to pay off the gang’s debt.”
In response to ADOC’s failures, the court ordered that mental health patients must get some time out of their cells, security checks must be regularly conducted, assessments must be properly done, and people who require hospital-level care must receive it within a reasonable period of time.
Staff must conduct regular drills on how to respond to suicide attempts, the court wrote, and a mental health professional must provide a confidential, out-of-cell evaluation prior to discharging a person from suicide watch and then conduct follow-up examinations for three days.
The court also ordered ADOC to explain how “Tommy Lee Rutledge’s cell reached 104 degrees, causing him to die of hyperthermia, in a unit that was supposedly air conditioned, and how the ADOC will prevent that from ever occurring again.”
The court left open the possibility of additional action against the state if staffing levels do not improve, AP reports.