An independent expert who has monitored the mental health care was terminated reducing the transparency around an often failing system.
CHICAGO — The Illinois Department of Corrections has long faced accusations of abuse and violence toward people with mental illness and has continually failed to fill positions for mental health care workers. Now for the first time in five years, its treatment of people with mental illness will no longer be under the oversight of an independent federal monitor. Civil-rights advocates say that leaves incarcerated people in a dangerous situation.
“They are left with no remedy, no oversight. And frankly, as best we can tell from talking to our clients, without actually being treated,” Alan Mills, executive director of Uptown People’s Law Center and a lawyer for people in prison, said.
Naomi Puzzello, a spokesperson for the Department, said even though there’s no longer an outside monitor “the department remains committed to providing quality mental health care to the individuals in custody in compliance with the department’s policies and procedures and the Constitution.”
Given the history of failures, Mills is skeptical and attorneys still hope to use the courts to force the department to provide better care and submit to oversight.
The recently terminated monitor, Dr. Pablo Stewart, was first appointed as part of a 2016 legal agreement stemming from a lawsuit alleging care was so poor inside the department of corrections, that it was unconstitutional.
In a report this year, Stewart wrote that while he’s overseen mental health care the department improved the overall quality, but he noted a persistent lack of mental health staff and problems with staff using force unnecessarily.
Use of Force instead of treatment
For his report, Stewart reviewed videos of staff using force against people with mental illness and determined 20 percent of those cases raised serious questions about whether force was necessary.
He described an incident where staff used a pepperball launcher to shoot a projectile containing an irritant similar to peppergas, directly at a naked patient at short range. He described another suspicious incident in which a prisoner was taken to an area without security cameras and later “had documented bleeding head wounds.”
The use of force against people with mental illness has been a longstanding issue in Illinois prisons. In 2018, Larry Earvin, a prisoner at Western Illinois Correctional Center with mental illness, was beaten by guards. The 65-year old had 15 rib fractures and a punctured colon. Three officers have since pleaded or been found guilty of federal charges killing Earvin.
The same year as Earvin’s death, the independent monitor reported that he “encountered mentally ill offenders with newly missing teeth and physical exam evidence of recent trauma to their faces.” He said that if he had encountered such injuries with his own patients, he would be obligated to report them to the police.
WBEZ has detailed a history of alleged abuse that went unaddressed at the facility where Earvin was eventually killed by guards, as well as department wide issues, with staff remaining employed even after the department found they committed serious wrongdoing.
In court filings, the Department of Corrections has said it takes allegations of abuse seriously, and any allegations are investigated and appropriately addressed. However, Jimia Stokes, who was a mental health worker at Pontiac Correctional Center in 2018, told WBEZ that was not her experience. She said she repeatedly heard from her patients that staff were retaliating against them for behaviors connected to their mental illness. Stokes also said she witnessed a suicidal patient drenched in pepper spray and saw one man kept in a cell with feces, which he believed was punishment from staff.
Stokes said when she attempted to report the problems, she was met with retaliation, and described an “us versus them” mentality, where you were either on the side of guards or against them.
Speaking to WBEZ in 2021, the court monitor, Pablo Stewart, said the “us vs. them” mentality has a direct connection to the lack of treatment options.
“The guards aren’t sophisticated mental health practitioners, so they see a guy who’s acting out and throwing feces at them. They don’t say ‘Oh, it’s because he has untreated schizophrenia,” Stewart said.
Understaffing and lack of treatment
The settlement agreement required the department to add mental health staff, but the court monitor said it never reached the levels promised.
According to court filings from the plaintiffs, only four prisons have all of their “qualified mental health positions” filled, making it impossible to provide sufficient care in the state’s other facilities.
For example, the attorneys wrote that one prison fell 5000 hours short of treatment time in a single month in 2021. That means Wexford, the private company the state pays to provide health care, was “providing only 59% of the mental health staff for which IDOC is paying,” according to plaintiff’s filings.
Asked about those accusations, Puzzello, the IDOC spokesperson said the department would respond in court.
Suicides and self harm
The plaintiffs say the poor conditions can lead to tragic consequences, including suicide and self-harm. According to state records, obtained by WBEZ, 20 people in Illinois prisons have died by suicide since 2019. In their court filings, the civil rights lawyers claim people at Pontiac Correctional Center are left in their cells for days, and that stress levels are so high that, in August some of their clients “set fires on their bodies inside their locked cells.”
Stokes, the former prison mental health worker, said when she worked inside Pontiac Correctional Center in 2018 she expected she’d be able to provide therapy and crisis support. But resources were so stretched, she was often only able to perform rote tasks.
“You actually don’t have time to do anything, but just ask these standard questions. ‘Are you suicidal? Do you feel like hurting yourself? Can you guarantee your safety?’ That’s pretty much it.”
Amanda Antholt, a lawyer at Equip for Equality and an attorney for prisoners, said they’ve been committed to working with the department for a decade to make changes, and they keep failing. Even though the current oversight is terminated, she said they will keep going to court and fighting for improvements.
“The people who are incarcerated are being actively harmed by the failure to provide care and the conditions that they are held in. And most of these people are going to be coming home, and we don’t want them coming back worse off than when they went in,” Antholt said.
Editor’s note: some of the images in this story have been altered to increase clarity.