It’s unclear what exactly is driving the drop in “serious” diagnoses. But “whenever you draw a magic line, and somebody gets all these rights above it and none below it,” said Jack Beck, director of the Prison Visiting Project for the nonprofit Correctional Association of New York, “you create an incentive to push people below.” The association was one of a coalition of organizations that called for the change in policy.
The New York Office of Mental Health says the decrease reflects improvements to the screening process. Efforts to base diagnoses on firmer evidence “has resulted in somewhat fewer, but better-substantiated diagnoses” of serious mental illness, said a spokesman for the office in an emailed statement.
In Hall’s case, prison mental health staff never labeled his problems as “serious.”
Instead, they repeatedly downgraded his diagnosis. After three months in solitary — during which Hall was put on suicide watch twice — they changed his status to a level for inmates who have experienced “at least six months of psychiatric stability.”
Two weeks after his diagnosis was downgraded, and two days after he was transferred to solitary at Great Meadow, guards found Hall in his cell hanging from a bed sheet.
As part of a report issued on every inmate death, the Corrections Department’s Medical Review Board found no documented reason behind the change in Hall’s diagnosis.
A 2011 Poughkeepsie Journal investigation detailed a spike in inmate suicides in 2010, which disproportionately took place in solitary confinement. Death reports from the state’s oversight committee obtained by the Journal suggest several inmates who have committed suicide in recent years may have been under-diagnosed.
Hall’s family is suing the Corrections Department and the Office of Mental Health, among other defendants, for failing to treat his mental illness and instead locking him in solitary.
“If someone knew anything, had any inkling that there was that going on, why was he put there?” asked his aunt Sonya Hall.
New York State’s Office of Mental Health, which is in charge of inmates’ mental health care, declined to comment on Hall’s case, citing the litigation.
Amir Hall (or Mir, as his family calls him) was originally arrested in October 2007, for the unarmed robbery of a Verizon store. He made off with $86. Released on parole, he lived with his sister Shaleah Hall and her two sons while working at a local Holiday Inn and studying to become a nurse.
“Sometimes I sit there thinking that he’s going to walk through the door and make everybody laugh,” said Shaleah, who has “In Loving Memory of Amir” tattooed in a curling ribbon on her right bicep. “He was the life of the party. If you met him, you would just love him.”
But Hall’s mood could shift in an instant, Shaleah said. He was often paranoid, worried that people judged him for being gay. He would snap, then apologize repeatedly for it afterward.
“You had to walk on eggshells sometimes, because you never knew if he was going to be happy or sad that day,” Shaleah said. “It was like this ever since we were kids.”
One of those outbursts landed Hall back in prison for violating parole, after he got into a fight with Shaleah’s friend.
Knowing her brother’s history of mental illness, Shaleah said solitary confinement must have “drove him crazy.”
“I feel like they treated him like an animal,” she said. “They just locked him away and forgot about him.”
In a response to the state oversight committee’s assessment of Hall’s case, the Office of Mental Health said they were retraining staff on screening for suicide risk. The Corrections Department said they were working to improve communication when inmates are transferred to new facilities.
Sarah Kerr, a staff attorney with the Prisoners’ Rights Project of the Legal Aid Society, noted Hall’s case during a Senate hearing on solitary confinement. “The repeated punitive responses to [Hall] as he psychiatrically deteriorated in solitary confinement exemplify the importance of vigilance and monitoring, and the need for diversion from harmful solitary confinement,” she wrote.
Kerr points out that significant improvements have been made for inmates diagnosed above the “serious” mental illness line. The new mental health units provide at least four hours of out-of-cell treatment a day, and speed up an inmate’s return to the general population.
“I don’t think those improvements should be taken lightly,” said Kerr. “In terms of mental health policy, we’re way ahead of the country.”
But when it comes to solitary confinement, “New York is among the worst states,” said Taylor Pendergrass of the New York Civil Liberties Union, which is suing the state over its use of isolation. “Even if you’re totally sane and you go into solitary, it’s incredibly hard to deal with the psychological toll of that,” he said.
Solitary confinement is used in jails and prisons across the country, though there’s no reliable data to compare its prevalence among states. Experts say New York stands out for sentencing inmates to solitary for infractions as minor as having too many postage stamps or a messy cell. A report from the NYCLU found that five out of six solitary sentences in New York prisons were for “non-violent misbehavior.”
Under the state’s new law, all inmates housed in solitary — known in New York as Special Housing Units, or SHU — receive regular check-ins from mental health staff. The screenings are meant to catch inmates not originally diagnosed with a disorder who develop problems in isolation.
But Jennifer Parish, director of criminal justice advocacy at the Urban Justice Center, said she thinks many staff members still view inmates’ symptoms as attempts to avoid punishment. “If you don’t believe that being in solitary can have detrimental effects to a person’s mental health, you’re going to see someone who just says, ‘I want to get out of here,’” she said.
Beck has seen the same skepticism in conversations with some prison staff. “There’s a bias in the system that looks at the incarcerated population as anti-social, malingerers, manipulators,” Beck said. “I hear that all the time.”
When inmates ask to see mental health staff, “we have found far too often that it appears security staff really resent people asking for these interventions,” Beck said. “We have in a few facilities what I think are credible stories of individuals being beaten up when they want to go to the crisis center.”
As Sarah Kerr sees it, “if mental health staff are overly concerned that people are feigning illness, that they’re conning their way out of special housing … that will lead to tragedies.”
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