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Prison Suicide

When liberal paternalism becomes collusion with the Department of Correction
Torture as therapy and therapy as punishment

By Susan Mortimer

April 2008


The rate of 'suicide' in Massachusetts prisons is three times the national rate. In the past two years deaths behind bars have escalated and much attention has been paid to this continuing trend. Ignoring the root causes of such deaths, the Commonwealth and the press (The Boston Globe) have pushed instead for ill-conceived reforms, which will increase the suffering of Massachusetts prisoners, but not the safety.

Massachusetts Correctional Legal Services, some legislators and the Disability Law Center presume that these deaths were in fact suicide and not murder by the DOC; that the prisoners were 'mentally ill' at the time of their conviction; and that only 'mentally ill' people commit suicide. While we do not have space here to enumerate all the reasons why such presumptions are fallacious, we must acknowledge that racism, poverty and the War on Drugs are the foundation of the prison industrial complex. Powerlessness, constant stress, solitary confinement and sensory deprivation inflict great suffering. Lack of fresh air and exercise, medical neglect and abuse, inadequate nutrition, guard violence, daily deprivation and degradation combine to destroy physical and psychological health. From the extremes of sensory deprivation to seemingly mundane daily occurrences, prison policy and practice violate human rights. Thus, we believe that conditions of confinement, inflicted by the state, manufacture disability.

While we recognize that some behaviors may be viewed as mental illness, designating and placing the focus of an investigation into the deaths of 'mentally ill' prisoners allows administrators, guards and medical staff to evade responsibility for the cruel, inhumane and degrading conditions that engender such desperate behavior. Further, labeling people as 'mentally ill' masks disablement caused by child abuse, poverty, racism, sexism and the coup de grace of prison conditions. Coping responses to inequality and unsafe conditions must be differentiated from 'mental illness'. Counterproductive measures meted out for such coping mechanisms punish individuals for the harms the DOC inflicts upon them. This institutional abuse brings some prisoners to a terrible choice: to live in unending despair or to end their suffering.

The role of paternalism in the development of Residential Treatment Units is clear. Liberal reformers want to do the charitable thing. But charity emanates from pity of the allegedly inferior individual; it does not seek to ally with prisoners to work for systemic change. Paternalism originates in privilege and assumed superiority. It is loathe to challenge the power of the state. It wants to do what it believes is best for the victim without consulting her. Criminal justice policy born of charitable ideology has had devastating effects on the minds and bodies of incarcerated people. (Quakers advocated penitentiaries as a charitable way to improve prisoners’ minds. Prosecutors and jailors use reforms such as parole to punish and to lengthen sentences.)

Enter Massachusetts Correctional Legal Services, Representative (and psychologist) Ruth Balser, the Disability Law Center and the Boston Globe. The lawyers are suing for Residential Treatment Units (RTU) and Balser is sponsoring HB1313, a bill calling for $40 million for secure mental health units within prisons to be staffed with Department of Mental Health employees. The Globe has editorialized in favor of RTUs. Last May during oversight hearings on Prison Suicide and Prison Mental Health at the State House, Boston Globe reporter Beth Healy declined to accept written testimony from the only invited group opposed to the treatment units (the Statewide Harm Reduction Coalition). Healy is a member of the Spotlight Team that spent several months working on a three-part investigative series on prison suicides. The expose is biased toward Residential Treatment Units. It appears to have been directed, particularly regarding the pro-RTU viewpoint, by MCLS’ Leslie Walker. Walker is a long-time proponent of RTUs. The Globe published her op-ed, touting treatment units, on the final day of its prison suicide series. She has ignored prisoners and families who understand that the DOC co-opts reform measures to inflict punishment and to add to its bloated budget.

By insisting on labeling prisoners who may be suicidal as 'mentally ill', liberal reformers are choosing not to address the root causes of prison deaths. Closer monitoring of suicidal prisoners in RTUs would not treat despair - a product of prison environs. Instead it formalizes policy, protects the DOC administration and consolidates more power in the prison industrial complex.

HB1313 gives wide latitude to DOC superintendents and Commissioner Harold Clarke to administer RTUs under DMH supervision. At present, however, even low-level guards challenge medical orders, withhold pink slips (requests for medical attention), look through patient records and hamper prisoner efforts to get medications in a timely manner. HB1313 does not address guard interference in provision of therapeutic services or guard-on-prisoner violence except to mandate forty hours of mental health training annually for correctional staff assigned to the treatment units. All other guards would be required to undergo eight hours of training yearly. Prior studies commissioned by the DOC have recommended such training. The department has repeatedly failed to implement even such minimal requirements.

Many prisoners deride the concept of special mental health treatment units as 'same guards, same treatment, different location'. (See the writings of Joe Labriola, Albert Gagne, Stephen Metcalf, The Lifers Group and others at www.massdecarcerate.org.) They understand that the prison culture affects mental health clinicians as deeply as DOC employees. Indeed many ‘lifers’ and older prisoners speak eloquently about being subjected to behavior modification programs, aversive conditioning, electro-shock ‘therapy’, forced administration of powerful sedatives and four point restraints.

Nevertheless, against this reformist backdrop the DOC has seized the liberal momentum. In February, four Custom Therapeutic Modules were delivered to MCI-Cedar Junction. The CTMs are steel cages, measuring approximately 4’ by 4’ by 8’, which contain a small opening for shackled legs and a metal stool. A sales slip shows that the DOC Central Office in Milford ordered the units at a cost of $15,000 each. *

Can a person be ‘cured’ in a cage? Can humanization occur in a dehumanizing atmosphere? If prisoners need treatment, it is, in large part, for injuries from the institutional violence to which they are subjected in prison and within a society that wages war against its young, the poor and people of color.

The push for RTUs inverts cause and effect of disablement in the prison system. Any legislation, lawsuit or advocacy work which requires that abused and disabled prisoners be ‘helped’ to heal by the very entity which tortures them is no help at all. It is betrayal and collusion with state -sanctioned violence.

*(On April 23, I met with Representative Ruth Balser’s aides. I provided a copy of the sales slip and photographs of “Custom Therapeutic Modules. The Representative was invited to comment. On April 28 Balser’s aide Jake Larson was again invited to provide a comment. To date there has been no response.)

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Susan Mortimer is an anti-prison activist whose disabled brother is a Massachusetts prisoner. She knew Anthony Garafolo, a paraplegic, whose June 2006 death in a prison hospital unit the Department of Correction has labeled a suicide.

Andrea Hornbein contributed to this article.

SEE PRISONER WRITINGS: $40 Million Rip-off by Al Gagne, The Murder of Minds, Prison Suicides by Joe Labriola and Ineffectiveness of Mental Health and Sex Offender Treatment under DOC, Parole Board and Public Safety Supervision by Stephen Metcalf at www.massdecarcerate.org.

Photographs and sales slip for DOC’s delivery of Custom Therapeutic Modules to MCI-Walpole are also at www.massdecarcerate.org.

HB1313 text

Suggested reading: Disablement, Segregation and Prisons by Marta Russell, The Monthly Review July/August 2001.

Visit www.StopForce.org.

Lorraine Jaillet’s April 28 comments regarding RTUs: - Hi Susan, I am responding to your article for “The Bridge' re: Residential Treatment Units. As you know my son Anthony Garafolo died at the M.C.I. Shirley Health Services Unit on June 20, 2006, a death that never should have happened. All my son wanted was to have the 'slot' opened on his cell door to get some 'air.' He was refused that simple request. He made a lot of noise, used vulgarity in hopes that someone would listen. Hours later they found him hanging by a sheet in the shower; an act that he could not have accomplished because he was a paraplegic and because he could not get his wheelchair into the shower stall. I STRONGLY believe that my son died at the hands of the guards. He was begging for air and the 'staff' would not even open the slot on his door. Now these 'cages' (Custom Therapeutic Modules), 4’x4’x8’ are supposed to be the solution. I think not! When will they ever learn that the culture has to change within those walls? These are the same guards and medical staff that will be in charge of prisoners in these cages. Advocates and legislators speak of trying to help the ‘mentally ill’. Most of the prisoners are not mentally ill, and if they are, the 'culture within' is driving them there. My son was NOT mentally ill. His intestines were protruding from the surgical site on his buttocks. DOC and medical staff let this happen. Staff did nothing to help him. They allowed his colostomy bags to overflow. I witnessed this myself during visits. The 'staff' would say is 'they’re on order'. This is what I am trying to convey to anyone who cares to listen. CHANGE THE CULTURE WITHIN the walls. These are prisoners; they are also human beings. Treat them accordingly. I personally am not going to go away. My son was murdered at the hands of the D.O.C and I hope to prove this. Lorraine Jaillet (Anthony Garafolo's Mother)