Meanwhile, Barron is not alone. Another federal inmate in Colorado, Jack Powers, whose gruesome story we chronicled last year in The Atlantic, was recently disciplined by prison officials for cutting off his earlobes -- acts of self-mutilation that are part of his long-diagnosed mental illness. Powers was written up with an "incident report" and lost "good time' on his record -- meaning that he lost credit for days off his prison sentence (there is no parole in the federal system). His underlying mental illness? It still hasn't been adequately treated.
Last Monday via email, I asked David Berkebile, the warden at ADX-Florence, to help me understand what the prison's policies are with respect to mentally ill prisoners who seek help, don't get it, and then hurt themselves. I asked him how he could square the treatment of Barron and Powers with the terms of Samuels' "suicide prevention" memo. I asked him what policy justified the punishment of mentally ill federal prisoners. I have not yet received a response from Berkebile -- or from the Justice Department.
While waiting for the feds to explain themselves, I reached out for help to Jeffrey Metzner, a renown forensic psychologist with decades of training and experience evaluating mental illness in prison inmates. Metzner told me that while he wasn't familiar with current BOP policies as they relate to Barron, "the logical solution is to prohibit self-mutilation as being the basis for a disciplinary infraction." He also provided me with helpful context and perspective on the scope of the problem and the challenge that prison officials face. Metzner said:
I have evaluated correctional mental health systems in state prisons that had policies and procedures that made self-mutilation a disciplinary infraction that could lead to a variety of disciplinary measures following a "due process" hearing. Historically, I think the basis for some of these policies and procedures was related to tattooing and gang affiliations. From a mental health perspective, I do not have any problems with such a regulation specific to tattooing due to obvious security issues from a correctional perspective...
Inmates who self-mutilate are problematic from a correctional perspective because they frequently require transport from a locked down setting such as administrative segregation to either the institution's emergency room or equivalent (i.e. an infirmary) or at times to an outside medical facility in order to receive medical/surgical interventions that are not available within the prison complex. Such inmates who self-mutilate usually participate in such behaviors on multiple occasions, often within relatively brief periods of time. This behavior is both disruptive to the functioning of the correctional institution as well as very expensive related to both medical costs and the need for custody transport.
These inmates are problematic from a mental health perspective because it is often very difficult to determine whether the behavior is a reflection of a suicide attempt, an attempt to achieve some other goal (e.g., change cells, change housing unit, attempt to talk with another inmate, etc.) or symptomatic of an underlying mental disorder (usually a personality disorder-most commonly borderline personality disorder or antisocial personality disorder).
In correctional systems that do not have an adequate mental health system, these inmates represent the "mad versus bad" dilemma. Custody staff often views these inmates as having a mental illness (i.e. "mad") that should essentially be solely handled by the mental health staff. At the same time, mental health staff frequently views these inmates as being "bad" and not having a mental illness. Therefore, mental health staff often perceives no responsibility in managing these behaviorally disruptive inmates. In an adequate mental health system, these problematic inmates need to be managed jointly by both custody and mental health staffs based on a treatment plan that is developed jointly by the staffs with input from the inmate.
Either the Bureau of Prisons is serious about wanting to help suicidal inmates or it is not. If it is serious, then it cannot punish such inmates, especially those who seek help before acting. Nor can federal officials plausibly claim that they are serious about responding with aid to self-destructive inmates when they punish mentally ill prisoners who harm no one but themselves. These policies violate federal law, the Eighth Amendment's "cruel and unusual punishment' clause, and reasonable standards of decency in a just and moral society.
This piece is part of The Atlantic's continuing series, An American Gulag. The series landing page is here.