An Experiment in Atlanta May Transform Care of Mentally Ill Prisoners

Faced with allegations of systemic abuse and neglect, federal prison officials move—quietly and, so far, effectively—to improve the level of care and treatment those inmates receive.

With significant litigation about the abuse and neglect of mentally ill prisoners wending its way through the federal courts, and with the Justice Department's Inspector General watching closely, the Bureau of Prisons last fall quietly established what government lawyers are calling a "High Security Mental Health Step-Down Unit" at the United States Penitentiary in Atlanta. It is believed to be the first federal prison program ever designed and implemented to provide substantial long-term care and treatment for high-security mentally ill inmates.

The Atlanta Experiment, if you can call it that, is moving slowly but surely. The first group of inmates arrived at the 30-bed unit in early September. There are currently 16 severely mentally ill prisoners in the program, most either transferred directly from the ADX-Florence "Supermax" prison in Colorado or from the federal mental health prison hospital in Springfield, Missouri. Within the next month or so, an additional four inmates should join the group and the plan is for the Unit to remain at a working level of approximately 20 prisoners.

What's different here, what has not happened before in any federal prison, is that the new program is adequately staffed with mental health professionals who have designed a treatment-focused program intended to enable high-security prisoners eventually to “step down” from solitary confinement to less restrictive environments. The idea, now very much in vogue on Capitol Hill, is to provide better care for ill inmates, reduce the costs of incarceration, and lessen the risk of recidivism for those prisoners ultimately released from confinement.

What's also different here is the level of attention and care the Atlanta inmates are receiving. Unlike their mentally ill colleagues at other federal prisons, the men in this unit are receiving direct, continuous access to trained mental health professionals. For the 16 men, there are now two psychologists, a psychiatric nurse and at least two other mental health professionals whose offices are in the unit and who are devoted entirely to the unit. (By contrast, when the federal civil rights litigation first was filed in Colorado against the Bureau of Prisons there were at ADX-Florence two psychologists and one psychiatrist for an inmate population of between 420 and 450.)

Some of the inmates, including some who have been in custody for 30 years, say it's the first time they have felt as though they are being treated by mental health professionals who care about their well being, according to their lawyers. The inmates say they are adjusting to group meetings with other prisoners. And they say the staff is responding to issues relating to their mental illness in a way intended to decelerate problems. "The staff is not having to go into cells with gas and chains" the way they do in Colorado, one attorney told me.

Although the Bureau of Prisons has not publicly acknowledged the creation of the unit, and although it is unclear precisely who in Washington is responsible for its creation, government lawyers began referencing it in open court last spring and have since confirmed its existence to lawyers involved in the case. Notably, BOP Director Charles Samuels curiously did not mention the Unit when asked last year during a Senate Judiciary Committee hearing to assess the relationship between solitary confinement and mental illness in his prisons.

Whomever conceived of the idea, and whomever is directing its implementation today, it's clear that this is both a top-down and bottom-up operation. When the Atlanta unit first opened up there were serious issues of security and protocol, I'm told. But the general counsel of the Bureau of Prisons, and several other high-ranking BOP officials, were promptly sent to Atlanta, to the unit itself, to fix those problems. "It is being managed at a very granular level," one source told me, "and it's clear at least for now they want it to succeed."

It's possible that BOP officials, or even officials at the Justice Department or White House, don't want to publicize the unit until its success is assured. But the identity of one prison official working well on the Atlanta unit has emerged from the mist. Lawyers for some of the inmates praise the recent work of a BOP psychologist named Diana Schoeller, whom they say has done an exemplary job in difficult circumstances. "The inmates respect her and appreciate what she has done," one attorney told me. "If it weren't for her, the vibe of the place would be very different."

Over the past two years, no one has been more critical than me in describing the patterns and practices of abuse and neglect the BOP has heaped upon mentally ill federal prisoners. No one has been more alarmed by the lack of transparency and accountability prison officials have exhibited in explaining their misconduct to the American people. And few have been more skeptical than me about the willingness of the Obama Administration both to honestly acknowledge the problem and then do something about it. Here is the Atlantic's continuing series, "An American Gulag" about the plight of these inmates.

But the creation of this unit is a good thing, an important thing, and the people responsible for it deserve praise. So long as the BOP continues to provide adequate resources and attention to it, so long as federal officials continue to care about better treatment for these mentally ill people, there is hope for the thousands of other mentally ill prisoners within the federal system.  Adequate care and treatment for 20 ill men, providing those inmates with a measure of dignity after the degradation they have suffered, is a really good start. I hope that both the BOP and its fiercest critics acknowledge that.