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Shadae Schmidt died in the Secure Housing Unit (SHU) of California Institute for Women (CIW) on 13th March, 2014.

“I went to borrow scissors from the cops last week, and I was told that they don’t lend out scissors anymore because they have special industrial scissors now for cutting down bodies. He showed them to me. That’s how normal this is. […] We have women dropping like flies and not one person has been questioned as to why we believe they are killing themselves. I have been down almost 20 years and I have never seen anything like this. Ever.”

– Letter from prisoner at California Institute for Women (CIW) 3/21/15

In April of this year, the California Coalition for Women Prisoners (CCWP) provided California Senator Mark Leno with a memo RE: “Female offenders” and medical and mental health care neglect. It opened with quotes that female prisoners had provided CCWP in hundreds of in-person interviews and letters.

“Medical care here is very poor. Inmates are treated like animal. Period. We’re looked at as if we’re not human beings.” and “I’ve gone back to medical for the same issue over a 100 times. So that they can get the $5 co-pay that I don’t have to give.” and “I feel they do not care…it’s my fault or I’m lying about being paralyzed…I had to ‘prove’ I was incontinent. They made me urinate in bed. They would not give me enough catheters.”

Medical care is dire. Mental-healthcare is desperate. Four women have killed themselves at CIW in San Bernardino County in the last 18 months. The suicide rate at the facility is more than eight times the national rate for female prisoners and more than five times the rate for the California prison system as a whole.

Before the recent surge, there were three suicides at CIW in 14 years.

Leno, a Democrat, has been one of the most progressive voices in the Golden State when it comes to prison reforms. It was hoped that he’d be able to open rigorous inquiries as why women are “dropping like flies”, as to why they were hanging themselves and cutting themselves in record numbers.

CCWP got a read on the mental healthcare provision inside CA prisons through interviews and a survey (conducted in summer 2014) from prisoners in California Correction Women’s Facility (CCWF) and CIW, and others recently released. CCWP found that medical and mental health care access and treatment in Californian women prisons fell well below constitutional standards. Suicide prevention is scarce if not lacking entirely.

The AP reported last month how this is “a shocking turnaround” CIW was cited last year as a rare example of good care of California prisoners.

“The prison’s psychiatric program was promoted as a positive example in May 2014 by Matthew Lopes, a federal court-appointed overseer who monitors mental health treatment for inmates. Of six inpatient programs for mentally ill inmates statewide, he found that only the one at the women’s institution was providing proper care.”

All four women who died at CIW were receiving mental health treatment in the days before their deaths.

OFFICIAL DATA

COMPSTAT data gathered by the California Department of  CDCR backed up concerns of increased suicides and suicide attempts.

Figures from women’s prisons, over the 13 months 2/14-2/15.

CIW 16 attempted suicides 3
CCWF 7 attempted suicides 0
CMF 20 attempted suicides 1 suicide
FSP 2 attempted suicides 0 suicides

Figures from all men’s prisons not designated “high security” over the 13 months 2/14-2/15.

ASP 5 attempted suicides 0 suicides
CAL 5 attempted suicides 0 suicides
CEN 3 attempted suicides 0 suicides
CTF 6 attempted suicides 0 suicides
CVSP 1 attempted suicide 0 suicides
ISP 5 attempted suicides 0 suicides
MCSP 17 attempted suicides 2 suicides
PVSP 5 attempted suicides 0 suicides
SOL 8 attempted suicides 1 suicide
VSPW 7 attempted suicides 0 suicides

Source: CDCR COMPSTAT DAI Statistical Report.

CIW had more suicides reported by CDCR than any other CA prison in 2014; CIW also had an alarming number of attempted suicides in the same period. CIW had the third highest number of attempted suicides, but the highest rate of suicide attempts when adjusted for population.

THOSE THAT PASSED

Behind these tragic findings are even more tragic deaths. The deaths of Stephanie Felix, Gui Fei Zhang and Shadae Schmidt were reported by some local and solidarity press, but mostly went by unnoticed and, worse, unquestioned. For

Stephanie Felix committed suicide at CIW on 3/9/15, after previous suicide attempts and after asking for emergency mental health care several times, including that very same day. Ms. Felix had been housed in the SCU, but she was placed back in general population where her mental health declined. During a previous suicide attempt, two prisoners performed CPR on her to save her life, despite being told to stop and facing disciplinary consequences for their actions. (Reported to CCWP by letters 3/15)

Gui Fei Zhang, a 73-year-old Chinese woman, committed suicide on 2/17/15 at CIW. She was released from suicide watch back to general population the day before she killed herself. (Reported to CCWP in interviews 4/10/15)

Shadae Schmidt was a 32-year-old African-American woman who died in the CIW SHU on 3/13/14. Shadae had a stroke in February 2014 and was prematurely returned to the SHU. She was given medication that made her sick but her requests for a change in prescription were ignored. CCWP is still waiting to hear any reports of investigations into Shadae’s death. We have noticed that there is one preventable death listed in the CDCR data for the month she died. (Reported to CCWP by family and friends in 2014)

Uncovering the common causation factors between these deaths has been an ongoing concern for CCWP.

CONCLUSIONS

CCWP concluded generally that:

• Prisoners in the SHU at CIW report heightened medical and mental health care neglect

• CCWF and CIW have poor records of seeing patients in the period mandated once requests for mental health help are submitted.

• Processing time with mental health clinicians is too short – 15 minutes does not allow for adequate diagnosis, treatment, etc..

• Chronic care patients are required to be seen every 90 days, even though many patients require more medical attention; many chronic care patients are not seen every 90 days.

• Overcrowding at CCWF and CIW is still impacting mental health care access; the SCU at CIW is often overcrowded because of the increasing need for acute mental health care.

• The threat of being moved to the PIP prevents many SCU patients from seeking help.

• Patients in the SCU are increasingly cutting themselves to deal with emotional trauma and/or to get the mental health or medical attention they need.

• If people report suicidality after 2pm, mental health departments are closed and mental health workers retrieve patients from the cages (where suicidal patients are caged and cuffed) to treat patients in the emergency rooms of the medical departments — loud, chaotic environments with no chairs, and little privacy.

Specific to neglectful mental healthcare, CCWP noted that:

• Patients, including those who are very sick and/or disabled, routinely wait outside for scheduled doctor’s appointments for 2 to 5 hours in all weather (including rain and heat alerts). “Too many prisoners, too few doctors,” is the common experience.

• Patients do not feel respected, believed or listened to by their primary doctor. People are often told that they are “lying” when they report on health history, symptoms, or past treatments that have been helpful for them.

• Misdiagnoses are still too common.

• Serious lack of follow-up care after surgeries continues to be a significant problem.

• There are often significant delays in refilling prescribed medications. People are going without life-saving and chronic care medications while they wait.

• Treatment recommendations from specialists are rarely ordered and/or followed by doctors at the prisons.

• Gender non-conforming and transgender prisoners face increased medical and mental health neglect because of discrimination based on their gender non-conforming or transgender status.

• When prisoners file grievances (602s) for medical and mental health neglect, they often experience direct retaliation from healthcare providers and/or further denial of access to care.

Recommendations

Despite decades of lawsuits to remedy prison health care and court orders to reduce prison overcrowding, the inhumane conditions inside CA women’s prisons continue. The CCWP has called for an independent investigation into the circumstances surrounding all deaths at CIW in 2014 and 2015. The CDCR says it is monitoring CIW more closely than any other prison in the system.

CCWP calls, sensibly, for a reduction of overcrowding through the implementation of existing release programs. It also calls for immediate transfer of all prisoners with mental health issues from the SHU.