Mental health treatment for prisoners in solitary confinement at David Wade Correctional Center — while not perfect — does not rise to the level of a violation of prisoners’ civil rights, an expert defense witness testified Wednesday as part of a four-week-long federal class-action trial against the prison and the state Department of Public Safety and Corrections.
Dr. John Thomspson, chair of the Department of Psychiatry at Tulane University School of Medicine, testified in federal court that while improvements could be made, the problems with provision of mental health care to prisoners in solitary confinement at David Wade Correctional Center in north Louisiana doesn’t reach the level of “deliberate indifference,” a legal standard that the plaintiffs’ attorneys — who are representing a plaintiff class of all prisoners who are or could be put into solitary at David Wade — need to meet in order to prove civil rights violations.
The suit, originally filed in 2018 by the Roderick and Solange MacArthur Justice Center and Disability Rights Louisiana (formerly known as The Advocacy Center), claims that prison officials do not properly screen, diagnose or treat mental illness for prisoners held in solitary confinement — also referred to as “extended lockdown” or “restrictive housing” — where they are held in their cells, sometimes for months or years, for 23 hours a day and rarely allowed social interaction.
The plaintiffs claim the conditions and alleged lack of care create or exacerbate mental illness among prisoners.
The trial, which is in front of judge Elizabeth Foote in the Western District of Louisiana, is in its fourth week. During his testimony, Thompson, who was called as a witness for the Department of Public Safety and Corrections, said that the level prisoner care at the facility is appropriate.
“I think they’re at an adequate standard of care where they are,” Thompson said of David Wade, “But they certainly could improve with more psychiatric time, better communication, better documentation of what happens at the bars … the things that make sense.”
Late last month, the plaintiff’s expert witness on mental health care, Dr. Kathryn Burns, who was the chief psychiatrist for the Ohio state prison system, told a different story on the stand.
Burns testified that mental health care in restrictive housing at the facility was “almost non-existent” aside from medication. Several former prisoners who spent time in solitary confinement at David Wade also testified that the filthy conditions, lack of social interaction, and abuse from guards caused them to have mental health issues, which they received little treatment for.
Thompson visited the prison twice — once in 2019 and again in 2020 — where he and two other doctors interviewed around fifty prisoners — most of whom had spent time in restrictive housing. He then produced a report that concluded that
Thomspon, who is also the chief of staff at the Louisiana Department of Health’s Eastern Louisiana Mental Health System, has supervised psychiatrists who provide care to prisoners at Elayn Hunt Correctional Center and the Louisiana Correctional Institute for Women, along with detainees at the New Orleans jail.
Thompson said that based on his interviews and review of documents he felt mental health care was available for prisoners in restrictive housing at David Wade, and that the mental health staff was qualified to provide care.
“A lot of times in corrections, you’ll see individuals that are given duties that may look higher than what you might see in a medical setting,” Thompson said. “But they have a lot of practice and a lot of experience in it.”
Thompson acknowledged a number of the problems with the administration of mental health care identified by Burns, the plaintiffs’ expert — including a lack of confidential mental-health visits, “individualized” prisoner treatment plans that are in fact all identical, a contracted psychiatrist who only visited the prison twice a month, and the use of shackles on suicide watch.
But unlike Burns, Thompson said those were normal issues for mental health care in a prison setting, rather than anything particularly egregious.
“In any system you evaluate, treatment plans end up being cookie-cutter,” Thompson said of the prisoners’ files. “These were particularly cookie-cutter, and they could be individualized to demonstrate what actually the mental health professionals are doing. Because they’re doing a lot of good work. But it would be nice if they had, you know, better goals and objectives.”
He also acknowledged that over a dozen prisoners told him that staff on restrictive housing tiers would leave the windows open in winter as a form of punishment — what some people incarcerated at the facility have referred to as “bluesing.” Lawyers for the Louisiana Department of Corrections have denied that such a thing ever takes place.
During cross-examination, Melanie Bray, an attorney for Disability Rights Louisiana who is representing the plaintiffs, suggested that Thompson’s report left out portions of interviews with prisoners that were critical of how mental health care was administered at the facility — including that some felt they would be retaliated against for seeking mental health care.
In contrast to Burns, Thompson also testified that current research on whether extended periods of restrictive housing causes or exacerbates mental illness is inconclusive — though he still argued it should be limited.
Burns testified that the general consensus among psychiatrists is that restrictive housing can exacerbate symptoms of mental illness, and pointed to a position statement from the American Psychiatric Association that advocates for limiting restrictive housing for people with mental illness..
Thompson said that he was generally in favor of limiting the use of restrictive housing because it does not further correctional goals, but the impact on mental health was not clear from the literature. While restrictive housing can have a negative impact on some people’s mental health, others will adjust, he said.
“People in prison camps live forever in a prison camp environment where they actually are being tortured, because they accomodate to that environment,” Thompson said. “And so there are horrible situations that people accommodate to all throughout history.”
Judge Foote seemed skeptical of that reasoning.
“But we shouldn’t put people in horrible situations just because people might be able to accommodate to them,” Foote responded — which elicited an objection from a DPSC attorney.