Corrections Law
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Medical Care: Mental Health

     Monthly Law Journal Artice: Civil Liability for Inadequate Prisoner Medical Care, 2007 (9) AELE Mo. L.J. 301.
     Monthly Law Journal Article: Forced Feeding or Medication of Prisoners, 2007 (12) AELE Mo. L. J. 301.
     Monthly Law Journal Article: Mental Health Care of Prisoners, 2009 (11) AELE Mo. L. J. 301.

     A jail detainee received medical treatment for a burn that she suffered from setting her seatbelt on fire while trying to escape a police car following her arrest. She claimed that the medical treatment was inadequate, as a result of which she required skin grafting surgery after her release. She also claimed that she was illegally deprived of her psychiatric medicine for about two weeks while detained. A federal appeals court overturned summary judgment for the defendants in part, finding that a reasonable jury could find that one doctor knew or should have known of the plaintiff’s need for psychiatric medication as shown by a nurse’s notation, yet failed to take steps to ensure that she received it. There was also evidence that psychiatric social workers knew or had reason to know that she had serious psychiatric needs that required treatment and that there was a risk that she would begin experiencing symptoms of depression and bipolar disorder days before she could expect to receive any medication to treat those conditions. Richmond v. Huq, #16-2560,  872 F.3d 355 (6th Cir. 2017).

     A federal appeals court has overturned a trial court’s dismissal of a former inmate’s lawsuit claiming that she was psychologically traumatized by being forced to undergo sexual shame therapy while incarcerated. The appeals court ruled that it was erroneous to deny as futile the plaintiff’s request for leave to amend to include new assertions when she may be able to allege that she was unaware of her injuries until sometime after she stopped participating in the therapy sessions, and she may have reasonably viewed the embarrassment and humiliation she felt as the ordinary, and therefore not harmful, response to the therapy. Gregg v. Hawaii DPS, #14-16785, 870 F.3d 883, (9th Cir. 2017).

     A prisoner with a history of mental illness exhibited “escalating symptoms” after he stopped taking his medication, and was transferred to the prison’s mental health unit. After some time there, he was transferred to a segregation unit. He believed that he was transferred there not because he no longer needed specialized treatment, but in retaliation for filing complaints against prison staff members. Further, after the transfer to segregation, he was allegedly denied “minimally adequate” mental health care for over 20 months. A federal appeals court overturned summary judgment in favor of the defendants. The prisoner presented sufficient evidence from which a reasonable jury could find that two doctors caused his transfer to segregation for reasons unrelated to medical judgment. Summary judgment was affirmed, however, for defendants with “more tenuous” connections to the prisons mental health care including two doctors who supervised the contract between the corrections department and its medical provider, and the warden, who was also not personally responsible for any possible constitutional violation. Rasho v. Elyea, #14-1902, 856 F.3d 469 (7th Cir. 2017).

      An inmate at a treatment and detention facility for persons believed to be prone to sexual violence claimed that the staff there had caused him to take the antipsychotic drug Risperdal for over a month without his knowledge or consent. A federal appeals court reversed summary judgment. The staff failed to follow Illinois’ mandated procedures for ordering forced medication. The plaintiff had not properly been found to be a danger to himself or others. A doctor had prescribed the medication after the inmate complained about feelings of aggression and hopelessness, so that he could take the medication if he wanted, but a nurse who did not know what the pill was, included it with the inmate’s medication for blood pressure, cholesterol, and stomach problems, which the plaintiff then took without consent or knowledge. The U.S. Supreme Court has recognized a “significant liberty interest,” under the due process clause in “avoiding the unwanted administration of antipsychotic drugs,” which can have “serious, even fatal, side effects.” While the plaintiff was not forced to take the pill, the doctor “must have known that pills were delivered to the inmates, unlabeled, in little cups.” Johnson v. Tinwalla, #15-3525, 2017 U.S. App. Lexis 7554 (7th Cir.).
      A prisoner suffering from Post Traumatic Stress Disorder (PTSD) claimed that prison wardens and supervisory physicians acted with deliberate indifference to his serious medical needs. The wardens were entitled to qualified immunity because there was no specific evidence that they were directly involved in or responsible for the allegedly inadequate treatment. Further, the evidence showed that the physicians were aware of the prisoner's medical needs and took steps to meet them. The prisoner also failed to show that he engaged in activities protected by the First Amendment or that his transfer to another facility or placement in segregation was retaliatory or violated due process. In fact, the transfer was to facilitate him receiving necessary psychiatric treatment. Saylor v. Randy Kohl, M.D., #14-3889, 2016 U.S. App. Lexis 1459 (8th Cir.).
    A county filed a petition for involuntary commitment of a prisoner for mental health care as well as for the involuntary administration of psychotropic medication and treatment. Upholding the granting of the petition, the Wisconsin Supreme Court held that the statute under which the requests were granted did not violate the prisoner's due process rights because it was reasonably related to a legitimate governmental interest in providing treatment to mentally ill inmates, and the evidence proved by a clear and convincing standard that the prisoner was incompetent to refuse treatment, based on undisputed testimony from a medical expert. Winnebago County v. Christopher S., #2014AP001048, 2016 WI 1, 2016 Wisc. Lexis 1
     A prisoner claimed that hia Eighth Amendment rights were violated when he was secured and kept in a four-point restraint chair naked for 14 hours, although he allegedly did not pose a threat to himself or others. He had a long history of mental illness, which included schizo-affective disorder and bipolar disorder. His symptoms had intensified after his detention in solitary confinement, during which he was kept in his cell 23 hours a day, with one hour of daily recreation in a solitary pen on weekdays. He suffered from both auditory and visual hallucinations, paranoid thoughts, episodes of self-harm, suicidal impulses, and episodes of smearing or throwing his own feces. A federal appeals court vacated summary judgment for the defendants, finding that, viewing the facts in the light most favorable to the plaintiff, there were genuine issues of material fact as to whether he posed an imminent threat at the time of the restraint. Young v. Martin, #13-4057, 2015 U.S. App. Lexis 15922 (3rd Cir.).
     A federal prisoner serving a felony sentence challenged her civil commitment under 18 U.S.C. Sec. 4245, claiming that the statutory preponderance of the evidence standard applied to civil commitment of prisoners by the statute violated due process, which she argued required clear and convincing evidence for civil commitment. Rejecting this argument, a federal appeals court stated that clear and convincing evidence is indeed needed for the indefinite commitment of a person with mental illness who is an ordinary citizen, but that it did not violate due process for Congress to apply a different standard to an incarcerated felon. While prisoners still have interests in not being confined to mental hospitals, they "have lost their right to freedom from confinement as a result of their convictions. Sealed Appellee v. Sealed Appellant, #14-10274, 2014 U.S. App. Lexis ___ (5th Cir.).
     A prisoner being admitted to a federal penitentiary allegedly told an intake psychologist that he was mentally ill to the extent that it impaired his ability to function and that he was afraid that he would be attacked if he was placed in the general population. He was placed in the general population and was attacked by another prisoner without provocation on his way to lunch, suffering extensive injuries to his face and head. He sued the U.S. government under the Federal Tort Claims Act, 28 U.S.C. Sec. 2674, claiming that the psychologist did not examine all his available medical documents before releasing him into the general population and that guards failed to monitor their assigned areas, thereby failing to observe the assault, all in violation of mandatory regulations. The federal appeals court overturned summary judgment granted to the government under the discretionary function exception to liability under the Act. The appeals court found that the government had failed to meet its burden of showing that the discretion function exception shielded it from liability as a matter of law under these circumstances. Keller v. United States, #13-3113, 2014 U.S. App. Lexis 21718 (7th Cir.).
     A private psychiatrist who examined a pretrial detainee in a county jail under a contract with his employer to provide mental health services there acted under color of state law. She performed a public function in examining the detainee, who had been acting strangely, and determining that he did not meet the criteria for involuntary hospitalization in a psychiatric facility. Accordingly, the detainee could proceed with his claim that her actions denied him the mental health services he needed while detained. Carl v. Muskegon County, #13-2296, 763 F.3d 592 (6th Cir. 2014).
     Under California state law, persons found not guilty by reason of insanity have the same constitutional rights to refuse to take antipsychotic medication as sexually violent predators and mentally disordered offenders, until and unless a court finds that they are either a danger to others or incompetent to make the decision. The plaintiff was entitled to a hearing to rule on whether he should be forcibly medicated. In re Greenshields, #B252222, 227 Cal. App. 4th 1284, 174 Cal. Rptr. 3d 482, 2014 Cal. App. Lexis 615.
     A prisoner who engaged in suicide attempts, fighting, and other disruptive activities allegedly suffered from significant mental illness. Prison officials repeatedly subjected him to observation placements and Behavioral Action Plans (BAPs). Summary judgment for the defendants on claims for deliberate indifference to serious medical needs was upheld, but the appeals court found that the prisoner had raised genuine issues of disputed material fact as to whether the imposition of the BAP imposed an atypical and significant hardship compared to the ordinary incidents of prison life, without appropriate notice and an opportunity to be heard, in violation of due process. There was also a genuine issue as to whether the BAP imposed conditions of confinement denying him the "minimal civilized measures of life's necessities." Townsend v. Cooper, #12-3620, 2014 U.S. App. Lexis 13776 (7th Cir.).
     A detainee in custody awaiting a probable cause determination was rapidly tapered off his psychotropic medication at a jail. He complained of seizure-like symptoms and was placed in an isolated cell for seven hours, after which he was found dead. The plaintiff's lawyer argued, correctly, that the correct standard for jury instructions in the lawsuit was objective reasonableness not the deliberate indifference standard that had been used by both parties in the case pleadings, summary judgment briefing, subsequent appeal, and remand pretrial preparations. The trial court barred the plaintiff's attorney from arguing this because of tardiness in raising the issue. The federal appeals court reversed, stating that the delay in asserting the correct standard was "puzzling," but that the trial court had failed to show how the defendants would suffer any prejudice because of the delay. King v. Kramer, #13-2379, 2014 U.S. App. Lexis 13252 (7th Cir.).
     During his intake at a facility, a pretrial detainee said that he had no prior suicide attempts, no thoughts of killing or injuring himself, and no major medical problems. A number of weeks later, after he reported suicidal thoughts, he was placed on a 15-minute suicide watch, but subsequently denied that such thoughts continued, while complaining about health issues and acting out in an attempt to be housed outside lockdown. On a night that he was seen crying in his cell, he attempted to hang himself in his cell. He suffered severe brain damage and disability from the unsuccessful suicide attempt. The federal appeals court reversed summary judgment as to two defendants, finding that there was a genuine issue of material fact as to whether they had been deliberately indifferent to the detainee's risk of suicide when he allegedly asked to see a crisis intervention person. If true, there was an obligation to refer the detainee to the person charged, under prison procedures, with making the definitive assessment of his psychological condition. Additionally, the county might have vicarious liability for state law claims arising out of the actions of these defendants. There was no support, however, for the claim that a doctor and a nurse acted with deliberate indifference. Pittman v. Cnty. of Madison, #12-3233, 2014 U.S. App. Lexis 4444 (7th Cir.).
    A prisoner who had been released from custody pursued a lawsuit asserting claims for deliberate indifference to his mental health needs, violations of his right to exercise his religion, and interference with his right of access to the courts. A federal appeals court held that his claims for declaratory and injunctive relief were moot as he was no longer in custody. His claim concerning his mental health treatment boiled down with a mere disagreement with the treatment provided, which was inadequate for a federal civil rights claim. His claims concerning religious freedom and access to the courts were properly dismissed, as he failed to exhaust available administrative remedies concerning these issues, as required by the Prison Litigation Reform Act. Lastly, he was properly denied an appointed lawyer as he was unlikely to succeed on the merits and was able to present the case adequately by himself. Cano v. Taylor, #10-17030, 2014 U.S. App. Lexis 703 (9th Cir.).
     A federal appeals court upheld an order for the forced medication of a defendant to render him competent to stand trial. The fact that he might subsequently face civil commitment did not alter the circumstances, nor was the court impressed with the argument that he was "not dangerous" aside from having allegedly threatened bodily harm to the President of the U.S. This did not make it unimportant to uphold the government's interest in prosecuting him for a crime that was dangerous and serious and there was a solid evidentiary basis for the trial court's order, which was not clearly erroneous. United States v. Dillon, #13-3044, 2013 U.S. App. Lexis25597 (D.C. Cir).
     The Federal Bureau of Prisons was properly authorized to medicate a mentally ill prisoner without his consent. The evidence showed that he was mentally ill, that he posed a danger to himself or others, and that the treatment was in his medical interest. The determination was supported by the record of his past disciplinary conduct record. He threatened harm, attempted to bite or hit officers, repeatedly threw liquids in officers' faces, and engage in both actual and attempted stabbings. Testifying psychiatrists and psychologists showed a consensus that the prescribed antipsychotic medication was the proper treatment for his condition. U.S. v. Hardy, #12-2951, 2013 U.S. App. Lexis 15942 (2nd Cir.).
     A New York prisoner claimed that officials violated his equal protection and Eighth Amendment rights by denying his request for a leave of absence from incarceration to seek treatment for post-traumatic stress disorder. He claimed that prisoners suffering certain physical ailments were granted such leaves, but that he was denied one because his was a mental health issue. The defendants were entitled to qualified immunity because there was no evidence that they had acted unreasonably in believing that the mental health needs of prisoners were being adequately met in the facility. There was a rational basis for distinguishing between mental ailments for which treatment was available in the facility, and certain physical ailments that there were no treatments provided for while still incarcerated.  Spavone v. N.Y. State Department of Correctional Services, #11-617, 2013 U.S. App. Lexis 12549 (2nd Cir.).
     A 23-year-old prisoner, with no known life-threatening conditions, was transferred to a new facility. Under the care of employees of a private medical provider that had a contract to provide care to prisoners, he was treated for moderate depression and prescribed medications. A month later, he was found dead in his cell and an autopsy showed that he died of an epileptic seizure disorder. He had been given both Amitriptyline and Trazodone the previous three days. In a lawsuit by his estate a forensic pathologist for the plaintiff reported that the death was likely caused by a fatal drug interaction. A federal appeals court rejected a motion for qualified immunity by the defendant psychiatrist, as a fact finder could find that he had been deliberately indifferent to a serious risk of harm from the drug interaction. Quigley v. Thai, #11-2014, 707 F.3d 675 (6th Cir. 2013).
     A 16-year-old in an Illinois juvenile detention facility had a history of mental illness and three known prior in custody suicide attempts. The record of his latest intake assessment indicated that he suffered from major depression, psychosis, bipolar disorder, anger, behavior disorders and Attention Deficit Hyperactivity Disorder. He had also previously gone through drug abuse counseling. He had a history of setting fires, cruelty to animals, threatening to kill teachers, alcohol and cannabis use, gang affiliation, and putting a gun to a cousin's head. Despite all this, the juvenile stated that he was not having depressive or manic symptoms and had not recently had suicidal thoughts. Prozac and lithium was prescribed for him and he was evaluated for suicide risk from time to time. Subsequently, he successfully hung himself in his cell. Even assuming that the plaintiff had shown that the defendants were aware of the suicide risk of using metal bunk beds in rooms for mentally disturbed detainees, and that alternative arrangements were feasible, the law was not clearly established enough to defeat the defendant supervisors' defense of qualified immunity. A defendant doctor was not sufficiently enough involved with the decedent to be liable for his death. Miller v. Harbaugh, #11-3418, 2012 U.S. App. Lexis 21855 (7th Cir.).
     A delusional convicted prisoner claimed that his involuntary medication with antipsychotic drugs and his transfer to a state hospital treatment unit from a city correctional center violated his due process rights. A federal appeals court rejected these claims, noting that such forcible medication can be approved based on "overriding justification and a determination of medical appropriateness." He received appropriate due process, including a hearing, within seven days of arrival at the treatment facility and before any involuntary medication had begun. The hearing determined, based on an evaluation that he suffered from a grave disability that made it impossible for him to function either in prison or in society following his release, which justified the medication. His constitutional liberty interest in avoiding involuntary medication was not expanded by the particulars of a state correctional policy on the subject. Green v. Dormire, #11–2251, 691 F.3d 917 (8th Cir.).
     The state of Nevada has reached a $450,000 settlement with the mother of an inmate who died in state prison. The board that approved the award was told by the state that he died from an adverse reaction to an administered anti-psychotic drug, even though his death certificate labeled his death a homicide. The plaintiff's attorney claimed that the prisoner "literally was strangled to death by the correctional officers" who were holding him down to administer the medication. Johnson v. Palmer, #2:11-cv-01604, U.S. District Court (D. Nev. Aug. 2012).
     A pre-trial detainee in a county facility had a history of depression but had exhibited no signs of suicidal tendencies. A social worker decided not to forward his request to see a prison psychiatrist to ask for anti-depressant medication. After the detainee hung himself and died, a lawsuit was filed for deliberate indifference against the psychiatrist, who was an employee of a private nonprofit organization which furnishes medical services to the facility. The psychiatrist could not seek qualified immunity from federal civil rights liability as a private doctor working part-time for a government entity, as there was no history of such immunity for such doctors at the time the federal civil rights statute was enacted. McCullum v. Tepe, #11-3424, 2012 U.S. App. Lexis 18171, 2012 Fed. App. 0287P (6th Cir.).
     When a court is presented with evidence from a mental health professional that unrepresented prisoner litigants in a civil lawsuit seeking damages from prison officials may be incompetent, it is a violation of the court's duty under Federal Rule of Civil Procedure 17(c)(2) to not at least consider whether an attorney should be appointed for the prisoner. That rule obligates the court to protect unrepresented people who are incompetent. In one case, a psychiatric report presented enough evidence of incompetence to make it an abuse of discretion not to appoint a representative. In another, a psychiatrist's letter at least required that the court consider the issue. Powell v. Symons, #10–2157, 2012 U.S. App. Lexis 6467 (3rd Cir.).
     A mentally disturbed man arrested for assaulting an officer was forcibly dressed in pink underwear at the county jail, and yelled out that he was being "raped" (which was not the case). Following his release on bail, and hearing that there was a warrant for his arrest for spitting on an officer during the dress out, he ran away from his home, fearing another arrest. Running four or five miles, he died the next day from acute cardiac arrhythmia. A federal appeals court found that his estate validly stated a federal civil rights claim, and that testimony was properly offered to show that the decedent experienced a "sense of humiliation at being forced to wear pink." With no explanation or defense offered for the practice of dressing detainees in pink, the practice "appears to be punishment without legal justification." The trial court acted properly, however, in excluding testimony by the plaintiff's expert that the dress-out procedure was "probably" the cause of his death. That testimony failed to take into account "generally accepted facts" that cardiac arrhythmia occurred at a generally higher rate among schizophrenics, and explain how that and the fact that stress could render the condition fatal were enough to pinpoint the specific incident that caused the death. Family members should not have been barred from testifying about what the decedent told them about his experiences, for the purpose of showing his state of mind in reaction to it. Wagner v. County of Maricopa, #10-15501, 2012 U.S. App. Lexis 4721 (9th Cir.).
     A schizophrenic man arrested for an attempted bank robbery often refused to take his medication, bathe or eat while in a county jail. He was transported back and forth between a number of mental health facilities and the jail on a number of occasions. While at the jail pending a transfer to a state psychiatric institution, he died from excessively drinking water ("psychogenic polydipsia."). While his estate could pursue claims concerning the sanitary condition of his cell (despite the fact that he may have helped cause the conditions, based on his mental incompetence, there was no basis that any of the defendants were liable for his death, absent any evidence that they were on notice that he might compulsively engage in water drinking to the extent that it would put his life in danger. Estate of Rice v. Correctional Medical Services, #09–2804, 2012 U.S. App. Lexis 5728 (7th Cir.),
      The U.S. Supreme Court has upheld the order of a special three-judge court ordering that the California state prison system reduce its population from 156,000 prisoners, nearly double capacity, by approximately 46,000 prisoners, or 137.5% of design capacity within two years. Current overcrowding was found to have resulted in inadequate medical care and mental health treatment. The Court found that the injunctive order complied with the stringent requirements of the Prison Litigation Reform Act, and that the court below properly gave "substantial weight" to any potential adverse impact on public safety from the order. Brown v. Plata, #09–1233, 2011 U.S. Lexis 4012.
    A prisoner who claimed that a psychologist improperly ordered him placed on suicide watch instead of medicating him failed to establish a claim for deliberate indifference. There was nothing to show that the defendant's actions were inconsistent with his duties as a medical professional. The prisoner had a history of substance abuse and expressed a desire to be medicated with Zoloft, which the psychologist did not believe he needed. Walker v. Eyke, #09-1695, 2011 U.S. App. Lexis 6512 (Unpub. 6th Cir.).
      A former prisoner sued a prison doctor, claiming that he knew he had been diagnosed with schizophrenia, but had refused to provide him with antipsychotic medication, resulting in him hearing voices for six months while incarcerated. The trial court appointed a lawyer to represent him, after he stated that his mental impairment made it difficult to present his case. Despite this, the plaintiff's responses to discovery requests were late, incomplete, and vague, and he failed to provide medical records within his control. In response to a question about his medical treatment since 2000, the plaintiff stated that he had been hospitalized about 150 times, but offered no details about where or when, failing to name any hospitals or physicians. A federal appeals court upheld the dismissal of the lawsuit as a sanction for failing to comply with discovery requests. The court below had taken the prisoner's mental condition into account in extending deadlines and appointing a lawyer to assist him. Despite these accommodations, the plaintiff failed to cure defects in his discovery responses, and failed to appear in court when his presence was required by court order. Watkins v. Nielsen, #10-2366, 2010 U.S. App. Lexis 25775 (Unpub. 7th Cir.).
    A Massachusetts man civilly committed as a sexually dangerous person, claimed that doubling bunking him in a cell with another detainee violated his due process rights and exposed him to harm. But he did not allege any specifics as to how double bunking caused him any ham. He failed to show how either his treatment needs or his safety required a single cell. He also did not show any unusual circumstances, such as being forced to be housed with a suicidal person. Rector v. Dept. of Correction, #10-1079, 2010 U.S. App. Lexis 14924 (Unpub. 1st Cir.).
     A prisoner sued a prison psychiatrist who treated him for various psychological disorders, asserting that the doctor prescribed anti-psychotic medications in order to cause him to commit suicide. The evidence, however, indicated that the inmate, who stated that he had lost trust in the doctor, exhibited paranoid thoughts, stopped taking his medication, and threatened suicide, and that the doctor had him placed under observation. There was no evidence of deliberate indifference to the prisoner's medical needs, much less an intent to harm him. There was also no evidence of the inmate's contention that the anti-psychotic medication prescribed interacted with other medication he was taking to cause suicidal tendencies. Thomas v. Beard, #10-1375, 2010 U.S. App. Lexis 16390 (Unpub. 3rd Cir.).
     A federal investigation into conditions at Cook County Jail in Chicago, Illinois allegedly found widespread unconstitutional conditions resulting in unnecessary inmate deaths and amputations, inadequate medical care, and routine prisoner beatings. The federal government settled a lawsuit with the county in an effort to remedy these problems. The agreement calls for the hiring of 600 additional jail guards, the hiring of four new outside jail monitors, and improvements in jail medical and mental health facilities. It also provides for stepped-up inspections for contraband and more video surveillance of inmate housing. U.S.A. v. Cook County, Illinois, #10-C-2946 (U.S. Dist Ct., N.D. Ill., May 13, 2010). Click here to read the Complaint in the case. Click here to read the press release announcing the settlement agreement.
     Officials at a treatment center for sex offenders were properly denied summary judgment in a lawsuit claiming that the were deliberately indifferent to the risk that he would be assaulted by another offender. He adequately alleged that it was "readily apparent" that placing him in a room with another sex offender who then assaulted him subjected him to an objectively serious risk of harm. There were also sufficient facts from which a jury could find that a defendant acted with deliberate indifference to a serious medical need by failing to provide him with prescribed psychological treatment. Nelson v. Shuffman, #09-2225, 603 F.3d 439 (8th Cir. 2009).
    A prisoner sought an injunction against being placed in a double-bunked cell. He had repeatedly refused orders to enter such a cell, and had been disciplined for these refusals. He claimed to suffer from "mental health issues" which would make double-bunking an "inhumane" condition of confinement and put him at substantial risk of harm from anxiety over the possibility of fights and violence. The trial court held that he had stated a possible Eighth Amendment claim, but that he had to produce some evidence of his purported mental health issues. The court rejected the plaintiff's due process and equal protection claims since he had no protected right to a single-bunk cell and had not been treated differently than other similarly situated inmates. Finally, the prisoner had no First Amendment right to "keep to himself" and refuse to be placed in a double-bunked cell. He was given 45 days to produce evidence of a mental illness justifying his alleged need not to be placed in a cell with another prisoner. Restucci v. Clarke, #09-10584, 2009 U.S. Dist. Lexis 106880 (D. Mass.).
     In a lawsuit filed by the sister of a detainee who successfully committed suicide, a federal appeals court upheld a finding of no liability on civil rights claims against the county, but reversed summary judgment for a psychiatrist under contract with the jail on a medical malpractice claim. The psychiatrist, who was consulted by jail personnel on the detainee's prescriptions, tried to meet with him for a psychiatric examination, but the detainee became "highly agitated" and refused to speak with him in front of a jail officer. The psychiatrist believed that this was a manic episode and discontinued an antidepressant medication to attempt to deal with it. For purposes of the medical malpractice claim, this was a treatment decision, resulting in a duty of care. Whether the psychiatrist violated the applicable standard of care and whether this proximately caused the detainee's death required further proceedings to determine. While it was clear that the jail's express policy required the presence of a jail officer during the interview with the psychiatrist, this was not a violation of the detainee's constitutional rights. Hunter v. Amin, #08-3719, 2009 U.S. App. Lexis 21731 (7th Cir.).
     Prison officials did not act with deliberate indifference to a prisoner's mental health needs in downgrading his mental health status and having him placed in the general population, where he harmed himself. There was no established protected liberty interest in a prisoner's mental health classification. Rather than showing deliberate indifference, the actions taken merely reflected a difference of opinion about the care that the plaintiff needed. West v. Higgins, #08-11309, 2009 U.S. App. Lexis 21057 (Unpub. 11th Cir.).
     An inmate failed to show that a prison psychiatrist failed to provide him with needed treatment or disregarded a known risk of harm he faced. He also failed to show that the psychiatrist conspired with prison officials to unlawfully revoke his single-cell status or that placing him in a double-cell subjected him to an atypical and significant hardship. His claims that he suffered from depression, paranoia, and physical discomfort were not serious enough to show an Eighth Amendment violation. Hodges v. Wilson, #08-4868, 2009 U.S. App. Lexis 17828 (Unpub. 3rd Cir.).
     Injuries a prisoner allegedly suffered from withdrawal from Xanax, which he claimed included hallucinations, nausea, anxiety, and fluctuating blood pressure, did not satisfy the requirement, under 42 U.S.C. Sec. 19997e(e) that he show physical injury before being able to recover damages for mental injuries. At the time, the plaintiff prisoner himself only complained of cold symptoms and "agitation." Additionally, because medical personnel provided other psychotropic medication during his Xanax withdrawal, they were not deliberately indifferent to his serious medical needs. Chatham v. Adcock, #07-14995, 2009 U.S. App. Lexis 13731 (Unpub. 11th Cir.).
     A new Florida law, effective July 1, 2009, requires law enforcement agencies to have a protocol with care facilities concerning mental health examination of persons transported there. "Each law enforcement agency shall develop a memorandum of understanding with each receiving facility within the law enforcement's jurisdiction which reflects a single set of protocols for the safe and secure transportation of the person and transfer of custody of the person. These protocols must also address crisis-intervention measures."
     Jail employees were not entitled to qualified immunity in a lawsuit contending that they were deliberately indifferent to the serious medical needs of a prisoner with mental problems, resulting in his death. The complaint alleged that the prisoner's mother brought his anti-depression medicine to the jail, that he received it until it ran out, and that his new prescription was not available until two days later. When the prisoner's cellmate informed an employee of the sheriff's department that the prisoner had been engaging in odd behavior and swallowing shampoo, a reasonable jury could conclude that the defendants knew that he needed medical attention, but acted with deliberate indifference to that need. Vaughn v. Gray, #07-2921, 2009 U.S. App. Lexis 4800 (8th Cir.).
     A prisoner failed to show that there was a genuine issue concerning whether he was provided inadequate treatment for mental health problems. He was provided with psychiatric medications within 30 days of his arrival at a county jail. His lawsuit demonstrated merely a disagreement with the course of treatment provided, rather than deliberate indifference to serious medical needs. The court also rejected a claim concerning treatment provided for an erupted wisdom tooth, when a dentist who examined the prisoner found no cause for concern. Jaquez v. Newell, #07-CV-498, 2009 U.S. Dist. Lexis 15964 (N.D. Ok.).
     A prisoner failed to show that the decision to forcibly medicate him with anti-psychotic drugs constituted deliberate indifference to his serious medical needs. The trial court had authorized the expenditure of funds for the prisoner to hire an expert for the purpose of making an assessment of the medical evidence, but the prisoner declined to do so. His failure to present expert witness evidence could not be overcome solely by the prisoner's presentation of his own sworn statement concerning his treatment. Aruanno v. Glazman, #07-2543, 2009 U.S. App. Lexis 4154 (Unpub. 3rd Cir.).
     Inmate failed to establish a claim for inadequate medical treatment, as he was examined by a number of mental health providers while incarcerated, as well as being provided with treatment for a number of physical ailments. His medical needs were not "serious," he suffered no long-term effects from any delay in treatment, and he never complained about his treatment while at the prison. Tsakonas v. Cicchi, No. 07-4115, 2009 U.S. App. Lexis 1856 (3rd Cir.).
     Prison administrators would be authorized to provide consent to medical treatment on a prisoner's behalf when he was engaged in a hunger strike predicated on "delusional" reasons that showed an "irrational" thought process. Conservatorship of Burton, No. F0548632009, Cal. App. Lexis 96 (Cal. App. 5th Dist.).
     An Ohio prisoner claimed that lithium prescribed for his mental condition caused failure of his kidneys, and that he was he being medicated in this manner over his objections. He also claimed that he was improperly held down and forcibly administered anti-psychotic drugs on at least one occasion. The court also found, in the alternative, that the requirements of procedural due process had been met. There was no violation of the Eighth Amendment prohibition on cruel and unusual punishment since the facts alleged did not show that the care provided by prison doctors was grossly inadequate or medically unsound. Kramer v. Wilkinson, No. 07-4104, 2008 U.S. App. Lexis 24538 (Unpub. 6th Cir.).
     In a class action over alleged inadequate mental health care of inmates at a county jail, the plaintiffs failed to define in "reasonably particular" detail, what adequate mental health screening would be or a system for delivering medications, and that injunctive relief concerning the treatment of the class was manageable and "conceivable," in light of the individual characteristics and circumstances of class members, including the severity and nature of their mental illnesses. Class certification was therefore properly denied. Shook v. Board of County Commissioners, County of El Paso, No. 06-1454, 2008 U.S. App. Lexis 18542 (10th Cir.).
    While an inmate's claim concerning his allegedly inadequate mental health treatment focused on his desire to be admitted to a particular mental health facility, he was nevertheless required under 42 U.S.C. Sec. 1997e of the Prison Litigation Reform Act to exhaust all available administrative procedures before filing suit, even if those procedures could not provide him with the precise relief that he was seeking. He had an opportunity to appeal a decision to transfer him out of the facility after a determination that his conduct had become a "barrier" to his participation in the program there, but failed to appeal. Additionally, examining psychologists failed to find that he suffered from a mental illness. The trial court properly granted summary judgment to the defendants in his lawsuit. Gruenberg v. Lundquist, No. 08-1251, 2008 U.S. App. Lexis 18216 (Unpub. 7th Cir.).
     A psychiatrist's deliberate indifference caused a mentally ill prisoner's death from severe dehydration he experienced after he was kept in a 90 to 100 degree observation room for several days. A jury awarded $2 million in compensatory damages and $3 million in punitive damages. The compensatory damage award was reduced to $1.5 million. A federal appeals court rejected arguments that the remaining damage awards were excessive, and found that there was sufficient evidence for the deliberate indifference finding, as well as a medical malpractice claim. Further proceedings were ordered on the trial court's reasons for allocating the compensatory damage award between the federal deliberate indifference claim and a state law medical malpractice claim, which was subject to a cap on non-economic damages. Gibson v. Moskowitz, No. 07-1074, 2008 U.S. App. Lexis 9233 (6th Cir.).
     A federal civil detainee sufficiently presented a claim that prison employees acted with deliberate indifference to his mental health needs by denying him needed psychiatric treatment despite his deteriorating condition, which went beyond mere negligence in care. Because he was a civil detainee, and not a prisoner, he was not required to exhaust available administrative remedies under the Prison Litigation Reform Act, 42 U.S.C. Sec. 1997e(a). Additionally, as a civil detainee, his claims were analyzed under the due process clause of the Fifth Amendment, rather than under the Eighth Amendment's prohibition on cruel and unusual punishment. The detainee was confined under 18 U.S.C. Sec. 4246(a), providing for the hospitalization (and continued detention) of a person in the custody of the Bureau of Prisons when their sentence is about to expire or when criminal charges against them have been dismissed on the basis of their mental condition, if they suffer from a mental disease or defect as a result of which their release would create a "substantial risk of bodily harm to another persons or serious damage to property of another." Hicks v. James, No. 06-6786, 2007 U.S. App. Lexis 28251 (4th Cir.).
     In a lawsuit over the death of an allegedly mentally ill pretrial detainee while in custody in a county jail, the plaintiff failed to show that the decedent had been discriminated against because of his alleged disability of mental illness or that there had been deliberate indifference to his serious medical needs. There was also no proof of an official policy or custom of depriving mentally ill detainees of needed medical treatment. The cause of the detainee's death was a previously undiagnosed physical ailment of  "peritonitis due to a perforated ulcer," and the prisoner's mental illness may have rendered meaningful communication with the medical personnel who treated him "almost impossible." In the absence of accurate information from the patient, the medical personnel were denied information that might have aided in their ability to timely diagnose the perforated ulcer. Winters v. Arkansas Dep't of Health & Human Servs., No. 06-2787 2007 U.S. App. Lexis 15486. (8th Cir.).
     A New York prisoner failed to show that correctional officials violated his due process rights by putting him on a restrictive diet that he claimed aggravated his existing mental health condition, resulting in him suffering a mental breakdown. There was no violation of due process, based on the fact that a medical clearance was given before the diet was implemented. A federal appeals court, however, reinstated the prisoner's Eighth Amendment claim, finding that the trial court used too high a standard, requiring the prisoner to show that correctional officials acted in a sadistic and malicious manner, rather than with deliberate indifference to his health or safety. The prisoner adequately alleged that correctional officials knew about the seriousness of his mental condition, and intentionally used a false charge to impose the restricted diet which caused his breakdown, requiring further proceedings. Guilbert v. Sennet, No. 05-6594, 2007 U.S. App. Lexis 13401 (2nd Cir.).
     While a prisoner suffering from a bipolar disorder and severe depression showed that he had serious medical needs, he failed to show that a mental health counselor acted with deliberate indifference to these needs by denying him medication after learning from a psychiatrist that he had been self-medicating himself. The counselor made a good-faith effort to determine whether the inmate's symptoms justified medication and allegedly determined that they did not. Goodrich v. Clinton County Prison, No. 04-3741, 2007 U.S. App. Lexis 1148 (3rd Cir.). [N/R]
     New York state corrections law does not give prison superintendents authority to authorize the commitment of inmates who are sexual offenders to psychiatric hospitals in a unilateral manner. Prisoners are entitled, prior to such commitment, to procedural safeguards, including a right to be heard in court. New York ex rel. Harkavy v. Consilvio, No. 140, 2006 N.Y. Lexis 3580. [N/R]
     Despite prior suicide attempt by detainee, jail caseworker/counselor was not liable for 18-year-old's subsequent successful suicide when she returned him to a single person cell in the general population of the jail. She was entitled to qualified immunity, as there was no clearly established law indicating that her actions would violate his constitutional rights, even if she arguably acted with poor judgment. Perez v. Oakland County, No. 05-1583, 2006 U.S. App. Lexis 25754 (6th Cir.). [2006 JB Dec]
     Detainee in county jail presented a viable equal protection claim by alleging that the jail had a policy and practice of discrimination and that an officer there discriminated against him in his conditions of confinement because of his mental illness of bi-polar disorder. Glisson v. Sangamon County Sheriff's Department, No. 05-3250, 408 F. Supp. 2d 609 (C.D. Ill. 2006). [N/R]
     Bipolar prisoner who saw mental health staff, counselors, and doctors 38 times in a 13 month period failed to show that prison authorities acted with deliberate indifference to his serious medical needs, or retaliated against him for filing a grievance by pursuing misconduct charges against him or transferring him to another facility. Moots v. Lombardi, No. 05-1594, 2006 U.S. App. Lexis 17479 (8th Cir.). [2006 JB Sep]
     Prisoner's claim that officials violated his due process rights by requiring him to agree to take anti-psychotic medications specified by a program coordinator of a sex offender treatment program as a condition of parole was not frivolous, and should not have been dismissed on that basis. The prisoner stated a possible claim for infringement on his liberty interest in avoiding the unwanted administration of anti-psychotic medications. Bundy v. Stommel, No. 05-1099, 168 Fed. Appx. 870 (10th Cir. 2006). [N/R]
     Under Kentucky state law, a county jail, rather than the state, had the financial responsibility of providing indigent prisoners with psychotropic medications. Osborne v. Commonwealth, No. 2004-SC-000566, 185 S.W.2d 645 (Ky. 2006). [N/R]
     Nebraska prisoner did not have a clear right under state law to access to his mental health records, nor a federally protected constitutional right to such access, and therefore was not entitled to a court order requiring correctional officials to provide him with a copy of the records. State ex rel. Jacob v. Bohn, No. S-04-1410, 711 N.W.2d 884 (Neb. 2006). [N/R]
     Schizophrenic prisoner who murdered Jeffrey Dahmer and two other persons failed to show that prison officials at Supermax facility knew that the heat in his cell, the constant illumination there, and the denial of his request for audiotapes to "still the voices" in his head were making his mental illness worse. Scarver v. Litscher, No. 05-2999, 2006 U.S. App. Lexis 1135 (7th Cir.). [2006 JB Mar]
     Man detained by the State of Wisconsin as a sexually violent person failed to show that he was provided with constitutionally inadequate mental health treatment. He failed to show that decisions about his treatment were either made by unqualified personnel or that his treatment was "outside the bounds" of acceptable professional judgment. Williams v. Nelson, No. 04-C-774C, 398 F. Supp. 2d 977 (W.D. Wis. 2005). [N/R]
     Connecticut prisoner's allegation that his meetings with mental health staff at the prison were conducted on the cell tier, within the hearing of other inmates, adequately stated a possible claim for violation of his right to privacy concerning his mental health issues under federal and state law. Hunnicutt v. Armstrong, No. 04-1565, 152 Fed. Appx. 34 (2nd Cir. 2005). [N/R]
     In lawsuit claiming that county failed to provide adequate medical care to mentally ill prisoners, a report by a consulting expert retained by the county to evaluate health services and programs at the county's jails was not protected from discovery under the work products doctrine protecting materials prepared in anticipation of litigation. The expert was not asked to investigate any particular claims but rather to help the county develop long range planning and analysis of its health care needs. There was no evidence that the county's outside litigation attorney was involved in or directed the preparation of the report. Mims v. Dallas County, No. 3-04-CV-2754, 230 F.R.D. 479 (N.D. Tex. 2005). [N/R]
     Detainee suffering from paranoid schizophrenia, acute psychosis, impulse-control disorder, and "polysubstance abuse" could not assert disability discrimination claims since his impairments, because they could be corrected "or mitigated" by medication, did not constitute disabilities. Jail personnel did not use excessive force in using pepper spray to subdue him when he actively resisted his transfer to a hospital for treatment, and did not violate his right to receive adequate medical attention. Atwell v. Hart County, Kentucky, No. 03-6421, 122 Fed. Appx. 215 (6th Cir. 2005). [2005 JB Dec]
    Prison officials did not show deliberate indifference to the serious needs of a mentally ill and suicidal prisoner by failing to provide requested therapeutic art supplies, when they did provide a medical examination and anti-psychotic medications. Scarver v. Litscher, No.01C497, 371 S. Supp. 2d 986 (W.D. Wis. 2005). [N/R]
     Mere three-day delay between the date a prisoner was incarcerated in a county jail and the date she was seen by a psychiatrist did not establish deliberate indifference by the County or its Commissioner to her serious medical needs. Evidence in the record showed that she was seen by mental health personnel whenever she requested, and that problems with her medication were remedied as soon as those problems were brought to the attention of medical personnel. Atkins v. County of Orange, No. 01CIV.11536, 372 F. Supp. 2d 377 (S.D.N.Y. 2005). [N/R]
     A jail doctor's decision not to put a pre-trial detainee on psychiatric medications after he attempted to swallow a razor blade was not deliberate indifference to a serious medical need. The doctor made a medical determination that the detainee was not psychotic, and had him placed in segregation and under close monitoring and supervision by the jail's mental health personnel. Edmonds v. Horton, No. 03-6031, 113 Fed. Appx. 62 (6th Cir. 2004). [N/R]
     Federal trial court applied the wrong legal standard in denying certification of a class action lawsuit challenging the alleged denial of access to mental health care at a county jail. Shook v. El Paso County, No. 03-1397, 386 F.3d 963 (10th Cir. 2004). [2005 JB Jan]
     Statements by state prison psychologist to mentally ill prisoner who made suicidal threats that no one would care if he died did not constitute deliberate indifference to serious medical needs, when psychologist also recommended that the prisoner remain under observation, and the prisoner had access to other psychologists at the prison, as well as to a psychiatrist to whom he had been referred. Means v. Cullen, 297 F. Supp. 1148 (W.D. Wis. 2003). [N/R]
     Private psychiatric hospital and not-for-profit company which owned it were not immune under Tennessee law for potential liability for county jail inmate's suicide on the basis of their employee's alleged action in telling county jail that suicide protocol precautions were not necessary for this prisoner. Employee also qualified as a "state employee" because of his service in screening prisoners to determine if hospitalization was appropriate, and as a state employee, he was entitled to statutory immunity, but this did not alter the result as to the hospital or its owner. Shelburne v. Frontier Health, 126 S.W.3d 838 (Tenn. 2003). [N/R]
     Psychiatrist was entitled to summary judgment on prisoner's claim against him alleging unjustified forced administration of anti-psychotic drugs and excessive doses of one such drug, causing memory loss, headaches, twitching, and confusion. Prisoner failed to properly present expert testimony or other medical evidence sufficient to establish a claim of deliberate indifference to his serious medical needs, or that the psychiatrist had subjective knowledge that there was an excessive risk to the prisoner's health and that the psychiatrist then failed to act on the basis of that knowledge. Roberson v. Goodman, 293 F. Supp. 2d 1075 (D.N.D. 2003). [N/R]
     California Supreme Court rules that mentally ill inmates, placed in mental institutions after the conclusion of their sentences, may not be forced to take anti-psychotic drugs unless they are found to be an immediate danger to themselves or others or incompetent to refuse treatment. In re Qawi, No. S100099, 2004 Cal. LEXIS 1, 7 Cal. Rptr. 3d 780, 81 P.3d 224. [2004 JB Feb]
     Plaintiff failed to show that county had a policy of deliberate indifference in training correctional officers in the handling of mentally ill detainees, or that any such inadequacy in county's training caused detainee's death. No liability for county for the death of detainee from heart failure while incarcerated. Carey v. Helton, No. 01-5623, 70 Fed. Appx. 291 (6th Cir. 2003). [N/R]
     Prisoners asserting claims against county and sheriff for alleged systemic violations of their rights as persons with "serious mental health needs" were not required to exhaust available administrative remedies before filing suit when there was "no available administrative remedies" that the plaintiffs could have used for relief. Shook v. Bd. of County Commissioners of the County of El Paso, 216 F.R.D. 644 (D. Colo. 2003). [N/R]
     Mentally ill county jail inmates could not pursue their claims for disability discrimination against the county and county officials for alleged degrading treatment. They failed to show that they were denied the benefits of any services, program or activity of the jail, or that violent and self-destructive inmates who were mentally ill were treated any differently than violent and self-destructive inmates not suffering from a mental illness. Atkins v. County of Orange, 251 F. Supp. 2d 1225 (S.D.N.Y. 2003). [2003 JB Aug]
     Montana Supreme Court finds that prison's practice of subjecting certain inmates to behavior modification plans, along with the living conditions in the areas where such inmates were housed, violated the state constitutional right to "human dignity" of mentally ill prisoner and represented cruel and unusual punishment, especially when used as a substitute for medical treatment for disruptive and suicidal prisoner. Walker v. State of Montana, #01-528, 68 P.3d 872 (Mont. 2003). [2003 JB Aug]
    Federal appeals court establishes legal standard for medicating criminal defendants involuntarily to enable them to be competent for trial. United States v. Gomes, No. 01-1143, 289 F.3d 71 (2nd Cir. 2002). [2002 JB Oct]
     Widow of manic depressive detainee who suffered a heart attack and died while in custody could pursue claim that county policy of delaying medical screening of combative inmates constituted a substantial risk of serious harm to the decedent. Gibson v. County of Washoe, Nevada, #99-17338, 290 F.3d 1175 (9th Cir. 2002). [2002 JB Oct]
     Prisoner's mental health disorder, diagnosed as bipolar disorder, was sufficiently serious so that deliberate indifference to his resulting medical needs, including anxiety he allegedly suffered due to a lack of medication review, would violate the Eighth Amendment. Further proceedings ordered as to whether manager of counseling treatment services purposefully misdiagnosed prisoner's mental illness or denied medication review. Page v. Norvell, 186 F. Supp. 2d 1134 (D. Ore. 2000). [N/R]
     Federal trial court prohibits housing of seriously mentally ill inmates at "super-maximum" security state prison, based on claim that conditions there, as applied to the mentally ill, amounted to cruel and unusual punishment. Jones 'El v. Berge, #00-C-421-C, 164 F. Supp. 2d 1096 (W.D. Wis. 2001). [2002 JB Apr]
     290:22 Mentally ill prisoners in New York City jails are entitled, under state law, to help in obtaining continuing treatment on their discharge; trial court issues preliminary injunction requiring discharge planning for such prisoners. Brad v. City of New York, 712 N.Y.S.2d (Sup. 2000).
     278:24 New Jersey reaches wide-ranging $16 million settlement in lawsuit over allegedly inadequate treatment of mentally-ill prisoners and disability discrimination against them; plaintiffs' attorneys to receive $1.22 million in attorneys' fees; disciplinary policies to take prisoners' mental illness into account; all new prisoners to receive mental health assessment within 72 hours. D.M. v. Terhune, 67 F. Supp. 2d 401 (D.N.J. 1999).
     [N/R] Pretrial detainee who was incompetent to stand trial could immediately appeal administrative order permitting medical personnel to forcibly administer anti- psychotic medication, but was not entitled to an evidentiary hearing before the district court when administrative proceeding complied with due process. U.S. v. Morgan, No. 99-6245, 193 F.3d 252 (4th Cir. 1999).

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