Disability Rights Network of Pennsylvania (DRN), a nonprofit corporation, has been designated by Pennsylvania as the organization under the federal Protection and Advocacy for Individuals with Mental Illness Act, 42 U.S.C. §§ 10801-07, to advocate for and protect the rights of individuals with mental illness, including prisoners with mental illness in state correctional facilities. DRN filed a complaint March 11 in the U.S. District Court for the Middle District of Pennsylvania, Disability Rights Network of Pennsylvania v. Wetzel, No. 13-CV-0635 (M.D. Pa. March 11, 2013), alleging that the secretary of the Department of Corrections (DOC), John E. Wetzel, knows or is deliberately indifferent to the fact that prisoners with serious mental illness confined to segregated units, known as restricted housing units (RHU), are subjected to horrific conditions that violate the Eighth Amendment's prohibition against cruel and unusual punishment.

Because these prisoners have serious disabilities and lack almost any contact with the outside world, this litigation has great import. It is virtually the only way to shed light on, and to put an end to, an abusive system that ought not to be tolerated in a civilized society and that creates adverse impacts on public safety.

DRN seeks an injunction requiring the secretary of the DOC to cease violating the Eighth Amendment rights of prisoners with mental illness in Pennsylvania RHUs, provide them with constitutionally adequate mental health care, and protect them against dangerous and unconstitutional conditions of confinement. As of December 10, 2012, approximately 800 men and women diagnosed with serious mental illness were held in isolation within RHUs.

Prior to filing this lawsuit, DRN performed multiple on-site visits of several state correctional institutions to investigate the confinement of prisoners with serious mental illness in solitary or isolated confinement in RHUs and met with DOC counsel as well as line and senior staff. The monitoring visits were announced in advance and were conducted by DRN attorneys and advocates over the course of several years. DRN personnel interviewed hundreds of prisoners in DOC facilities and requested medical, mental health and disciplinary records for nearly 200 prisoners. DRN personnel reviewed and evaluated these records with the aid of a psychiatrist with significant experience in correctional mental health care.

Isolation of prisoners with serious mental illness is a modern-day nightmare, but was described by Charles Dickens over 150 years ago as "cruel and wrong" when he wrote about the practice of housing prisoners in complete isolation at Eastern State Penitentiary in Philadelphia, according to "Eastern State Penitentiary: A Prison With a Past" by Chai Woodham, published October 1, 2008, on Smithsonian.com.

While, ultimately, the state (and many other states that had adopted the "Eastern State" practice) abandoned the use of such isolation early in the 20th century, solitary confinement again became the darling of correctional administrators beginning in the 1980s, likely as a consequence of the so-called "war on drugs."

Today, RHU prisoners are locked inside concrete cells that are less than 100 square feet, about the size of an average bathroom, for 23 hours a day on weekdays and 24 hours a day on weekends and holidays. Many prisoners remain in these cells for months or years on end. RHU prisoners are denied adequate mental health care and prohibited from working, participating in educational or therapeutic programs, or attending religious services. They cannot hold a prison job or participate in rehabilitation services for drug and alcohol addiction, sex offenses, violence prevention, criminal thinking, domestic violence, or victim awareness. In many instances, completion of these services is a prerequisite for parole. RHU prisoners have only the most minimal contact with other human beings, except when they are slid food through a narrow slot in their steel cell doors, or when they are assigned a cellmate, who may be psychotic or violent.

Cell-front mental health "contacts" provided to RHU prisoners last only a few minutes a week or month and are generally used only to consider current mood or special problems and rarely result in any therapeutic treatment. These brief visits are performed by psychology staff where the RHU prisoner shouts through a closed steel cell door, permitting other nearby prisoners to hear these conversations that should be confidential. On rare occasions, RHU prisoners speak with a psychiatrist but almost always for medication adjustments and not therapy.

Prolonged isolation under such harsh living conditions exacerbates the symptoms of prisoners' mental illness, which can include refusing to leave their cells, declining medical treatment, sleeplessness, hallucinations, paranoia, covering themselves with feces, head-banging, seriously injuring themselves and prison staff, and suicide. Frequently, these actions, which are symptoms of serious mental illness, are regarded as prison rule infractions, which result in disciplinary proceedings and more time in the RHU.

Prisoners are confined to segregation after a disciplinary hearing with no consideration that a prisoner's mental illness may have influenced or caused the misconduct at issue. Mental health staff input is non-existent at the disciplinary hearings, even when requested by prisoners with mental illness. Hearing examiners at disciplinary hearings also do not take into consideration the deleterious effects on a prisoner's mental health when sentencing a prisoner to the RHU.

The result is a Dickensian nightmare, in which many prisoners, because of their mental illness, are trapped in an endless cycle of isolation and punishment, deprivation of adequate mental health treatment, further deterioration of their mental illness, and inability to qualify for parole. Indeed, prisoners with mental illness in RHUs, on average, serve much longer sentences than other prisoners because they cannot access programs necessary for parole and are also viewed as poor parole prospects. This practice must end, humane treatment must be provided, and adequate mental health services must be delivered to these individuals. DRN, through this litigation, seeks to achieve these minimal constitutional imperatives.

DRN is represented by its own counsel, as well as counsel from the American Civil Liberties Union of Pennsylvania; the Pennsylvania Institutional Law Project; Kairys, Rudovsky, Messing & Feinberg; and Covington & Burling.

Robert W. Meek has worked exclusively on behalf of people with disabilities for nearly 25 years. He earned his J.D. from Villanova University School of Law in 1978 and a bachelor's degree from the U.S. Naval Academy in 1971. Jeffrey M. Skakalski is a staff attorney at the Disability Rights Network of Pennsylvania, specializing in mental health law, and previously worked as a public defender. He received his bachelor's degree from Colorado State University in 2003 and his J.D. from Penn State Dickinson School of Law in 2008.