On Monday, the United States appeared before the United Nations in Geneva to defend its human rights record for the second time ever.
Nearly 120 countries turned up to offer recommendations—a turnout so high that each country had just 65 seconds to speak. The response was damning: countries from Chad to China berated the U.S., stressing that police brutality and discrimination had gotten out of control.
If the session had been one day later, these critics would have had another weapon in their arsenal. On Tuesday, a new report by Human Rights Watch unveiled a similarly brutal portrayal of life inside America’s prisons for mentally ill inmates, filled with stories of widespread abuse, including solitary confinement, neglect, improper medical care, and corporeal punishment by officers.
The investigation, entitled “Callous and Cruel,” (PDF) is a 127-page blockbuster. Its stories are horrific: a mentally ill prisoner is strapped down, a helmet on his head, and a policeman delivers a faceful of pepper spray used to subdue combative inmates. Prisoners are found naked and unconscious in piles of their own urine and feces. Mentally ill inmates are shackled into full-body restraints as punishment. A schizophrenic man died after correctional officers placed him in a scalding shower for two hours.
In one of the most harrowing stories, the report says a 35-year-old schizophrenic inmate named Christopher Lopez was incarcerated for kicking a correctional officer. He was kept in isolation almost all day. Early one morning in 2013, staff found him unresponsive, and forcibly removed him for observation. While he was being watched, Lopez had a seizure, was laid out on the floor, pumped with psychotropic drugs, and then stopped breathing. Video of the incident apparently shows observing nurses and staff members didn’t tend to him for 20 minutes, after he was no longer breathing. By the time medical attention was given, Lopez was dead.
Mentally ill patients are both more likely than the general population to be locked up, and more likely to be mistreated in prison, the report says. According to the Treatment Advocacy Center, there are an estimated 360,000 prisoners with serious mental illness—particularly schizophrenia, bipolar disorder, and severe depression—spread across 5,100 American jails and prisons.
HRW found that compared to other prisoners, mentally ill inmates are much more likely to be held in solitary confinement—in some states, like Pennsylvania and South Carolina, they’re twice as likely. This can create a dangerous cycle: when mentally ill patients are confined, their behavior worsens, resulting in even longer terms of isolation.
In Colorado, where three percent of prisoners suffer from mental disabilities, they comprise more than a third of the incidents where force is used.
But there’s no national data analyzing the treatment of this prisoner demographic as a whole. The Human Rights Watch report highlights particular incidents, but doesn’t comprehensively survey the prisons. Instead, researchers pulled data from court cases and special litigation from Department of Justice investigations. They interviewed more than 125 people from the correctional system and those involved in monitoring abuses.
The report found that American prisons have a dearth of mental-health services, and the employees lack training to deal with the special needs of mentally ill inmates. Many prisoners don’t adjust well to the regimented life in lock-up, which can exacerbate symptoms. “They find it difficult to understand—or to accept—the role mental illness can play in prisoners’ ability to follow the rules behind bars,” the report says.
Instead, what prison staff often resorts to is brute strength, which can have deadly consequences. “All too often, force is what staff members know and what they use. In badly-run facilities, officers control inmates, including those with mental illness, through punitive violence,” says Jamie Fellner, a senior adviser at HRW, in a press release.
Cited in the investigation is a federal report into abuses at Rikers Island in New York City, where 40 percent of prisoners suffer from mental illness. In an incident from 2012, mentally disabled inmates were brought to a clinic and brutally beaten:
“Based on inmate statements and clinic staff accounts, a captain and multiple officers took turns punching the inmates in the face and body while they were restrained,” the filing read. “One clinician reported that she observed one inmate being punched in the head while handcuffed to a gurney for what she believed to be five minutes.”
Recently, correctional facilities have taken note of the need for trained medical and correctional staff. In Arizona and California, there are already new policies that restrict the use of pepper spray on mentally ill prisoners.
But without a national plan, progress has been inconsistent. Five years ago, the United States underwent its first human rights review at the United Nations. It agreed to ratify a series of international rights treaties, including the Convention on the Rights of Persons with Disabilities. This was the only one of the group that President Obama acted on and submitted to Congress, but it failed to pass by six votes in 2012.
If a four-hour session at the United Nations condemning the U.S.’s human rights record didn’t make it clear: the world has been watching, and the incriminating treatment inside prisons is unlikely to go unnoticed.