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Medical Expert: Inadequate Mental Health Care Directly Contributed To Inmate Suicides In Arizona Prisons

Three people incarcerated in Arizona state prisons recently died by suicide in the span of four weeks. Now a medical expert who reviewed the deceased inmates' medical records has determined a lack of proper mental health care directly contributed to their deaths. 

ACLU National Prison Project Director David Fathi says his office reviewed the medical history of the inmates during their monitoring work in a prison health care settlement with the state.

"Our expert psychiatrist concluded that in all three cases, the brief and superficial nature of their mental health encounters was a contributing factor to their suicides,” Fathi said.

Fathi says his office has found hundreds of incidents of inmate mental health encounters lasting just a few minutes.

"We've uncovered this wide-spread practice of drive-by mental health encounters that are as short as five, three and sometimes just one minute in length," Fathi said. "Obviously there is simply no way to provide meaningful, adequate, mental health care in a one or two minute encounter."

While the department has maintained its contractor, Centurion of Arizona, is providing adequate health care, Fathi says the state is depriving incarcerated people of essential mental health care to which they are legally entitled.

In his review of the suicides, Dr. Pablo Stewart wrote that one patient "received exceedingly poor counseling care and psychiatric care in the weeks leading up to his death." 

"An 8/19 visit lasted 10 minutes," Stewart wrote. "This was a very superficial visit where nothing of substance was actually discussed. This visit is especially deficient in that the patient had been placed in segregated housing which very likely exacerbated his underlying depression. The patient hanged himself eight days later."

After reviewing another inmate's records, Stewart determined "that the patient had a complicated mental health history and that, due to the abbreviated nature of the visits, he was not provided adequate mental health care, which directly contributed to his suicide."

"During two of these cases of people who died by suicide, their final mental health encounter was just 3 minutes, during which the clinician determined that the person was not at risk of self-harm," Fathi said. "And the person subsequently committed suicide.

Fathi filed Dr. Stewart's declaration in United States District Court docket for the Parsons versus Shinn prison health care settlement on Friday. In that settlement, the state and attorneys representing inmates agreed to a set of benchmarks called a stipulation that is supposed to generate better health care in state-run prisons.

Fathi says the court has interpreted the stipulation to require that mental health encounters be "meaningful."

"Most mental health encounters should be a minimum of 30 minutes," Fathi said. "For people on suicide watch, they're supposed to be a minimum of 10 minutes in duration."

But Fathi said the state can count shorter encounters as compliant as long as they can prove they were "meaningful" and effective. "We're finding that more than 99% of short encounters are found to be meaningful and appropriate," Fathi said. "The state is flagrantly abusing this limited exception."

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Jimmy Jenkins is a senior field correspondent at KJZZ and a contributor to NPR’s Election 2020 and Criminal Justice station collaborations. His work has been featured on Morning Edition, All Things Considered, Marketplace, Here and Now, The Takeaway and NPR Newscasts.Originally from Terre Haute, Indiana, Jenkins has a B.S. in criminology from Indiana State University and a master’s degree in journalism from Indiana University.Much of his reporting has focused on the criminal justice system. Jenkins has reported on Tasers, body cameras, use of force, jail privatization, prison health care and the criminal contempt trial of former Maricopa County Sheriff Joe Arpaio.