HARRISBURG, Pa. (CN) - Pennsylvania subjects mentally ill inmates to longer wait times for treatment than any other state, "often in extended solitary confinement, making them even sicker," 11 plaintiffs claim in a federal class action.
"While federal courts have ruled that delays of more than seven days from the court's commitment order to hospitalization for treatment are unconstitutional, in Pennsylvania many patients wait over a year," the men and women say in the Oct. 22 complaint against the Pennsylvania Department of Human Services, and the CEOs of Norristown and Torrance State Hospitals.
The named plaintiffs were deemed incompetent to stand trial on criminal charges and ordered by a state court judge to undergo competency restoration in one of Pennsylvania's two forensic hospitals licensed to provide competency restoration.
One plaintiff, a homeless Latino with traumatic brain injury, was arrested for assault and spent more than 960 days in jail without treatment, according to the 66-page lawsuit.
Other plaintiffs include a homeless black man diagnosed with schizophrenia who spent more than 340 days in a Philadelphia jail without treatment; a mentally impaired black woman who spent 250 days in Philadelphia jail after spitting on a police officer; a black man in his 60s who spent 675 days in jail after being arrested for breaking into a neighbor's apartment; and a black mentally disabled man with low motor function in his 50s, who spent a year waiting for treatment after being arrested for struggling while he was strapped into an ambulance when he was found drunk on a sidewalk.
These plaintiffs were represented by public defenders.
A former assistant public defender is representing a white plaintiff in his mid-50s who is deaf and schizophrenic. He has been waiting in the system for more than 10 years on murder charges and still experiences "auditory and visual hallucinations that are strikingly similar in content to those that he reportedly experienced 10 years ago, and expresses grave concern over similar delusions," according to the complaint.
An appointed attorney represents a black woman in her early 40s who spent more than 480 days in jail on assault charges, without treatment.
Three plaintiffs are represented by family members. A sister represents a mentally ill man in his late 50s who has spent more than 900 days waiting on burglary charges; a father represents a paranoid schizophrenic in his late 40s who shot a gun into the air and has been jailed for more than 7 months; and a paranoid schizophrenic, represented by his sister, was put into solitary confinement for more than a month on assault charges from an altercation in a psychiatric hospital while he was acutely psychotic.
The plaintiffs say that confining severely mentally ill people "in close quarters with (and without adequate protection from) large numbers of antisocial persons with excess time and few productive activities results in bullying and predation [and that] because these individuals often lack the skills to cope with a prison environment, they are more prone to accrue disciplinary violations leading to harsh punishment and solitary confinement."
Mentally ill people "languish in jails for months and even years, in a punitive environment, without treatment or adequate mental health care, and often in long-term segregation, while they wait for an opening at one of DHS's two forensic hospitals. ... Delays in gaining admission to one of the two hospitals have caused plaintiffs' and the class members' mental health to deteriorate, relegated many of them to extended stays in solitary confinement, and in some cases forced them to spend more time in jail than they would have spent if they had pled or been found guilty. At least two people have died in jail while awaiting a transfer," according to the complaint.
Norristown State Hospital, 15 miles northeast of Philadelphia, is responsible for one-third of Pennsylvania's 67 counties. Torrance State Hospital, 40 miles east of Pittsburgh in Derry, handles the rest.
Both Norristown and Torrance forensic units have been at capacity for many years, and admissions waiting lists for new patients have wait times which "far exceed any constitutionally permitted delay," according to the complaint.
A list of the longest wait times for admission to Norristown from 18 counties last year has an average of 278 days.
There are 237 beds available in the state for these forensic units: 137 at Norristown and 100 at Torrance.
But actually, even fewer beds are available, as the beds are filled with other patients, such as criminal defendants found not guilty by reason of insanity, and patients who have been deemed unlikely to become competent, but who nonetheless remain in the forensic unit awaiting suitable placement.
The longest wait time at Norristown last year was 429 days; at least five people waited for more than a year, and wait times increased this year, up to 477 days in Philadelphia and one delay of 589 days. On Aug. 21 this year the Norristown waiting list had 121 patients on it, but that number increased to 174 when the lawsuit was filed.
Mentally ill people in Pittsburgh jails have waited for up to 119 days in the past year, according to the complaint.
But in an allegation similar to those made in the Veterans Administration hospitals scandal, "wait times shown on the Torrance and Norristown wait lists maintained by DHS frequently under-report the actual wait times, sometimes by two months or more," according to the lawsuit.
Pennsylvania's Mental Health Procedures Act states that a person must be "substantially unable to understand the nature or object of the proceedings against him or to participate and assist in his defense" and that it is "reasonably certain that the involuntary treatment will provide the defendant with the capacity to stand trial," the complaint states.
It adds: "Most of the individuals adjudicated incompetent to stand trial have difficulty understanding why they are imprisoned, what it means to be charged with a crime, or how to assist their attorney in defending them against the criminal charges."
Once a court issues an order for competency restoration treatment, state law requires that the person "shall be transferred, for this purpose, to a mental health facility," and the person immediately becomes a patient of the Department of Human Services.
Plaintiffs say the "ongoing failure" to address these growing delays violates the constitutional right to due process and the Americans with Disabilities Act and Rehabilitation Act.
They seek class certification of two classes and injunctive relief.
Their lead counsel is Witold Walczak with the ACLU of Pennsylvania in Pittsburgh, with assistance from attorneys with Arnold & Porter in Washington, D.C.
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