A federal judge has determined that the risk of suicide among state prisoners in Alabama "is so severe and imminent" that he ordered the state's Department of Corrections to immediately implement permanent mental health remedies to address "severe and systematic inadequacies."
The decision by Judge Myron Thompson on Saturday, comes after 15 prisoners killed themselves in the span of 15 months.
In a 210-page ruling that includes summaries of the circumstances leading to each of the inmate suicides, Thompson agreed with prisoners' attorneys that the spike had reached crisis levels, a result of what he previously said are "horrendously inadequate" mental health services provided to inmates.
In addition to ordering the Alabama Department of Corrections to comply with a host of court ordered measures he issued in a 2017 ruling, Thompson also required the state to establish an internal monitoring system and said the court will appoint an interim external monitor to oversee the department's progress.
"The more someone fails to do something he agreed to do, the bigger the need to supervise whether he does it in the future," Thompson wrote, adding that existing monitoring efforts "have been too little, too late."
Five of the 15 suicides occurred between January and March this year. In one instance a prisoner with "severe mental illnesses, as well as intellectual and physical disabilities" killed himself 10 days after testifying in court that he had not received adequate treatment, according to the documents. In another, a man hanged himself roughly 12 hours after being transferred from mental health observation to a segregated cell, rather than being placed on suicide watch.
Although ADOC acknowledged in the court documents that persistent and severe correctional understaffing has significantly contributed to its noncompliance, attorneys had argued that prison officials were working on a plan to reduce the rash of suicides.
"The defendants argue that they cannot prevent all suicides in ADOC. It is true that, as in the free world, not all suicides can be prevented. But this reality in no way excuses ADOC's substantial and pervasive suicide-prevention inadequacies. Unless and until ADOC lives up to its Eighth Amendment obligations, avoidable tragedies will continue," Thompson wrote.
Lawyers from the Southern Poverty Law Center and the Alabama Disabilities Advocacy Program, which represent prisoners in the ongoing case, welcomed the increased oversight.
"The court's opinion recognizes the urgency of the situation facing ADOC. The system remains grossly understaffed and people are dying as a result," Maria Morris, senior supervising attorney at the SPLC told Mary Scott Hodgin, reporter for NPR member station WBHM.
"The time has long since come for ADOC to comply with its constitutional obligations, Morris added in a written statement.
Last month, the U.S. Department of Justice determined the state "routinely violates the constitutional rights of prisoners by failing to protect them from prisoner-on-prisoner violence and sexual abuse," NPR's Debbie Elliott reported.
The immediate steps ordered by Thompson were intended to address specific failures by the ADOC. They include adequately-trained personnel for suicide risk assessments; placing people who are suicidal or potentially suicidal on suicide watch; following up with inmates released from suicide watch; and limiting segregated confinement for prisoners released from suicide watch.
Additionally, ADOC must enforce existing policies, including 30-minute check-ins on people in segregation, where most of the suicides occurred, and requiring that staff take immediate life-saving measures when they find an inmate attempting suicide, including immediately cutting down inmates who have hanged themselves.