2014-02-06 raemisch wasko-aclu (rtp update)

8/13/2019 2014-02-06 Raemisch Wasko-ACLU (RTP Update)

1/4


2/4Page 2 of 4

meaningful human contact. CDOC has previously pledged to the ACLU that prisoners will beheld in these low levels of the RTP only for short periods of time and that prisoners would not be

retained in the low levels for misbehavior stemming from mental illness. Yet, Sam Mandez a

prisoner whos plight the ACLU has gone to lengths to highlight in a film -1which you, Mr.

Raemisch, to your great credit, watched, shared with CDOC staff and encouraged legislators towatch continues to deteriorate in prolonged isolation within the RTP.

As you may recall, Sam was placed in administrative segregation when he was nineteenyears old for minor prison rule infractions. He then spent the next 15 years in administrative

segregation, and in his profound isolation, became seriously mentally ill. Sam began hearing

voices in his head telling him to harm himself and, as a result, Sam repeatedly did harm himselfand attempt suicide. While Sam has never seriously harmed another inmate or staff member in

prison, he was never able to meet CDOCs behavioral expectations to work his way out of

administrative segregation. It was not until the ACLU became involved in Sams case that inNovember 2012, CDOC finally transferred Sam out of administrative segregation and into the

new RTP. In the fourteen months since Sam was transferred to the RTP, he has spent all but two

months in conditions almost identical to administrative segregation. He is stuck in the lowest

levels of the RTP, relegated to spending virtually his entire day inside his cell alone with histhoughts, and he is deteriorating in this isolation. CDOC refuses to promote Sam to higher levels

of the RTP because of relatively minor prison rule infractions that appear closely related toSams mental illness, such as engaging in self-harming behavior.

Records produced by CDOC regarding Sam reflect that for the vast majority of his days

in the RTP, Sam has left his cell only a few times a week to exercise and once a week to shower.The centerpiece of RTPs therapeutic intervention for Sam appears to be group therapy, which

he is offered 0-3 times per week, and which centers on a non-individualized workbook-based

curriculum. Notably, during his first twelve months in the RTP, Sam never refused individual

therapy and refused group therapy only twice; yet, during that same time period, CDOCcancelled Sams scheduled therapy 31 times, which means one in every four scheduled therapy

session was cancelled.

Of perhaps greater concern, while in isolation at the RTP, Sam receives negligible one-

on-one contact with mental health professionals. During his first nine months in the RTP, Sam

spent an average of seven minutes every week meeting one-on-one with a mental healthprofessional. It was surprising to us to learn that the longer Sam has been in the RTP program,

the less time he has spent meeting individually with a mental health professional. Recent data

provided by CDOC shows that from May 28, 2013, through December 31, 2013, Sam spent anaverage of four minutes each week meeting one-on-one with a mental health professional. Many

weeks and months Sam had absolutely no individual mental health contacts. In Spring of 2013,

for instance, Sam went 114 days without an individual mental health contact. Sam reports that

he cannot recall the last time he met alone with a mental health professional.

Sam became seriously mentally ill in the solitary conditions of administrative

segregation, so it should come as no surprise that Sam continues to deteriorate mentally in thesolitary conditions of the RTP. Recently, we received a deeply disturbing report about Sam by

forensic psychiatrist Dr. Jeffrey Metzner, who has worked extensively with CDOC in the recent

1The film, OUT OF SIGHT,OUT OF MINDTHE STORY OF SAM MANDEZ, can be viewed here:

http://vimeo.com/78840078.
http://vimeo.com/78840078http://vimeo.com/78840078http://vimeo.com/78840078


3/4Page 3 of 4

past. We have attached the report, which was prepared at the request of Sams defense counsel,for your review. It confirms what the ACLU has long understood to be true that Sam is

receiving grossly inadequate out-of-cell time, and that the dearth of individual therapy CDOC

provides to Sam is particularly egregious. Dr. Metzner opines that Sams treatment in an

RTP setting has failed, and that Sam must now be transferred to a mental hospital for intensivetreatment and increased out-of-cell time. Dr. Metzner confirms that the negative behaviors

which hold Sam in the low levels of the RTP are certainly associated with both his serious

mental illness and personality disorder.2 Most importantly, Dr. Metzner reiterates that Sams

mental illness is exacerbated by CDOC continuing to house him in isolation and that if he

remains in this setting, it is likely Sam will experience continued deterioration.

We wish we could tell you that Sams treatment in the RTP program is uniquely

deficient, but through our investigation, we are learning that other prisoners in the RTP are also

stuck in prolonged isolation and receiving plainly inadequate mental health care. Numerous RTPprisoners report spending the vast majority of their day in their cell and leave the cell only to

engage in group sessions during which they must follow a non-individualized workbook-based

curriculum. Further, most of these prisoners report that they are receiving no individual mental

health contacts and, thus far, CDOCs response to our records request has borne this out. Wehave recently received complete records for a prisoner other than Sam Mandez who has been in

the RTP for approximately one year. During that time, he has spent an average of four minutes aweek meeting one-on-one with a mental health professional.

As you must know, RTP cannot be successful with the therapeutic model described

herein. CDOCs experiences with the Offenders with Mental Illness program and both of yourown statements reflect the professional consensus that seriously mentally ill prisoners will not

get better, and are likely to deteriorate, in isolation. Further, a strong therapeutic relationship

between a patient and mental health care provider, which can be established only through

consistent one-on-one contacts is the centerpiece of meaningful therapeutic intervention. RTPsimply cannot be successful without ensuring prisoners have regular individual mental health

contact with a consistent mental health professional.

Finally, it is clear to the ACLU that CDOC has far too few staff in the RTP to provide

intensive mental health treatment to the approximately 240 prisoners slated to be in the program.

Recent data from CDOC reflects that approximately 1 in 4 RTP groups are cancelled, and thenumber one reason for those cancellations is staffing shortage. It stands to reason that if CDOC

does not have sufficient staff to hold its scheduled groups, it cannot devote the much greater staff

time required to provide frequent individualmental health contacts with RTP residents.

2

Of course, prisoners who act out because of their mental illness should not be penalized for their misbehavior byassignment to isolated confinement the very condition of confinement that exacerbates mental illness. We have

understood that this vicious cycle in which a prisoners mental illness is exacerbated by isolation, causing the

prisoner to act out, and then guaranteeing that prisoner remain in isolation is what CDOC sought to end by

establishing the RTP program as an alternative to administrative segregation for seriously mentally ill prisoners.

Yet, just as Sam Mandez was stuck in administrative segregation due to a series of relatively minor prison rule

violations related to his mental illness, he now appears stuck in isolated confinement in the low levels of the RTP for

a series of relatively minor prison rule violations related to his mental illness. We have been told by CDOC

repeatedly that prisoner misbehavior stemming from mental illness would be handled clinically whenever possible,

but that does not seem to be the case for Sam.


4/4Page 4 of 4

We hope this letter has given you some insight into the distance that remains to betraveled to provide CDOCs seriously mentally ill prisoners with adequate mental health care in

a setting that does not isolate prisoners. We look forward to our continued collaboration on this

matter.

Sincerely,

Rebecca T. Wallace

Staff Attorney, ACLUOF COLORADOMark Silverstein

Legal Director, ACLU of Colorado

cc. Senator Jessie Ulibarri - [email protected]

encl. Dr. Jeffrey Metzners Supplemental Report regarding Samuel Mandez

2014-02-06 raemisch wasko-aclu (rtp update)

Documents