Restrictions imposed by the COVID-19 pandemic are raising concerns about the mental health of inmates at Pittsburgh’s Allegheny County Jail (ACJ), one of the largest jail facilities in the U.S.
The restrictions include: no personal visitors, hardly any time for incarcerated individuals outside of their cells, and chronic vacancies in mental health and health staff.
Incarcerated people, on average, have a greater need for mental health services, but inmates, family members, jail staff members and advocates say the need for support has only increased as authorities grapple with the threat of a potential COVID-19 outbreak, which jails throughout the U.S. have already experienced.
One employee at ACJ, who asked to remain anonymous for fear of retaliation at work, called the situation at the jail “horrendous” and “demoralizing.”
Short-staffing and demanding patient counts make counseling inmates nearly impossible, the employee said.
“A lot of people are really struggling being celled in 23 or more hours every day … I mean, we know this makes people crazy,” the employee said.
“But there’s no real opportunity to counsel people, because we just don’t have the staff for it.”
The jail’s vacancies are affecting the quality of care at the jail, said Charles Timbers, a former nurse practitioner at the jail, who said he was terminated for breaking social media policy by speaking out during the pandemic.
“They just don’t have the staff to meet the needs of the inmates, unfortunately, and the inmates do suffer as a result of that. Medically and mentally,” he said.
One inmate, who declined to be named out of concern for retribution in the system, said he had a choice when he did get 30 minutes of recreation time: call his family, exercise or shower.
The inmate, who was incarcerated at ACJ between May and August for violating probation, described spending two or three days in his cell without leaving, due to restrictions put in place to protect against COVID-19.
Despite several previous stays at the jail, the individual said his most recent stay was harrowing.
“I’m a strong-minded person, and me being down there, it almost broke me,” he told PublicSource.
His description of life for inmates was confirmed by a current ACJ employee.
Overall, incarcerated people have a greater need for mental health services than the general population. Roughly 75 percent of the jail population has a mental health or substance abuse issue, according to a 2019 report from the University of Pittsburgh Institute of Politics.
MiAngel Cody, founder and lead counsel of the Chicago-based nonprofit The Decarceration Collective, said the overrepresentation of individuals with mental health issues in the criminal justice system stems from the defunding of mental health services and the criminalization of mental illness.
“When you have people who don’t have other means and resources to address mental health issues, what has happened is prisons and jails have become the de facto warehousing of them,” she said.
Increased Anxiety, Depression Among Inmates
The Allegheny County Jail has been struggling with staff vacancies for years.
“Even before the virus frankly, it was like this,” said longtime Pennsylvania Prison Society volunteer Marion Damick. “They don’t have a sufficient supply of nurses, medication and/or psychiatrists.”
PublicSource spoke to 12 sources familiar with conditions at the jail, including people formerly incarcerated there, family members of current inmates, current and former ACJ workers and advocates about mental health treatment at ACJ during the pandemic.
Their accounts were largely similar in nature: grievances of increased anxiety and depression, paired with delays in treatment and a shortfall of mental and physical reprieves.
At the beginning of the pandemic, the problem worsened, though it has since [declined to] pre-pandemic numbers.
In February, ACJ had 45 healthcare staff vacancies. That number rose as high as 53 in June, and was back down to 46 at the beginning of September, according to reports provided to the Jail Oversight Board by the county.
Jodi Lynch, a former ACJ nurse practitioner who left the position in August after nearly three years, said inmate recreation time had been cut drastically since the pandemic began.
“Sometimes they’ll get a half hour. Sometimes they don’t get any at all,” she said of the period before her departure. “You can take a totally healthy person, mental health-wise, and you can lock them in a little room, and if they’re in there for 23-plus hours a day, day after day after day, they’re going to mentally decompensate.”
Warden Orlando Harper denied claims that inmates are not getting recreation time every day.
“That is not correct. Every individual at this jail is given at least an hour of recreation a day,” he said, adding that a consent order in a recent federal lawsuit permits the jail to allow 10 inmates out of their cells at a time.
“We are trying to get the number changed so that we can get these individuals out of cell more often,” Harper said.
Current and former ACJ staff disagreed with the warden. One current staff member, who asked to remain anonymous for fear of consequences at work, said the jail’s policy is indeed to allow each inmate an hour of recreation time each day, but it doesn’t always pan out in practice due to various issues.
The restrictions are an effort to stop the spread of COVID-19 throughout the jail population, according to the county’s website.
“Confined areas present challenges when it comes to mitigation and elimination of the spread of illness or disease, and COVID-19 is no exception,” the website says.
Harper confirmed that inmates have the choice of how they would like to spend their recreation time, including showering. Despite challenges by the pandemic and ongoing vacancies, jail officials have said they are making progress to ensure inmates get needed care.
However, at ACJ, many mental health positions, and healthcare positions in general, remain unfilled.
As of the first week of September, 46 healthcare staff positions at ACJ were vacant, including two positions that are supposed to be filled by Allegheny Health Network, which has a contract with the jail. The vacancies include the director of substance use programs as well as numerous mental health positions: one psychiatrist, four mental health nurses, five substance abuse counselors, two mental health specialists and three psychiatric aids.
Chief Deputy Warden of Healthcare Services Laura Williams acknowledged at the June Jail Oversight Board meeting that the facility has had staff turnover. She attributed the vacancies to Pittsburgh’s competitive healthcare job market, broadened leave policies during the pandemic and some employees calling off sick.
Williams said the facility “has been working diligently” to ensure proper care is provided.
“We have not succeeded all of the time in filling every vacancy. I know that and I’ll admit to that, but that hasn’t been because we have not put forth the effort,” she said during the meeting.
National Shortage of Psychiatrists
Williams also attributed the vacancies to a national shortage of psychiatrists.
“Most psychiatrists are very in demand, and this is not the most attractive [setting] for psychiatrists to work in, so it’s been very difficult to recruit for a psychiatrist,” she said.
One psychiatrist, contracted through AHN, was hired in recent weeks.
Some efforts are being taken to improve mental health conditions at the jail.
In June, the Jail Oversight Board created a suicide prevention and investigation committee (there have been 17 suicide attempts and one suicide at ACJ in an eight-month period ending Aug. 15, according to jail records) and approved $54,000 to continue providing cognitive behavior therapy for the veterans in the veteran’s unit.
The jail began allowing attorney visits in July.
Allegheny County recently signed a contract with the telecom company Global Tel-Link to provide call and video call services. Inmates will be issued tablets in October, according to Harper, and the cost for video calls will be $.25 per minute for up to 30 minutes.
Yet some people argue more must be done.
Implementing COVID-19 restrictions at the expense of inmates’ mental health creates a false dichotomy, said MiAngel Cody of the Decarceration Collective.
“[K]eeping people from getting COVID at the expense of their mental health says a lot about how we value health in this country.”
Juliette Rihl, a reporter for PublicSource, is a 2020 John Jay Justice Reporting Fellow. An story she published as part of her Fellowship, “The True Cost of Court Debt” is a finalist for the 2020 Online Journalism Awards. This is an edited and abridged version of a story published this week by PublicSource. The complete version can be downloaded here. Juliette can be reached at firstname.lastname@example.org or on Twitter @JulietteRihl.