Signed into law in 2008, the SHU Exclusion Law requires that inmates diagnosed with serious mental illness be removed from segregated confinement and placed into residential mental health treatment units (RMHTU). Most provisions of the SHU Exclusion Law became effective on July 1, 2011. This hearing will examine the status of the implementation of the SHU Exclusion Law; the operation of the new residential mental health units; and the challenges of providing effective mental health treatment in a prison environment. Further, in 2010, 20 inmates committed suicide in state correctional facilities - twice the number of suicides that occurred in 2009 and the highest prison suicide rate since 1982. Some of these suicides were committed by inmates with a history of mental illness. This hearing will examine the reason for the increase in the inmate suicide rate and the steps taken by the Department of Corrections and Community Supervision (DOCCS) and the Office of Mental Health (OMH) to prevent inmate suicides.

SHU Exclusion Law

The SHU Exclusion Law was enacted in 2008 to help ensure that inmates with serious mental illness would not languish in segregated confinement but instead be transferred to an RMHTU and receive proper therapeutic care. The law expanded on the reforms achieved by mental health advocates in the Disability Advocates, Inc. Private Settlement Agreement (DAI Settlement) agreed to in April 2007. Because the law required an expansion of mental health programs and major changes to correctional rules regarding the treatment of inmates with mental illness, the effective date was extended to July 1, 2011.

The DAI Settlement required the expansion of several existing mental health programs and creation of a Residential Mental Health Unit (RMHU) for inmates who are in disciplinary housing but have been assessed as having a serious mental illness. Based on the mandates of the DAI Settlement and the SHU Exclusion Law, a 100-bed RMHU opened at the Marcy Correctional Facility in 2009 and it is the Legislature's understanding that two other RMHUs were opened on July 1, 2011, at Five Points and Attica Correctional Facilities.

At the core of the SHU Exclusion Law is the requirement that all state prisoners placed into segregated confinement for disciplinary purposes receive an assessment by a mental health clinician. Inmates diagnosed with serious mental illness must be removed from segregated confinement and placed in a residential mental health treatment unit unless, in exceptional circumstances, doing so would jeopardize the security of the facility or other inmates. In the case of such exception, the inmate may remain in segregated confinement but must receive a heightened level of mental health care including at least two hours of out-of-cell therapy per day and periodically be re-assessed.

The SHU Exclusion Law also requires increased specialized mental health training for DOCCS staff and requires the Commission on Quality of Care and Advocacy for Persons with Disabilities to monitor and oversee all prison mental health programs and services.

Inmate Suicides

In 2010, twenty inmates committed suicide in state correctional facilities - twice the number of suicides that occurred in 2009 and the highest prison suicide rate since 1982. Eleven of these suicides were committed by inmates who had previously been diagnosed with a mental illness. All inmate deaths, including those determined to be self-inflicted, are investigated by the State Commission on Correction (SCOC). This investigation generally occurs over the course of a year resulting in a report of SCOC's findings. Because mental health treatment and information is confidential, these reports are heavily redacted, resulting in little information or oversight into the deaths of these inmates. This hearing will explore the issues surrounding inmate suicide, the role of mental health treatment in relation to suicide prevention, and the role of the state in investigating and addressing the death of persons under state custody.

Persons invited to present pertinent testimony to the Committees should complete and return the enclosed reply form as soon as possible. It is important that the reply form be fully completed and returned so that persons may be notified in the event of emergency postponement or cancellation. Oral testimony will be accepted by invitation only and limited to ten (10) minutes' duration. In preparing the order of witnesses, the Committees will attempt to accommodate individual requests to speak at particular times in view of special circumstances. These requests should be made on the attached reply form or communicated to the Committees' staff as early as possible.

Twenty (20) copies of any prepared testimony should be submitted at the hearing registration desk. The Committees would appreciate advance receipt of prepared statements. In order to further publicize these hearings, please inform interested parties and organizations of the Committees' hearing. In order to meet the needs of those who may have a disability, the Assembly, in accordance with its policy of non-discrimination on the basis of disability, as well as the 1990 Americans with Disabilities Act (ADA), has made its facilities and services available to all individuals with disabilities. For individuals with disabilities, accommodations will be provided, upon reasonable request, to afford such individuals access and admission to Assembly facilities and activities.

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1. What is the status of the implementation of the Special Housing Unit (SHU) Exclusion Law? What successes and what challenges have been revealed as a result of the implementation? What remains to fully comply with the mandates of the SHU Exclusion Law?

2. Are the Regional Mental Health Units (RMHU) opened at Five Points Correctional Facility and Attica Correctional Facilities fully operational? What has been the experience of the first RMHU at Marcy? Has the 20 bed expansion by the Office of Mental Health (OMH) at Central New York Psychiatric Center been completed and what has been the effect of these added beds?

3. Are there staff shortages or vacancies impacting the delivery of mental health services in the RMHTU's, CNYPC, or any other mental health unit at other facilities? Have there been any personnel reductions in mental health staffing or services in the past year?

4. How do DOCCS and OMH ensure a continuity of care for inmates with mental illness upon arrival in the Department, transfer during incarceration, and release to the community? What advances have been made in regards to discharge planning for inmates with mental illness?

5. With the benefit of hindsight, what might have been done differently regarding the 20 inmates who died as a result of self-harm in 2010? What have DOCCS and/or OMH done to reduce the number of inmate suicides? What training do corrections officers, administrators and OMH personnel receive in regards to identifying and treating those at risk for suicide and is such training sufficient? Do SHU facilities have more intensive suicide prevention programs than general confinement facilities?

6. Currently it takes approximately one year for the State Commission of Corrections (SCOC) to investigate the death of an inmate and issue a report of its findings. What can be done to reduce the length of time necessary to conduct such investigations? What resources, if any, are needed by the SCOC to reduce the timeframe in which it performs these functions?

7. How have "traveling" Rivers orders affected the need for inpatient care of the prison population? Once an inmate is back in the prison population and Mental Hygiene Legal Services no longer can represent the inmate, what access to legal services does an inmate have if he or she wishes to contest an ongoing Rivers order?

8. What steps have the Commission on Quality of Care and Advocacy for Persons with Disabilities (CQCAPD) taken to monitor compliance with the SHU Exclusion Law? Has CQCAPD hired additional staff or expended additional resources to comply with the SHU Exclusion Law?

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Persons invited to and wishing to present testimony at the joint public hearing on Mental Health Treatment in Prison are requested to complete this reply form as soon as possible and mail, email or fax it to: