USA: "Not part of my sentence": Violations of the human rights of women in custody

February 28, 1999

USA: "Not part of my sentence": Violations of the human rights of women in custody

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In some states, private companies have taken over prison health services. There have been a number of reports that inmates have died because essential medical services were restricted in order to save money. For example, in 1996 Melody Bird, an inmate in Pinellas County Jail, Florida, complained of serious chest pains and difficulty breathing. Nurses at the jail believed she was having a heart attack but were not permitted to call for an ambulance to take an inmate to hospital without prior approval from the medical director of the company contracted to provide health care services at the jail. They contacted the medical director but did not receive permission to call an ambulance for 13 hours. Melody Bird died before reaching the emergency room. After her death, it is reported, "company nurses came forward to say that they had been pressured to avoid sending inmates to the emergency room because of the expense." As well, it was discovered that the company sometimes paid the medical director bonuses to keep inmates out of the emergency room. Several authorities are reported to have ended contracts with private companies because of concerns that their services were of poor quality.(24)

Reports received by Amnesty International indicate that women's mental health needs are often unmet because prisons and jails are commonly able to treat only the most serious disorders and cannot offer the counselling services that would benefit many women. California psychiatrist, Dr. Terry A. Kupers, has noted that "many prison mental health services are limited to a psychiatrist who visits periodically to prescribe strong anti-psychotic medications...But there is no place for a woman who has been massively traumatized and feels depressed or angry to talk through her traumatic memories in a therapeutic setting."(25) Studies indicate that many incarcerated women experience mental health problems linked to having been victims of physical or sexual abuse. (26)

Various sources have expressed concern to Amnesty International that psychotropic drugs - medication for the treatment of serious psychiatric illness - are sometimes used improperly to control and sedate inmates rather than as medication for psychiatric conditions. In a recent study, women in a California prison reported that they were pressured into taking psychotropic medication while detained in jail before being tried. A number stated that drugs were often ordered by people - including correctional officers - who are not qualified to diagnose the psychiatric conditions for which the medications are appropriate treatment and who are not legally permitted to prescribe medications.(27) Some of the women in the study reported that the amount and mixture of drugs made it difficult for them to comprehend what was happening and adversely affected their ability to function during their trial. Lawyers in California, Illinois and Pennsylvania have also told Amnesty International that they have had clients who were so heavily drugged the lawyers had considerable difficulty communicating with them. A lawyer representing inmates at Valley State Prison for Women has drawn the issue to the attention of the United Nations Special Rapporteur on Violence Against Women:

"Rather than consistent treatment, women are prescribed heavy doses of psychotropic medications...I interviewed one mentally disabled woman who was so heavily drugged that she shook almost uncontrollably and could hardly speak throughout the interview. The relative incapacitation that accompanies such high doses of psychotropic medication renders women extremely vulnerable to sexual abuse and harassment." (28)