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Report: Illinois prisons among worst in U.S. for mental health care

Guards leave at shift change
Charles Rex Arbogast
AP file
Pontiac Correctional Center is singled out by consultant Sharen Barboza for conditions so troubling that she was personally affected by what she saw inside the facility.

Mental health services in Illinois prisons are among the worst in the country, creating “abysmal and harmful” conditions for staff and inmates, with Pontiac Correctional Center fostering a “disgusting and neglected environment,” according to a consultant’s report on mental health care in Illinois facilities.

The report by Sharen Barboza is one of three reports on prison conditions recently compiled for lawyers for inmates involved in federal lawsuits on inmate health care. The two other reports relate to racial disparities in use of force incidents at Pontiac and Menard prisons and low inpatient numbers at a Joliet mental health treatment center.

Harold Hirschman, one of the inmates' attorneys, said the reports are part of an ongoing effort to challenge widespread deficiencies in inmate health care, including services to 12,000 prisoners who receive mental health care. Those efforts suffered a serious setback last year when a federal appeals court rejected a settlement agreement in the Ashoor Rasho lawsuit that put in place improvements to mental health services in Illinois prisons.

“When Rasho was dismissed, we had a court order, or an agreed court order, that the system would be tested for constitutionality as of Sept. 30 of last year and all the extra work and all the discovery pointed towards being able to show what the system looked like then. The dismissal means all that it’s not clear when, if ever, we’re going to have a trial on the conditions in the system,” said Hirshman.

The three reports could be used in future litigation, said Hirshman.

An IDOC spokesman declined to comment on the reports.

In her December report, Barboza described inmate mental health care in Illinois as “one of the worst that I have seen in my nearly 25 years working in corrections.”

The report is based on 230 hours the consultant has spent in state prisons since 2023, talking with 369 individuals, including 113 private interviews with inmates receiving mental health services.

“I found conclusively that harm is being done to individuals incarcerated within the IDOC. That harm is not incidental, anecdotal, or limited. The harm is systemic across facilities, levels of care, and diagnostic groups,” Barboza said in her report.

Pontiac prison

Pontiac is singled out by Barboza for conditions so troubling that she was personally affected by what she saw inside the facility.

“I experienced sleep disturbance and nightmares after visiting PCC. I ruminated on the abhorrent environment and complete lack of adequate mental health services being provided to individuals with identified signs and symptoms of mental illness which were found to exceed what could be provided in a standard outpatient, general population setting,” the consultant disclosed in her report.

Many mentally ill inmates are specifically placed at Pontiac to receive services, Barboza noted, but “instead are held for prolonged periods in disgusting, leaking, rusty and dank cells in unlit housing units.” When inmates were seen for services outside their cells, “they were seen in small, cramped, out-of-the-way offices with crumbling walls or in a large room filled with cages and benches,” according to the report.

Human feces on a piece of plexiglass in a stairwell and reports of inmates hurling feces at one another is part of life inside the prison. “The disgusting and neglected environment demonstrated an utter disrespect for both the staff and the patients working and living in PCC,” Barboza said of her time in Pontiac.

The consultant said staff shortages at Pontiac resulted in space intended for mental health group meetings being used for storage and a break room for staff. Inmates described to Barboza “the importance of notoriety” to receive mental health care. It was not uncommon for inmates to act out or engage in self-harm to be seen by crisis staff.

After her visits to Pontiac, Barboza concluded, “I see little justification for continuing to place patients suffering from mental illness, or any incarcerated individual, at PCC.”

The state’s plan to demolish and rebuild Stateville Correctional Center ignores issues at Pontiac, a prison built in the late 1800s, said Hirshman.

“The governor says he doesn’t want to spend money fixing up Stateville. He wants to tear it down. Well, I think the next worse place, in terms of needing money to fix it up, is Pontiac and they haven’t had enough guards at Pontiac for years. And they can’t carry out the programming that they’re supposed to be doing there and yet they somehow, for some reason, insist on keeping it open,” said Hirshman.

Use of force

Hirschman said a second report shows severely mentally ill prisoners are still being treated inside prisons instead of the Joliet Treatment Center, a facility opened in 2017 to treat seriously mentally ill inmates.

The Joliet hospital replaced 30 beds previously set aside at the Elgin Mental Health Center for inmate needs. But a report by Josh Parness, a project coordinator with Dentons US, the law firm representing inmates, shows that in January just 13 inmates were receiving treatment at the Joliet facility designed to help 150 patients.

“So there has been absolutely no improvement for the most seriously mentally ill. Everything that prisoners tell us about Pontiac is very simple: they’re not getting mental health treatment, even though that’s what they’re there for. At Dixon [Correctional Center], it’s no better. This is supposedly an administration that is very interested in fulfilling its promise of delivering decent health care and decent mental healthcare. But on the ground, there are no boots on the ground, there is no delivery. There are words, there are pieces of paper, but that doesn’t help people,” said Hirshman.

In a separate report, the legal team received a report that indicates Black inmates at Pontiac are five times more likely to be involved in use-of- force incidents with staff than other inmates. A total of 331 use-of-force interventions were reviewed at Pontiac and 324 at Menard in southern Illinois.

The results by lawyer and academic researcher Max Schanzenbach considered variables for inmates’ age, length of sentence and whether the inmate is serving a sentence for murder. The data is based on records from June 2021 to June 2023 at the two maximum security prisons.

At Menard, Black inmates are about 2.2 times more likely to be involved in use-of-force interventions, according to the report.

Significant differences were found in a comparison of interventions among inmate populations.

“Although Black prisoners make up only 60% of the prison population at Pontiac, they comprise 89% of use-of-force incidents. A large average difference is observed at Menard as well, with Black prisoners comprising 62% of the total prison population but 77% of the use-of-force incidents,” said the report.

Hirschman said the report has been sent to the IDOC but he has received no response.

With no further litigation possible in the Rasho lawsuit, Hirshman said the legal team plans to enlist the public’s help in bringing attention and change to mental care in Illinois prisons. In the coming weeks, lawyers will be releasing “hundreds of pages of summaries of testimony, trial testimony, depositions, documents — you name it. We want to see something happen,” said Hirshman.

Edith Brady-Lunny was a correspondent at WGLT, joining the station in 2019. She left the station in 2024.