Mark Edward Walker, a Montana resident, was charged in 1994 with felony forgery, arson, and criminal mischief; sentenced to probation; violated the terms of his probation and then absconded to Colorado during his probation revocation proceedings. In 1997, he was arrested in Colorado on a criminal charge, and was confined for eleven months in the Colorado prison system in 1998 and then extradited to Montana, where he was ultimately confined in the Montana State Prison (MSP) in February, 1999. While incarcerated in Colorado, he was diagnosed with hebephrenic schizophrenic disorder, a diagnosis that was later changed to bipolar disorder, for which he was prescribed lithium. While on lithium, he did not receive any major disciplinary write-ups.295
On February 5, 1999, on his intake at Montana State prison, Walker indicated that he had been diagnosed as bipolar and had been taking lithium. On February 10, he notified the staff psychiatrist that he was experiencing stomach pains from the lithium, and shortly thereafter stopped taking his medication. The staff psychiatrist did not evaluate Walker until March 11, 1999. That evaluation lasted thirty minutes. The psychiatrist “discontinued prescribing Lithium for Walker without reviewing Walker’s medical records and without completing any psychological testing. He concluded that Walker did not have a serious mental illness, but rather an antisocial personality with narcissistic traits.”
Over the next year, Walker became increasingly disruptive; whereas he averaged only two severe disciplinary infractions a month in his first six months at MSP, in the next six months he averaged eleven. In August, 1999, he was transferred into the maximum security unit after he broke a showerhead and claimed to have swallowed it. According to correctional officer, he went from being a timid quiet prisoner into an “excited, belligerent, hostile, disruptive and suicidal inmate.” He yelled and screamed for hours on end, spit on officers, covered his cell with ketchup mustard and mayonnaise, refused to comply with direct orders from officers. He also made three suicide attempts on October 8, Walker tried to hang himself with a sheet. Four days later, he tried to hang himself with his prison overalls.
Rather than receiving psychiatric or psychological treatment, Walker’s behavior was treated as purely a disciplinary matter. He received more than one hundred disciplinary write-ups and was placed in disciplinary detention, or “lock down” for six months. While in lock down, he was also placed on the A-block for five separate “behavioral management plans”(BMPs). According to Walker and numerous other prisoners, the A-Block cells were filthy, with blood, feces, vomit, and other debris in them. One prisoner testified he had bloodied a cell by smashing his head against the wall. Walker inhabited that cell for a while. After Walker was removed, and the original prisoner returned, the blood streaks and the words he had written in blood on the wall remained unchanged.
BMPs consisted of withholding all “privileges from an inmate, and then returning them based on conduct.” They are not designed to be therapeutic, but are a tool to help manage dangerous behavior. Prisoners on BMPs are housed in a detention unit designed for disciplinary punishment; the cells are windowless, sparsely furnished and prisoners are allowed no time in the recreation yard. While on BMP, Walker was kept twenty-four hours a day in the cell. He was stripped of all his clothing, spending his days and nights naked. He was not permitted to have bedding or a pillow, but had to simply sleep on the concrete slab that served as a bed. The water to his sink and toilet were turned off (with guards turning it on at regular intervals). He was given a “space” or “suicide” blanket. He was not given hot meals, only slices of meat and cheese served with bread. Through “good behavior” Walker would then “earn” back pieces of clothing, a mattress, hot meals, etc. Although BMPs are supposed to last twenty-four to forty-eight hours, Walker’s first BMP lasted five days; his second BMP lasted eleven; his third six days (ending because he had a court date); his fourth lasted two weeks; and his fifth nearly three weeks, ending on March 1, 2000. MSP officials acknowledged that Walker did not respond well to the BMPs; indeed, his behavior grew progressively worse. While on a BMP in January 2000, Walker filed a pro se petition with the court asserting violations of the state constitution. He had to dictate it to a neighboring prisoner, because he did not have any paper or writing implements.
Throughout the year, the mental health staff at MSP continued to claim that Walker was not bipolar, although they recognized he was at chronic risk for self-harm. They also believed he was manipulating, in order to be reassigned to a less restrictive setting. At the request of Walker’s court-appointed attorney, a private psychiatrist specializing in forensic and correctional psychiatry, Dr. William Stratford, evaluated Walker in February 2000 and administered several mental evaluation tests, reviewed all of Walker’s medical records and interviewed Walker’s family. Basic on his evaluation, Stratford concluded that Walker suffered from bipolar disorder as well as a mixed personality disorder which severely hampers his social and occupational functioning. He further concluded that Walker had been properly treated his mental illness while imprisoned in Colorado, but that he was neglected while at MSP.
According to Dr. Stratford, MSP’s treatment of Walker had fallen so far below the standard of care that it was negligent and scandalous. He said MSP officials were too eager to label Walker as a bad person rather than seriously mentally ill. Because he was not treated, but merely disciplined, Walker “got worse and worse.” Dr. Terry Kupers also reviewed Walker’s records and interviewed him. Dr. Kupers concluded it was “absolutely clear” that Walker suffered from a serious mental illness, most likely bipolar disorder, and he testified it was “inexcusable” that Walker was not on medications, particularly since they were effective in the past. Indeed, he testified that the diagnosis by MSP mental health staff that Walker did not have a mental illness was “preposterous” and fell below medical ethical standards.
A Montana state district court denied Walker’s claim that he was the victim of cruel and unusual punishment in violation of the Montana constitution while incarcerated at MSP. The Supreme Court of Montana reversed this finding. On April 23, 2003, the court held that Walker’s treatment constituted an affront to the inviolable state constitutional right of human dignity possessed by the prisoner; it also concluded that the BMPs and living conditions on the A-block, to the extent they exacerbated his conditions, constituted unconstitutional cruel and unusual punishment.
295 All of the facts in this case study come from Walker v. Montana, 2003 MT 134 (Supreme Court of Montana, April 29, 2003).