Twenty-four-year-old R.P. has lived in New York State prisons since he was convicted on two counts of attempted assault and attempted criminal sale of a controlled substance in 1998. He is serving a four-to-eight year sentence and is scheduled to be released in September 2004. At one time, he was taking Resperdal, Sinequan, and Cogentin to control his psychosis and to deal with the internal voices that he routinely heard. But R.P. decided to stop taking his medications because they made him feel lazy and sleepy, and, he states somewhat bizarrely, he believed they were killing his sperm.589
Before he entered prison, R.P. had had a long history of psychosis. While incarcerated at Rikers Island, New York awaiting trial, he was held incompetent to stand trial and was sent to Mid-Hudson Psychiatric Center to be stabilized. After that, he was tried, found guilty, and sent to prison.
During his five years as a New York State prisoner, R.P., an African-American, has been in several prisons: Attica, Downstate, Clinton, Southport, and Wende. In four of these facilities, he has been placed in Special Housing Units (SHU) because of his violent outbursts against other prisoners and staff. At the Southport facility, he was housed in D-Block, a unit with solid doors on the cells, resulting in what his attorneys call “significant sensory deprivation.”590 Since May of 1999, he has been in the SHU continuously, brought out only when he decompensates to such an extent that he has to be temporarily removed to one of the satellite mental health units, and involuntarily medicated with shots of Haldol. In fact, he has accumulated so many disciplinary tickets for acts of self-harm, creating disturbances, and unhygienic acts, that he has accrued enough SHU time to keep him there until he has served out his full sentence.
Despite this well-documented history of bizarre behavior, R.P.’s diagnosis by prison authorities continually has changed. Sometimes, he is documented as having anti-social personality disorder; other times he has been diagnosed with attention deficit disorder or adjustment disorder. He has also been diagnosed with “psychosis non-specific.” None of these diagnoses have prevented his being housed in the SHU.591
In the SHU, lacking daily medications, his mental condition continues to deteriorate. Because he is in the SHU, he has no access to group therapy, no access to the kind of intensive counseling that might convince him to go back on his medications. He says he sees a psychotherapist “once in a blue, but they don’t take me seriously.” And he says that when they do come around, it is only to provide a couple minutes of formulaic cell-front questions. R.P. says that because he has refused to take his medications, he has not been seen by a psychiatrist in two years. By any definition, R.P. is clearly seriously mentally ill and in need of intensive mental health interventions. He has numerous razor cut scars on both arms, and the center of his stomach likewise has a long, fine scar, the aftermath of R.P.’s attempt to cut himself open.592
R.P. told Human Rights Watch:
“The voices,” R.P. stated:
Over the past couple years, R.P. has cut himself with razors, tried to hang himself, and swallowed hoarded painkillers. When he does these actions, he reported, the prison removes him to a suicide-watch observation cell for seven-to-ten days, provide him with no counseling and then returns him to the SHU.
589 Human Rights Watch interview with R.P., Wende Correctional Facility, Alden, New York, September 13, 2002. Some anti-psychotic medications are known to cause temporary impotence; but sterility is not a known side effect.
590 Details provided in correspondence with Prisoners Legal Services attorney Betsy Sterling.
591 Human Rights Watch telephone interview with Betsy Sterling, attorney, Prisoners Legal Services, March 27, 2003.
592 R.P. showed his scars to Human Rights Watch during an interview at Wende Correctional Facility, Alden, New York, September 13, 2002.