The stories are heart-wrenching. Serious violations of civil rights law are alleged.

Details in 39 pages of complaints about lack of mental health treatment for seriously ill inmates at Montana State Prison may have taken prison administration by surprise, but they were already aware that the system needs improvement.

Disability Rights Montana and the American Civil Liberties Union notified the directors of the Montana departments of Corrections and Health that they intend to bring a lawsuit unless the state corrects problems such as:

- Having only one psychiatrist to treat a caseload of 275 seriously mentally ill inmates.

- The psychiatrist and MSP’s intake staff often discontinuing medications without consulting the patient or after a cursory meeting that lasts five minutes or less.

- Putting mentally ill inmates in solitary confinement for 22 or more hours per day.

- Denying mentally ill inmates food, bedding and clothing as punishment for behaviors caused by their illnesses.

- Transfers of inmates found “guilty but mentally ill” from Montana State Hospital to the prison have violated their due process rights. Mentally ill prisoners are transferred to the prison from the Warm Springs hospital to make room at the hospital, according to Disability Rights Montana.

After such transfers, there is no follow up from MSH staff, nor does the prison house and treat the inmate in a clinically appropriate way, the complaint says.

The state hospital is always over capacity, Bernadette Franks-Ongoy, executive director of Disability Rights Montana, told The Gazette last week.

Disability Rights Montana had received so many complaints about MSP that it launched an investigation about 18 months ago. During that time, more than 50 prisoners were interviewed and thousands of pages of documents were reviewed, according to Franks-Ongoy.

“Everything that’s in this letter is supported by documentation,” she said. “Nothing is just them (inmates) or their family members just talking.”

“Major reform is in order in treatment and the environment,” she said. “Just pumping more money into the prison is not going to solve the problem.”

In just over a year on the job, Corrections Director Mike Batista has given numerous VIP tours of the Deer Lodge prison. Two legislative interim committees have visited and his staff has cooperated with the Disability Rights Montana investigation.

The department is looking at staffing, procedures and the limitations of an older facility. Batista said prison administration will seek information on peer review systems that are available for mental health services.

“We spent a lot of time discussing these issues with Disability Rights Montana,” he said, adding that he had expected to receive a consultant’s report to that organization, but had not.

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“We don’t know if the letter is right, but we do have some room for improvement on mental health care in prison,” he said.

“We have been moving forward with groups that have concerns about mental health care, not just in the prisons, but also in the community,” Batista said. “I hope we can come to some agreement on moving forward.”

Some mental health advocates visiting MSP also have noted positive features of prison treatment, he said.

It’s encouraging that Batista recognizes that improvement is needed. It’s important that the ACLU and Disability Rights Montana spelled out their complaints in a letter before filing a lawsuit. We call on those organizations and the Bullock administration to work together in good faith to address urgent matters and plan long-term reforms.

At a minimum, MSP needs additional competent, licensed mental health care professionals to adequately assess and treat the hundreds of mentally ill inmates among a prison population that numbered 1,429 last week. Not all of them are even on the sole psychiatrist’s caseload.

The prison mental health services require better quality assurance protocols and oversight, particularly when the prison doctor disagrees with previous mental health diagnoses and when the prison staff recommends starting or stopping psychiatric medications an inmate was taking on arrival at MSP.

Finally, the use of Montana State Hospital for treating mentally ill convicts needs to be examined as part of a study on the future of state-provided psychiatric inpatient treatment. Most of the patients at Warm Springs have not committed any crime, yet they are removed from communities all across the state and isolated in the sole state-run psychiatric hospital. There are better ways to treat these civil patients, just as there are more effective means of treating forensic patients.

The ACLU and Disability Rights Montana sounded an alarm that both lawmakers and Gov. Steve Bullock’s administration must take seriously enough to respond with a sense of urgency.

Look for more on mental health treatment issues in Monday’s Gazette opinion.