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Witnesses: Mental health at Ala. jail has improved

Sheriff Ana Franklin testified the jail spent more than $981,000 on inmate medical care last year, compared to its total budget of $5.8 million


Evan Belanger
The Decatur Daily, Ala.

Witnesses for the Morgan County Sheriff's Office testified in court Thursday that alleged inadequacies in the provision of mental health care at the county jail have already been remedied and represent only a small fraction of the jail’s total case load.

In closing arguments, attorney Barney Lovelace, who represents the Sheriff's Office, said all of the examples cited by an expert for the Southern Center for Human Rights occurred in the past and were not ongoing. He said the complaints covered just 2.5 percent of jail’s total case load of roughly 120 inmates.

Sarah Geraghty, attorney for the Southern Center, said improvements occurred only after Morgan County and the Sheriff's Office filed a motion June 27 to dismiss all remaining court orders governing the treatment of prisoners.

That leaves it for the court to decide whether the recent improvements at the jail satisfy the 1996 Prison Litigation Reform Act, which requires the court — upon request from a defendant — to terminate any provision of a jail consent decree that is more than two years old unless the court can find there is a current and ongoing violation of the prisoners’ constitutional rights.

Lovelace has already filed a motion arguing evidence presented by the Southern Center does not meet that standard. Federal District Judge Abdul Kallon gave the civil rights group, with represents a class made up of inmates at the jail, until Oct. 23 to file a brief in response.

The court heard testimony Wednesday from Dr. Kelly Coffman, a psychiatrist and assistant professor at Emory University School of Medicine in Atlanta, who described mental health provisions at the jail as “inadequate,” noting wait times as long as several months before inmates were able to see a psychiatrist and be prescribed medication.

She said the jail psychiatrist was not spending enough time at the jail, noting Dr. Shankar Yalamanchile, spent 6.3 minutes with each patient he saw in August.

But defense witnesses said Wednesday that wait times to see the psychiatrist had been substantially reduced since Yalamanchile took over psychiatric care of the inmates July 28. They said Yalamanchile was visiting the jail on a weekly basis, compared to twice a month for his predecessor, Dr. David Anakwenze.

There was a 39-day period during which no psychiatrist visited the jail between Anakwenze’s last visit June 19 and Yalamanchile’s first visit July 28.

Nicholas Barton, the jail’s psychiatric nurse, testified Yalamanchile had worked his way through the waiting list by mid-September and the only patients waiting for care as of Thursday were identified as needing care that week. He said he communicates routinely with Yalamanchile and Yalamanchile can call in prescriptions without visiting the jail.

Defense witnesses also testified two new intake nurses had been hired and a third was planned to help screen and assess inmates upon booking.

They disputed Coffman’s testimony that mentally ill inmates were not being referred upon booking to psychiatric care and instead had to request it themselves through a kiosk system in the jail, noting there were several other ways for jailers and medical providers to refer inmates for psychiatric care.

Attorneys for the Southern Center pointed out in cross-examination that most psychiatric visits at the jail still result from inmate requests, known as “sick calls,” and the attorneys had witnesses read written pleas for psychiatric care from inmates.

Dr. Johnny Bates is owner and CEO of Quality Corrections Health Care, which provides medical and psychiatric care at the jail. He testified there was no incentive to skimp on mental health care, because the company’s contract stipulates that the jail pay for all services provided.

“Unfortunately, the jails have become the dumping ground for the mentally ill, so we’re having to replace what’s out in the community,” he said. “The resources out in the community are terrible.”

Sheriff Ana Franklin testified the jail spent more than $981,000 on inmate medical care last year, compared to its total budget of $5.8 million. She did not specify how much was spent on mental health services.

Bates testified Quality Corrections switched from Anakwenze to Yalamanchile because the jail was taking on more inmates and Yalamanchile was able to visit the jail more frequently.

The Southern Center rested its case Thursday after the testimony of inmate Jessica Whitaker, who said she was denied information about possible side effects of the antipsychotic medication Risperdal she was prescribed at the jail last year. She said her meeting with Anakwenze lasted only about two minutes.

“I asked him if I could have some information on it, and he said no,” she said.

Whitaker reported she later developed side effects, including the stoppage of her menstrual cycle for about a year, spontaneous lactation, and the chronic clenching of her fists.

She said she did not report the side effects to the psychiatric nurse because she thought they were the result of stress and anxiety and did not realize they were side effects of the medication until she was specifically asked by Dr. Coffman during her investigation.

Coffman testified the day before that the incident demonstrated why it was important for the psychiatrist, not a nurse, to conduct follow-up visits with the patients. Coffman said the side effects place Whitaker, who has been taking the medication for more than year, at a higher risk of osteoporosis and cancer.

During closing comments, Kallon said Yalamanchile appeared to be within Coffman’s recommendation that the jail psychiatrist see at least 40 patients per month and that even in a private setting patients spend less time with a physician than support personnel.

At issue are two court orders requiring prompt treatment of inmates who take prescribed medications or have serious mental illnesses or suicidal tendencies.

The Southern Center has agreed to drop all other orders, including those that that govern inmate food and use of force.

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McClatchy-Tribune News Service

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