In one corner of Baltimore’s main pretrial detention facility, people with severe mental illnesses wait, often for months, to be transferred to a state psychiatric hospital for evaluation and treatment.
At the Baltimore Central Reception Center, those detainees are typically housed in inpatient psychiatric wards, but some of the aging facilities have become known for “extremely harsh” living conditions, according to lawyers for the ACLU’s National Prison Project, which regularly inspects parts of Baltimore’s sprawling pretrial jail complex as part of a decades-long health care lawsuit.
During a tour of the prison’s mental health unit in December, ACLU attorney Corinne Kendrick saw handwritten notebooks recording how much time each inmate had spent in the facility. Are they out of solitary confinement, or why not?
“In a lot of ways, this confirmed what the inmates were telling us, which is that they might be able to shower maybe twice a week if they were lucky,” Kendrick said. “They just can’t get out.”
The records also differed from other records submitted in the lawsuit by the prison’s mental health services provider, Centurion Health. For example, records submitted by Centurion stated that detainees refused to leave their cells, but handwritten records showed they were not actually allowed to leave due to behavioral issues, Kendrick said.
Now Kendrick and her colleagues have filed a motion in court asking the judge to sanction the state for destroying the handwritten records despite the defense’s oral and written requests to the Department of Corrections to preserve them.
According to court documents, the state of Maryland, represented by the private law firm Butler Snow, has asked the judge to give it more time to respond to the ACLU’s allegations of evidence destruction amid a long list of issues still to be decided. The judge asked Butler Snow to respond by the end of the week.
The Maryland Attorney General’s Office and the Maryland Department of Public Safety and Corrections, which runs the city’s jail, declined to comment on the case. Centurion did not respond to a request for comment.
Other filings allege that the state last year extended the amount of time people incarcerated in the psychiatric unit are allowed out of their cells, and that psychiatric monitors noted “significant improvements” in detention conditions, including time outside of solitary confinement, after their most recent tour in April 2024.
But the ACLU argues that conditions in psychiatric wards remain dire and that it has a right to more detailed records quantifying the amount of time spent outside of solitary confinement across psychiatric wards.
Many of the people incarcerated in the mental health unit are awaiting transfer to psychiatric facilities run by the Maryland Department of Health for evaluation and treatment.
But these facilities are overcrowded and waiting times for admission are at record highs, despite the state’s 10-day transfer limit.
In Baltimore County, where a judge recently fined the health department more than $600,000 for repeatedly failing to fix the problem, the Baltimore County public defender praised the county’s jail staff for doing their best to provide treatment despite difficult conditions.
But the city’s pretrial facilities have been run for decades by the state Department of Corrections, which is under federal oversight because of the Duval v. Moore case that dates back to the mid-1970s.
The class action lawsuit has been settled, reopened and settled again, most recently in 2016, but then reopened again to enforce the terms of the settlement. The state, through private lawyers, is now arguing that it should be allowed to opt out of the settlement.
While officials aim to allow several hours of out-of-cell time in the morning and afternoon for mental health and other programs or to “return to pre-pandemic levels,” some city jail detainees report only being out of their cells for two or three hours a week, the ACLU said in a recent court filing.
In a letter to the court in late 2022, ACLU lawyers said people held in psychiatric wards endure “some of the harshest and most degrading conditions ever experienced in any prison or jail in the United States, including death row or ‘supermax’ units.”
Lawyers described detainees being held in isolation without access to books or reading material, including religious texts, and reported that detainees were often not allowed to wear clothing, a practice used in correctional facilities to reduce the likelihood of suicide, even when detainees are stable and not at risk of harming themselves.
The ACLU cited a transgender woman who was committed to a psychiatric ward out of concerns for her safety and a man who was committed to a psychiatric ward because he was recovering from a head injury as examples of people who were unfairly barred from wearing clothing.
The battle for access
Kendrick, of the ACLU, said he noticed the prison logbooks during a December inspection and verbally told a representative from the state attorney general’s office he wanted copies of the records and urged the state to preserve them going forward.
Kendrick identified various records that shed light on issues of mental health treatment to which she believes the ACLU has a right: separate paper records kept by detention officers and nurses detailing time spent outside of solitary confinement, and daily census forms that document the movements of all detainees in the mental health unit.
The state granted the request, and the ACLU received its first and only copy of the logbook in January, Kendrick said, adding that the records returned were “incomplete.”
Kendrick said the ACLU received two sets of logs: handwritten logs kept by detention officers and computer-generated logs kept by Centurion.
The handwritten records showed inconsistencies that the ACLU uncovered in court documents: Some detainees who were not allowed or given the opportunity to leave their cells were recorded in records created by Centurion as having been allowed out of their cells for two hours for activities such as “dinner/lunch, movies, entertainment.” Other records showed detainees had been allowed out of their cells for 50 minutes, but Centurion recorded them as having been allowed out for two hours, the filing said.
The ACLU also said in its filing that one detainee whose count sheet showed he was not offered any out-of-cell custody time because of his behavior was listed on the facility’s count sheet as having received “a seven-minute treatment team meeting with mental health staff.”
“This means either mental health workers going to the front of the cell and screaming through a small hole, or having visits that are clearly not psychiatric but are not confidential in front of everyone,” Kendrick said in an interview. “Sometimes visits from treatment teams are shown, but those visits are extremely rare and extremely brief.”
“In no way would that be sufficient or appropriate mental health treatment,” Kendrick added, one of the central requirements of the consent decree resulting from the ACLU lawsuit.
A few months later, in April, the ACLU renewed its request for handwritten notes from January through March, and then each month thereafter, with additional records. Five weeks after the request, the state turned over some records, but none relating to the inpatient psychiatric ward, the ACLU wrote in court documents.
In a letter filed with the court by the ACLU, the state responded to requests for records detailing time spent outside solitary confinement by arguing that “they are not official documents and therefore are not to be preserved for production.”
“Instead, nursing staff will record IMHU patients’ out-of-cell time in nursing notes, which DPSCS will store in electronic patient health records,” Butler Snow attorney William Lunsford, representing the state, responded.
Stuck in a stalemate, the ACLU filed a motion asking the judge overseeing the case to compel the Department of Corrections to turn over the records and impose sanctions for “destruction of evidence.”
States prepare for major hearings
It’s unclear whether the dispute over the records will be resolved anytime soon.
As the state and the ACLU prepare for an Aug. 20 hearing on the prison lawsuit, the Butler Snow legal team recently reversed course from the state’s strategy of recent years of seeking deadline extensions.
Their new argument is that the state is already in compliance with the agreement, which constitutionally requires it to provide adequate medical and mental health services. State lawyers accuse the plaintiffs in the lawsuit and the independent monitors of moving the goalposts of the agreement. They also argue that the agreement expired on July 1.
“Given that the settlement agreement has expired, the court is technically required to dismiss the case,” the state’s lawyers argued. “But even if this court chooses not to dismiss the case because the settlement agreement has expired, there is no basis for continuing the settlement agreement.”
“The state firmly believes that the current conditions at BCBIC and the MTC clinic far exceed any interpretation of the minimum standard of care permitted by the constitution,” the lawyers added.
The fate of the lawsuit will likely be decided at a hearing on Aug. 20 by U.S. Federal Judge Matthew J. Maddox, who was appointed by President Joe Biden and recently took over the case.
