For the mentally ill behind bars in Montana, life goes from bad to worse 

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Schaefer prescribed lithium in July 2010. It made Colton ill and feverish. He's not currently taking any medications, nor is he in counseling. He's slated to get out March 14, 2014. He says he can make it until then, but, he says, other inmates seem worse. Sometimes he hears men screaming at night inside the Crossroads Correctional Facility, in Shelby. He says they have conversations with people who aren't there. "There are some people with pretty bad mental illness. I feel sorry for those guys."

Chances are, those men don't have the support that Colton does. His family continues to fight a legal battle on multiple fronts. In addition to the civil suit filed last month, they're asking Montana's Ninth Judicial District Court to order his release based on the allegation that he would not be incarcerated today if the DOC had provided proper medical care. A hearing is scheduled for April 26 to debate that complaint.

The Montana Supreme Court already denied one such appeal. But Donna is persistent. She wants to hold DOC accountable. She believes people should at least know the horror that her mentally ill son faces while alone in administrative segregation. She's written letters to Gov. Brian Schweitzer and DOC Director Mike Ferriter. She testifies before lawmakers and listens to the stories told by other parents during legislative proceedings. Too many of them, she says, sound like Colton's.

"This is so much bigger than my kid," she says. "This is a tragedy."



"Heaven into hell"

Some early American settlers believed demons lived in people who exhibited ungovernable behavior. The afflicted were called "lunatics" and "madmen." Doctors treated them with ice baths, malarial infections and lobotomies, a surgical procedure in which nerves in the frontal lobe are severed.

Those unable to manage mood swings and hallucinations were cared for at home. Unluckier ones lived in almshouses—overcrowded and dirty taxpayer-funded public homes—or in jail.

click to enlarge Raistlen Katka in a court appearance. He was - incarcerated as a minor and tried to kill himself. - PHOTO COURTESY ELIZA WILEY, HELENA INDEPENDENT RECORD
  • Photo courtesy Eliza Wiley, Helena Independent Record
  • Raistlen Katka in a court appearance. He was incarcerated as a minor and tried to kill himself.

In the early 1840s, Unitarian reformer Dorothea Dix was shocked at what she found in Massachusetts almshouses and prisons. She would later tell policy makers that ill people were "chained, naked, beaten with rods and lashed into obedience." They were held in "cages, closets, cellars, stalls, pens..."

Dix first encountered cases of what she called "transcendent madness" in 1841, while volunteering to teach Sunday school at an East Cambridge jail. She was so shaken by what she saw that she resolved to embark on a more than two-year tour of Massachusetts' poorhouses and prisons. Her goal was reform.

She documented a long list of unsanitary and inhumane conditions. One woman in particular stood out. She defied "efforts for controlling the contaminating violence of her excited passions," Dix said. "Every form of polluting phraseology, was poured forth in torrents, sweeping away every decent thought and giving reality to that blackness of darkness which, it is said, might convert a heaven into hell."

Dix told legislators that more hospital beds were needed. They agreed and funded an expansion of the state asylum in Worcester. Before her death in 1887, Dix went on to help create dozens of new state hospitals across the east and into the Midwest.

In 1877, Montana's Territorial Legislative Assembly awarded Dr. Charles F. Mussingbrod and Dr. A. Mitchell a contract to care for the "insane of the Territory of Montana." That first year, in Warm Springs, the facility housed 13 patients. Gardens, a greenhouse and a dairy dotted the site.

The state purchased the institution in 1912. Warm Springs State Hospital that year housed 854 patients.

By the mid-20th century, psychiatric institutions across the nation were outgrowing their capacity. Funding did not match needs. State hospitals became overcrowded warehouses.

In 1954, the first effective anti-psychotic medication, Thorazine, became available. The drug revolutionized how society, the ill and their families coped with mental illness. Within eight months, more than two million patients were taking it.

President John F. Kennedy's presidency further revolutionized the nation's strategies for combating mental illness. Kennedy had an intimate knowledge of the challenges wrought by such maladies. His sister Rosemary was developmentally disabled and mentally ill. She was lobotomized at 23.

In 1963, Kennedy told Congress that he aimed to completely overhaul the country's mental health apparatus. Rather than "social quarantine, a prolonged or permanent confinement in huge, unhappy mental hospitals where they were out of sight and forgotten," Kennedy said ill people should be returned to their communities. He laid out a plan for new mental health centers. They would be places where people could find support while remaining independent.

Fewer than half of the community mental health facilities Kennedy planned for came to fruition.

In 1955, there was one psychiatric bed available for every 300 Americans. Today, that number is one per 3,000.

Warm Springs State Hospital in Montana housed 1,890 people in 1954. Roughly 200 are treated there today. The state's population during that same period grew by more than 400,000.



"Psychological torture"

On December 13, 1994, Cascade County Prosecutors charged Mark Edward Walker with felony forgery, arson and two counts of criminal mischief.

Walker had been diagnosed with ADHD. He admitted to forging his brother's signature on several checks. The other charges stemmed from a fire that he started in his parents' garage.

In exchange for dismissal of the criminal mischief charges, Walker pleaded guilty to negligent arson and felony forgery. The Eighth Judicial District Court sentenced him to five years with the Department of Corrections.

The sentence was suspended. However, Walker violated the terms of his probation, prompting the state to revoke the original sentencing agreement. Walker fled. In 1997, he was arrested in Colorado.

For seven months, Walker remained incarcerated in the Colorado Department of Corrections. Psychiatric staff in Colorado diagnosed him with bipolar disorder and prescribed Lithium. The Montana Supreme Court would later find that Walker received no major disciplinary write-ups while in Colorado.

In November 1998, Walker was extradited to Montana and re-sentenced to five years with the Montana DOC. He was transferred to Montana State Prison on February 5, 1999. Five days later, Walker asked David Schaefer, the Montana DOC psychiatrist, to ensure that he received food with his lithium to ease nausea. Court documents allege that Schaefer learned of Walker's request as early as Feb. 20 but did not meet with Walker until March 11. By then, Walker had stopped taking his lithium.

When Schaefer finally reviewed Walker's file, he diagnosed him with antisocial personality disorder with narcissistic traits rather than bipolar disorder. Schaefer did not prescribe lithium.

Between August 1999 and January 2000, Walker averaged 11 major disciplinary write-ups a month. He spit on guards and covered his cell walls with ketchup, mustard and mayonnaise. On Oct. 8, 1999, he tried to hang himself with a sheet. Four days later, he tried to hang himself again, this time with his prison overalls.

click to enlarge Ben and Donna Wilson, Colton’s parents, at home in Charlo - PHOTO BY CHAD HARDER

Prison officials placed him on a behavior management plan. It included being placed in a cell alone without his mattress, pillow and personal belongings. His clothing was also taken away.

Walker was on disciplinary detention in January 2000. Because he had no paper or pen, he asked a neighboring inmate to help him draft a legal filing. Walker alleged in that petition that MSP officials were subjecting him to cruel and unusual punishment. He asked the court to intervene on his behalf.

The Montana Supreme Court reviewed the case on appeal. In 2003, after Walker had already been released from DOC custody, the court issued a strongly worded opinion against the state. It noted that Montana's constitutional right to human dignity mandates even greater protection than the federal constitution's Eighth Amendment protections against cruel and unusual punishment.

"If the particular conditions of segregation being challenged are such that they inflict a serious mental illness, greatly exacerbate mental illness or deprive inmates of their sanity," the justices wrote, "then [prison officials] have deprived inmates of a basic necessity of human existence—indeed, they have crossed into the realm of psychological torture."

In a landmark decision, the court directed DOC to adjust its policies and report back in 180 days. A court-appointed monitoring committee, composed of a retired psychiatrist, an attorney and an investigator, scrutinized prison procedures during multiple visits to MSP in 2004.

The committee noted that MSP altered its policies after the Walker decision. DOC, for instance, opened the Martz Diagnostic and Intake Unit in 2004. The unit basically serves as a reception area, where mental health staffers take inmates' histories before they enter the prison. Behavior management plans were changed, too. A mental health evaluation is now required before such a plan can be implemented. Similarly, psychiatric staff now have authority to pull an inmate off such a plan if they feel the inmate is worsening.

According to the report, "MSP appears to have taken significant steps to ensure that the behavioral management plans do not exacerbate the inmate's mental health condition and do not inflict serious mental illness or deprive inmates of their sanity."



"This person doesn't really need treatment"

Raistlen Katka's father beat him with belt buckles and wire hangers. Court documents filed on Katka's behalf say his father encouraged the little boy's half siblings to beat him with baseball bats and locked him in his room for days at a time.

Katka was diagnosed with post-traumatic stress disorder, mood disorder and major depressive disorder. Doctors prescribed a variety of psychotropic medications. He lived with multiple family members and in foster care before he acted out and got sent to the Pine Hills Youth Correctional Facility.

Katka got into a fight with two Pine Hills guards. He later pleaded guilty to two counts of assault on a peace officer. His plea agreement stipulated that he be transferred to adult court and sentenced to DOC custody for five years.

As with Colton Wilson, the district court recommended that Katka be placed in a three-month DOC boot camp. He would then be eligible for parole. In 2007, DOC sent him to the Missoula Assessment and Sanction Center for evaluation. The center is housed in the Missoula County Detention Facility. Inmates taken into DOC custody are sent there to evaluate appropriate placement.

A center psychologist recommended that Katka receive ongoing mental health treatment and mood-stabilizing medication.

One month after Katka arrived at the center, staffers placed him in the facility's maximum-security unit. During the six months Katka spent there, he was placed on suicide watch at least once. He didn't make it to boot camp. He was transferred to Montana State Prison in February 2008, just after his 16th birthday.

Katka damaged a fence at the prison, prompting DOC to send him to a restricted segregation unit. Five days a week, he spent 23 hours a day in his cell alone. He didn't get out at all on the other two days. His mental state worsened. He acted out. The prison placed him on a behavior management plan that included dressing him in a gown and putting him in a padded cell with no running water that remained lit through the night.

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