St. Tammany Parish Jail (Louisiana)

findings of the Civil Rights Division's investigation of conditions of confinement at the St. Tammany Parish Jail ("St. Tammany" or "Jail"), conducted pursuant to the Civil Rights ofInstitutionalized Persons Act, 42 U.S.C. § 1997 ("CRIPA"). During our investigation, we assessed St. Tammany's compliance with the Constitution, which requires the Jail to provide prisoners with humane conditions of confinement, including adequate mental health care. Consistent with the statutory requirements of CRIPA, we now write to inform you of our findings that St. Tammany fails to comply with the Constitution and of the steps St. Tammany needs to take to meet its obligations under the law. As described more fully below, we conclude that conditions of confinement at St. Tammany violate the constitutional rights of prisoners. In particular, we find that prisoners confined at St. Tammany do not receive adequate mental health care, including proper suicide prevention. As we were conducting our investigation, St. Tammany reported to us that it had begun to make necessary changes to its mental health care program. Many of these changes are consistent with or responsive to our critique and suggestions at the end of our onsite visit to the Jail. In October 2011, Jail officials submitted a letter detailing purported changes in policies, practices, and procedures including in the areas of mental health and substance abuse screening and assessment; the implementation of a suicide database and suicide watch log; increased psychiatric staffing, including hiring a masters-level social worker; abandoning its use of booking cages for housing prisoners with suicidal ideation; constructing five suicide-resistant cells, including one outfitted for physical restraints; eliminating its policy that allowed prisoners to self-administer medications; redrafting the mental health sections of its policies and -2- procedures; and expanding its quality improvement program. More recently, St. Tammany has provided information that will be of use to us in verifying the claimed structural and operational changes at the Jail. In our opinion, these purported changes are both significant and long overdue. St. Tammany has been cooperative throughout our investigation and receptive to our preliminary findings and initial recommendations. We commend St. Tammany’s stated efforts in enhancing mental health care at the facility. The changes described in the October 2011 letter, however, are a small part of the comprehensive reform necessary to ensure that St. Tammany provides treatment to prisoners in a manner that comports with the Constitution. Many of the changes described are either in the planning stages or too newly-initiated to allow for close assessment. Other announced changes have encountered barriers in implementation, and some of our concerns remain unaddressed. Institutional reform can only occur after deficient, broken systems are repaired, and we are encouraged that the Jail is taking some necessary steps to repair its deficient, broken mental health care system. St. Tammany is an integral part of the community’s public safety system. The constitutional treatment of prisoners in St. Tammany is not only an important legal obligation, but will have a direct effect of the success of prisoners on release and on public safety. As a result, we believe that a court enforceable agreement will be necessary to ensure sustainable reform. We look forward to beginning discussions with the Parish in the coming months to find an appropriate resolution. I. SUMMARY OF FINDINGS AND CONCLUSIONS We have concluded that St. Tammany is deliberately indifferently to the mental health care needs of its prisoners. St. Tammany fails to provide minimally adequate mental health care to prisoners at St. Tammany in violation of the Eighth and Fourteenth Amendments to the Constitution. This failure has led to the unneces