Treatment vs. security
The primary goal at this reformatory is safety and that mandates that certain security measures cannot be breached. “Security can’t be a stranglehold on programs that are necessary,” says Warden Larry Chandler.
Therefore, isolating the inmates on lockdown is a constant discussion at the reformatory.
“Isolation works in our favor sometimes but more often than not it works against us,” says Dr. Roby.
The doctors would prefer not to use isolation but they acknowledge the fact that it happens because they are in a prison setting. “It’s a prison system, so security is always first and foremost,” Dr. Young says.
“But there is an inherent weakness in that the psychologists and treatment staff have a different agenda than the officers,” says Dr. Roby. “They are here to protect everybody. We are here to treat people.”
Correctional officers are not only responsible for securing inmates but now help treatment staff and other mental health professionals identify and manage mentally ill inmates, says Sergeant Jeremy Rioux, correctional officer and first shift supervisor.
“It’s a thin line between mental health and security,” says Rioux. “My job is to make sure nobody gets hurt.”
The officers get assaulted often, sometimes six to seven times a day.
Just last year, an inmate broke two of Rioux’s ribs during a cell entry. “It took us 12 people to restrain him. He was clearly psychotic and not on medication and once he got on meds he was fine,” Rioux says.
Caseworker Thelma Barnes admits that there is always a fear working with these inmates. “Even though an inmate is stable and med compliant, there is always that risk of being assaulted.”
Not everybody that ends up in CPTU needs to be in there, Dr. Roby says. Often inmates, who gambled, are in debt on the yard or threatened somebody, emulate the symptoms needed to be referred to the treatment unit. “Those [inmates] are often more problematic than anyone because you have to figure out what their motivation is,” she says.
Inmate Watchers
“I don’t envy the jobs of the treatment staff trying to treat these guys. I can’t even imagine where to start. All I can do is care about them, look out for them and run messages and food for them,” says Matthew Estepp, an inmate watcher in CPTU. Although his primary responsibility is to be an early warning system for inmates committing self-harm, he says spends most of his time listening.
“There isn’t much an inmate watcher can do but I do what I can because it shows them that someone is in their corner,” he says.
Estepp has a unique perspective. He has been locked up for 26 years with a life and 45 year sentence ahead of him. He admits at the beginning of his time in prison he was a troublemaker and that helps him empathize with these men. But after spending months getting to know them, Estepp says it means a lot to the guys in this wing if you take time to talk to them.
Dr. Roby agrees. While she acknowledges their violent behavior, she also says she often sees a compassionate side and that the inmates in CPTU can also be supportive of one another. “I have heard another inmate yell down to another and say, ‘It’s OK, just hang in there.’”
“They are people’s brothers, they are people’s fathers and husbands and regardless of their mental illness and crime, they are doing their time and somebody on the outside misses them,” says Dr. Roby.
“They are people that have made bad decisions, bad choices,” says Dr. Young. “I think that if [these inmates] knew how to do it differently they would.” Young says she believes most of them are responsible for their behavior and that there should be consequences. But being lockdown for 23-24 hours she says “is a miserable experience for them and a poor quality of life for them. Many of them want to get out but some of them don’t because they have been in society and they saw what happened there.”
Both doctors and the warden acknowledge that successes in CPTU must be measured in small increments. “A huge success is seeing someone navigate through the program,” says Dr. Young.
Jeb Shouse is one of those success stories.
“When he entered C wing, he was very psychotic and delusional and was living in his own world,” says Dr. Roby and recalls the number of times he would throw urine and feces at people, refusing to take his meds. “I had to do something different because we didn’t feel like we were reaching him.”
The treatment staff decided to get creative and called his family in Alabama to get them involved. After seeing his mom, Jeb started taking medication. He still has a long way to go but he has more freedom now and is relatively stable, says Dr. Roby.
Months later before his parole hearing, Dr. Roby asks Jeb what he looks forward to when he gets out. “Freedom, Starbucks and seeing my family and grandmother,” he says. Although he did not get paroled on the first attempt, Jeb says he is “still looking forward to the day when I can taste freedom.”
Mentally ill inmates often end up spending more time in prison than the average inmate. They have a hard time following the strict rules of prison life and often have a more difficult time getting paroled because of their poor disciplinary records in prison.
The board is also reluctant to parole a mentally ill inmate because officials can’t find them adequate housing and mental health services in the community. These men frequently spend years waiting to serve out to find a rare spot in a halfway house or mental facility when they finally are released.
An inmate is cuffed and returned to his cell after acting out earlier that day. A spit mask is used to prevent him from spitting at the doctors and correctional officers. "Our priority is security. That mandates that we have certain security measures that cant be breached. But security can't be a stranglehold on progress," says Larry Chandler, warden of Kentucky State Reformatory.
Matthew Estepp, an inmate watcher with a life and 45 years sentence, talks to an inmate during a one-on-one watch. "I feel like I have an interesting perspective as an inmate." One-on-one watches are for inmates who need constant attention and most likely have showed signs of suicidal tendencies.
