Forced Medication Behind Bars | AVID Jail Project

When the AVID Jail Project first began regularly visiting King County Correctional Facility (KCCF) last year, we had no idea that the jail was forcibly medicating some inmates. Then, one day while doing rounds in solitary confinement, we met Dwayne Stelivan. Mr. Stelivan spoke calmly and clearly about his mental health history and his experiences both inside and outside of jail. On the outside, he worked regularly with a doctor to make decisions about his treatment, including whether to take antipsychotic medications. But at KCCF, he told us, the decision was made for him.

When Mr. Stelivan asked me to be present during a forced medication hearing at the jail, I agreed. As an attorney, I thought I knew what a hearing looked like. I was surprised when I found jail health staff standing informally outside Mr. Stelivan’s cell as he squatted down to talk through a thin slot in the metal door. Sensitive, confidential information about Mr. Stelivan’s mental health echoed around us as other inmates looked on and listened from mere feet away. We discussed the issues in no particular order for about ten minutes—the jail presented no witnesses or evidence for examination—and that was it.

Much of what I observed that day, and in the numerous inmate records we reviewed as part of our subsequent investigation, was troubling. No confidentiality. No notification to the criminal defense attorney. No one to help the inmate identify evidence or make arguments. Witnesses appearing via cell phone. And never any mention of outside judicial review. When we shared these concerns with other attorneys and advocates, most did not know that the jail was even doing these hearings and many expressed bewilderment and doubt about their legality.

Our society has decided that we have a fundamental right to control the medical treatment we receive, including whether to take powerful antipsychotic medication. It is only under very limited circumstances, and after careful weighing of the evidence, that this fundamental right can be overruled. When the entity that wants to forcibly medicate is the very same entity conducting the hearing, adherence to due process is a critical safeguard. It is even more important when the decision involves a pre-trial detainee—someone presumed innocent and often held in jail only because he or she cannot afford even the lowest bail. If KCCF wants its forced medication process to consider all interests and respect due process rights, then the jail should have no objection to the following:

  • Notify criminal defense counsel. Even though the inmate cannot have an attorney represent them at the hearing, the results of the hearing can profoundly influence a criminal case. Notification poses little to no cost to the jail;
  • Provide an advocate for the inmate who can help meaningfully present the inmate’s position and has sufficient background to challenge psychiatric recommendations;
  • Hold hearings in a setting that promotes confidentiality and respect. Almost everyone, including inmates and staff, behaves differently in a courtroom-like setting; and
  • Ensure the inmate understands and has access to outside court review.

These changes will help ensure awareness and understanding of a complicated issue that implicates our most basic of rights: the right to control our mind and body. The AVID Jail Project continues to press the jail for these changes.

The AVID Jail Project is a project of Disability Rights Washington. Access more videos and learn more about the AVID Jail Project on the AVID Jail Project page.

Disability Rights Washington, publisher of Rooted in Rights, is the designated protection and advocacy agency in Washington, and is a member of the National Disability Rights Network.

2 responses to “Forced Medication Behind Bars | AVID Jail Project

  1. Having worked as a Parole/Probation Officer (In Washington State they’re called Community Corrections Officers), for better than 37 years (I retired in 2008), one of my pet peeves was the way our mentally ill folks are treated in or out of incarceration. We are desperately in need of “parity” laws that treat mental illness and/or substance addled folks (often I found to be one in the same client) in this country the same as any other diseases (which they are).
    The story you related reminds me of many I saw; and, at one point I filed a complaint with the State Regulatory Agency that governed medication services within our prison system. It fell on deaf ears! Are we still living in the Draconian Dark Ages where inmates are used a guinea pigs on which to run experiments; trying out new drugs to see if they work?
    I am authoring a book about my experience, my career observations, and the on-going lack of “continuum of care” for these folks. Most of them need treatment…NOT jail. Our jails and prisons are full of people who are there in lieu of adequate space for treatment, sparse funding, and lack of real understanding of the issues; especially our Congressional
    Representatives! They, in the main, don’t seem to care that 22 soldiers a day are committing suicide (active AND discharged for “mental” {read PTSD} reasons). I have documented the previous fact. Our ex-military are winding up in our Court systems, jails and prisons; just like they did when I supervised them, early on in my career, during the Viet Nam Conflict (it never was declared a war). My point is, someone(s) in the legal arena need to get some balls and ovaries and put Congress’s feet to the fire and get them to pass “parity” laws that make mental health and substance abuse diseases that are treatable (also documented); and, should be treated before any attempt at incarceration. I think you’d find we would be spending far less money, than we are now, if “parity” laws were passed AND funded. Thank you for taking the time to read this. The title of my book is “The Fire Watchers”, fire being a metaphor for the conflagration of mental illness, substance abuse and lack of continuum of care for these folks. If all goes as planned and contracted, it will be published by Author House, a subsidiary of Random House Publishing, Inc. in the fall of this year (2016).

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