Markus Johnson slumped naked against the wall of his Illinois prison cell in 2019, skin flecked with pepper spray. Four men in black tactical gear pinned him, his face to the concrete, to cuff his hands behind his back. He couldn't resist, so dehydrated he would be dead by their next shift change. “I didn’t do anything,” Johnson moaned. It happened at the Danville Correctional Center, a medium-security prison a few hours south of Chicago. Johnson, 21 and serving a short sentence for gun possession, was in the throes of a mental collapse that had gone largely untreated. He had entered in good health, with hopes of using the time to gain work skills. Johnson, who suffered from bipolar disorder and schizophrenia, had refused to eat or take medication. He had stopped drinking water, hastening the physical collapse that often accompanies full-scale mental crises. Johnson's downward spiral represents the failures of prisons to care for the mentally ill, reports the New York Times. Many seriously ill people receive no treatment.
For those who do, the outcome is often determined by the vigilance and commitment of staff, which vary greatly from system to system, prison to prison, and shift to shift. Jails and prisons have become its largest provider of inpatient mental health treatment, with 10 times as many seriously mentally ill people now held behind bars as in hospitals. The population of incarcerated people with major psychological problems is estimated at 200,000 to 300,000. The burden of care often falls on prison staff who struggle with the roles of jailer and caregiver in a high-stress, dangerous, often dehumanizing environment. In 2021, Joshua McLemore, a 29-year-old with schizophrenia held for weeks in an isolation cell in Jackson County, Ind., died of organ failure resulting from refusing to eat or drink. In April, New York City agreed to pay $28 million to settle a lawsuit by the family of Nicholas Feliciano, a man with a history of mental illness who suffered severe brain damage after attempting to hang himself in the Rikers Island jail as correctional officers stood by. In Illinois, Johnson’s mother has filed a wrongful-death suit against the state and Wexford Health Sources, a for-profit health care contractor. The Times reviewed 1,500 pages of reports, along with depositions from those involved. They show missteps, missed opportunities, breaches of protocol and lapses in common sense.
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