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Jails fail to accommodate people with mental illness. In some cases, it’s a civil rights violation.

Conditions in some corrections facilities are a moral failure that also costs taxpayers millions.

  • Brett Sholtis
Martha Stringer, at left, talks with her daughter Kimberly Stringer, at right. The Stringers have filed a lawsuit against Bucks County Correctional Facility employees after Kimberly was pepper-sprayed and restrained while detained there while suffering from a mental health condition.


Martha Stringer, at left, talks with her daughter Kimberly Stringer, at right. The Stringers have filed a lawsuit against Bucks County Correctional Facility employees after Kimberly was pepper-sprayed and restrained while detained there while suffering from a mental health condition.

As a note of disclosure, WITF and the Reporters Committee for Freedom of the Press are challenging in court Bucks County’s refusal to release a video of an incident involving Kimberly Stringer while she was in Bucks County Correctional Facility.

Months before her arrest in April 2020, Kimberly Stringer had stopped showing up to get her regular injection of an antipsychotic drug. An artistic person, Stringer once planned to go to design school before a mental illness hijacked her life. For the past year, her medication had staved off the paranoia and disordered thinking that were symptoms of her illness. As the drug left her system, those fears and preoccupations returned.

Though her parents pleaded with her to take her medication, state law prevented psychiatrists from helping Stringer without her consent. But when Stringer’s neighbor called 911, saying she had punched him, police arrested her.

Stringer was in Bucks County Correctional Facility for more than 70 days awaiting trial. While there, her parents couldn’t reach her, because Stringer, who at one point was lying naked in her cell covered in excrement, didn’t say she wanted to talk with them. At the same time, when Stringer failed to follow orders, corrections officers pepper-sprayed her and put her in a restraint chair.

“I was kind of, I guess, frozen,” Stringer said during a recent interview with WITF, describing her catatonic mental state at the time. “They sprayed under the crack of the door, and the pepper spray just blew up in my face. That was actually painful. I don’t know how to explain it. It was abusive.”


From left to right, Martha, Kimberly and Paul Stringer sit for a photo. Kimberly lives with a serious mental health condition and was pepper-sprayed and restrained while detained at Bucks County Correctional Facility. Her parents have sued county employees.

Aspects of Stringer’s story are common across Pennsylvania. WITF found that nearly one-third of so-called “use of force” incidents with pepper spray, stun guns and other distressing methods of control involved a person with a serious mental health issue. That’s according to data WITF analyzed from 25 county jails during three months last year.

Kim was eventually released. She is back to taking medication and managing her condition, and she hopes to get back to drawing and painting soon. But to her parents, Martha and Paul Stringer, their daughter’s treatment is not only a moral outrage, it’s also a breach of her civil rights — and they sued prison staff as a result.

“We believe that her civil rights were being violated because she was struggling with a mental health issue while incarcerated, and that is a condition that deserves to be treated like a physical health condition,” Martha Stringer said.

Bucks County Correctional Facility did not respond to requests for comment.

Martha Stringer’s belief that mental health conditions should get equal treatment to physical illnesses in jails is part of a trend in civil litigation, said David Inscho, the Philadelphia-area attorney who filed the lawsuit.

Inscho explained that there are a few ways this works. In Kimberly Stringer’s case, because she had not yet been convicted of a crime, some of her rights fall under the 14th amendment of the U.S. Constitution, dealing with due process.

Under the 14th amendment, a person awaiting trial cannot be punished, Inscho said. One example of what is meant by punishment would be excessive force — and there’s a specific legal standard for what that means.

“Any type of use of force that would be objectively unreasonable is considered excessive,” Inscho said. To him, pepper-spraying someone who is catatonic in their cell is a classic example.

“She suffered horribly because of these events,” Inscho said. “Imagine yourself in a situation where you can’t understand what’s going on, and you’re being pepper-sprayed.”

When someone is mistreated in jail, their rights often fall under the Section 1983 of Title 42 of the U.S. Code, Inscho said. This allows people to sue government employees for violating their civil rights.

It’s the same code that led him to successfully settle a case with the family of David Campbell, who died in Lehigh County Jail in 2011. The lawsuit claimed Campbell was stripped naked, pepper-sprayed, assaulted and placed into a restraint chair by corrections officers before he died.

Michael Bien is a San Francisco-based lawyer whose civil rights cases have helped to change prison policies in California.

Citing violations of the 14th amendment is just one of the ways that lawyers seek recourse for people who were hurt or killed in jail, said California-based civil rights lawyer Michael Bien. For those who have been convicted of crimes, their rights often fall under the 8th Amendment, which prohibits excessive fines or bail and “cruel and unusual punishment.”

Bien served as lead counsel in three federal court class action trials in 2013 exposing what he called “cruel and unusual mistreatment of persons with mental illness” in California prisons. Those cases focused on three areas: Denial of psychiatric hospital services, use-of-force by corrections officers and overuse of solitary confinement. Bien’s clients won all three of those trials, changing California state policy in the process.

Those cases revealed a failure of prisons to take mental health conditions as seriously as they would a physical health condition, Bien said. He likened it to expecting a deaf person to follow a verbal order — and punishing them when they fail to do so.

Bien recounted testimony from a man with schizophrenia who was shocked with a stun gun after failing to come to the front of his cell. A judge asked him why he didn’t comply with the orders to do so. “And he said, ‘I think I heard them, but they were far less important, because the devil was sitting there in my room and giving me orders.’”

In many of these cases, a person is locked in their cell, posing no risk to anyone else, Bien said.

In his experience, the problem has less to do with bad corrections officers and more to do with the culture of prisons. Due to that culture, and their training, corrections officers may fail to consider a person’s mental conditions and ratchet up physical force when a person doesn’t comply with guards’ commands. “There should be de-escalation,” Bien said. “There should be mental health workers.”

Randy Belice for Northwestern University

Jamelia Morgan is a Northwestern Pritzker School of Law Professor of Law.

In addition to the 8th and 14th amendments, the failure to provide accommodations for people with mental illness in jail can also be a violation of the Title II of the Americans With Disabilities Act, said Jamelia Morgan, a professor at Northwestern University’s Pritzker School of Law.

That statute prevents people with disabilities from being excluded from services, programs and activities provided by state and local government entities, Morgan said. Certain mental health conditions may fall under the category of a disability. And a jail is a government entity.

“We’re seeing a denial of what is arguably a reasonable accommodation,” Morgan said. For example: A person is brought to jail and not given access to their psychiatric medication. As a result, their behavior changes and they fail to follow corrections officers’ instructions.

The challenge here is that law around ADA cases includes an administrative remedy, Morgan said. That means prisoners are supposed to file a grievance and take their problem up the chain of command before they can sue in court. That’s especially tricky if someone’s illness makes it difficult for them to communicate clearly.

Morgan said prisoners with mental health conditions should get reasonable accommodations such as the ability to talk through issues with a counselor or psychologist instead of security staff. That would be part of a de-escalation strategy to help avoid violent physical encounters with corrections officers.

“In most cases, it’s just a matter of how that particular person’s disability responds to particular stress — that kind of strategic choices,” Morgan said. “And so in some cases, it’s as simple as having medical staff respond as opposed to security staff.”

The system as it exists gives most people only one way to fix a problem — suing. Successful cases can mean stripping away county funds that could have been used to prevent these violent incidents in the first place.

Bucks County District Attorney Matt Weintraub declined to talk about the Stringer lawsuit. But he estimated that Bucks County lost 65 psychiatric beds over the past two decades — while demand for mental health services has risen steadily.

“We need more beds,” Weintraub said. “That’s the bottom line.”

Brett Sholtis/WITF

Matt Weintraub is the district attorney of Bucks County.

Weintraub said jails are “a very poor replacement” for psychiatric care, but he also saw the need for control measures like pepper spray and restraint chairs when people with mental illness “are still violent, or lashing out or dangerous — and moreso, dangerous because they can’t respond appropriately to commands.”

Martha Stringer said if they win the suit or the county settles, it will help them provide for Kim. But she also hopes it will prompt changes in how Bucks County handles these situations.

“I came to the conclusion that if this was happening to her, it was probably happening to many other inmates, because we know that, unfortunately, people that are struggling with their mental health and have interactions with the law often end up in jail,” Stringer said.

For Kim, every day brings struggle and uncertainty. She’s getting weekly electroconvulsive therapy and court-ordered antipsychotic injections. She has an apartment, she’s on medicaid, and she’s glad she’s not in a hospital or a jail.

“Although I have some complaints and disagreements, this is not as bad as it could be or become, so I just go along with whatever the people managing me expect of me, and my life is okay,” she said in a letter.

She hopes corrections officers — and everyone who has a position of authority over someone else — will consider what it would be like to be in her situation.

“I would just say, be considerate,” Kimberly said. “You know, like, be considerate of what you’re doing to somebody else.”

WITF is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering challenges and solutions to accessing mental health care in the U.S. The partners on this project include The Carter Center, The Center for Public Integrity, and newsrooms in Arizona, California, Georgia, Illinois, Pennsylvania, and Texas.


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