PEORIA — A federal judge on Tuesday soundly rejected a proposal from the Illinois Department of Corrections to address serious flaws in mental health care for 12,000 state inmates.
The IDOC faces an injunction in federal court that forces its compliance with a 2016 settlement agreement that called for significant improvements to the state's mental health care in response to a 2007 lawsuit filed by inmates in U.S. District Court for the Central District of Illinois.
In April, U.S. District Court Judge Michael Mihm ruled the state had violated prisoners' constitutional rights and shown deliberate indifference to their conditions.
At a hearing Tuesday, Mihm was blunt in his assessment of the state's plan to address the deficiencies in caring for those who are in crisis and in segregation units.
Assistant Chief Deputy Attorney General Douglas Rees recommended a two-step plan to identify and provide additional care for inmates at the highest risk for harm.
"It's not a plan. It's nothing, really," responded Mihm, noting that the most seriously mentally ill were identified long ago during the decade the lawsuit has been winding its way through federal court system.
Mihm reminded the state numerous times Tuesday about accounts he heard from inmates who have testified about how the lack of care has affected them.
Mihm said he will issue a final ruling Friday that may be appealed by the state.
Failure to meet the terms of the agreement could eventually lead to the appointment of a receiver to oversee the mandated improvements.
The legal teams for both sides reviewed the plan with Mihm to draft a final plan for relief that will be part of the judge's final order.
Mihm agreed with Rees' concern that the inmates' proposal contained too many specific requirements that could interfere with IDOC control over its sprawling prison network of 41,000 inmates in more than two dozen facilities, including prisons in Pontiac, Lincoln and Decatur.
"The department remains committed to the settlement agreement. We believe with each passing month it gets better," said Rees.
As examples of how things are improving Rees cited no delays at 15 facilities in initial evaluations for inmates referred for mental health services and only four facilities reporting delays of 60 days.
The state also is making headway in its reduction of backlogs in psychiatric evaluations, said Rees.
The state's use of a private health care provider to deliver medical and mental health care complicates the issue somewhat, but does not lessen the state's obligation to ensure adequate and constitutional care, said Mihm.
Under the state's contract with Wexford Health Sources, the responsibility for hiring sufficient staff to provide care rests with the company. The state still struggles with the chronic challenge of hiring and retaining enough trained mental health workers.
"If there is one thing that stands out, it's a lack of staff," said Mihm.
"The inadequate number of psychiatrists and mental health professionals simply makes the job the department is constitutionally required to perform impossible," said the judge.
Mihm also opposed a state request for more flexibility in how existing staff is assigned within the mental health system.
A court-appointed monitor testified earlier this year that the state has hired about half of the 65 psychiatrists needed for the mental health caseload.
Currently, the state has 1,100 individuals in segregation, with 900 of them diagnosed with a mental illness. A new unit recently opened at a state facility in Elgin is expected to provide care for about 40 seriously mentally ill inmates held in segregation.