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The U.S. Penitentiary at Lewisburg in Pennsylvania in 2010.

Where Crossword Puzzles Count as Counseling

A new lawsuit alleges poor care for mentally ill inmates at one of the highest security prisons in the country.

A new lawsuit alleges mental health care at one of the highest security — and most violent — prisons in the country is so paltry that five-minute therapy sessions take place in the shower and suicidal inmates are given crossword puzzles.

This story was produced in collaboration with National Public Radio.

The class-action suit filed Friday takes aim at the Special Management Unit at the U.S. Penitentiary at Lewisburg, where most men are locked down in small solitary cells for nearly 24 hours a day. Inmates are often doubled up in the cells, which psychologists say can be even more harmful than single-celled solitary confinement.

The SMU unit holds some of the federal system’s most disruptive prisoners. A 2016 investigation by The Marshall Project and National Public Radio found that housing two volatile people together in the same solitary cell has fomented violence: The prison has an assault rate six times higher than federal prisons overall. Prisoners who resisted “double-celling” have been put into hard metal restraints until they complied.

The lawsuit was filed against the Bureau of Prisons by the Pennsylvania Institutional Law Project, the Washington Lawyers’ Committee for Civil Rights and Urban Affairs, and the law firm of Latham & Watkins.

“The conditions at Lewisburg are solitary confinement of two people. That causes serious problems for anyone,” said Phil Fornaci, director of the D.C. Prisoners’ Project at the Washington Lawyers’ Committee. “For a person with a serious mental health issue, it’s almost completely intolerable to be caged in that situation indefinitely... [And] at Lewisburg, there is virtually no treatment.”

The Bureau of Prisons declined to comment on pending legislation.

The lawsuit alleges that mental health treatment at Lewisburg consists of counselors walking by cell doors and asking — in full hearing range of cellmates and other prisoners — how the inmate is doing. Those who have been flagged by the prison as mentally ill might get a five-minute therapy session in the cellblock shower. Inmates considering suicide say they have been given only a “mental health packet” containing crossword puzzles, Sudoku, and “mindfulness activities.”

Documents obtained by The Marshall Project and NPR through a Freedom of Information Act request show at least two men killed by their cellmates at Lewisburg were not receiving treatment for previously diagnosed mental illnesses.

Jimmy Barker, who died after a fight with his cellmate in August 2015, was deemed fit for double-celled solitary despite multiple prior suicide attempts and psychiatric hospitalizations.

Gerardo Arche-Felix was allegedly strangled by his cellmate two months after Barker died. He, too, had been found by prison staff at Lewisburg to have “no significant mental health issues,” although he had previously been diagnosed with schizophrenia and put under an involuntary treatment order. In the months before he was killed, Arche-Felix complained in letters to his daughter that he had abruptly stopped receiving his medication while at Lewisburg. His cellmate, Jose Hernandez-Vasquez, who also had a history of mental illness, was indicted for the murder in May.

Former Lewisburg inmate Andra Gray said he didn’t receive the mental health care he needed during his nearly seven years in the SMU. “I was getting medication until I got to Lewisburg. And when I asked the doctor, they said, ‘Oh, we don’t think you need it,’” Gray said. “You’re already thinking suicide within the first two or three months and then they give you a book and say, ‘color this’ or ‘cross this word out.’ You’re not thinking about searching a word out. You’re thinking about life or death.”

One of Gray’s former roommates committed suicide at Lewisburg soon after they were moved into separate cells. Gray claims his cellmate threatened to commit suicide in front of guards but was ignored.

One of the groups behind the lawsuit, the D.C. Prison Project, has also sued the Bureau of Prisons over mental health care at the supermax prison in Florence, Colorado, known as ADX.

BOP policy says seriously mentally ill inmates should not be held at ADX and the SMU. One of the named plaintiffs in the case, Jusamuel Rodriguez McCreary, is being held in an “ADX cell” at Lewisburg, where he is locked alone behind two sets of doors. He cannot hear any voices from his cell. McCreary attempted suicide at Lewisburg in May, the lawsuit says.

Last year, the BOP implemented some changes to the SMU after the Department of Justice made recommendations. Many of them were aimed at mental health care, such as improving the psychiatric screening process for incoming inmates. The new policy also lessened the amount of time someone could be held in the unit. Since then, some inmates have been moved out of Lewisburg, creating more single-cells. There are now 650 men housed in the penitentiary, 485 of whom are in the SMU.

But attorneys and advocates claim the changes don’t go far enough. “For the people who are left there, the conditions haven’t changed,” said Stacey Litner, advocacy director for the D.C. Prison Project. “For the most part, people are still double-celled and there’s still a complete lack of access to mental health care or medication.”