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Mentally Ill Inmate Caught In A Catch-22, Advocate Says

By David Forster
LAW WEEK COLORADO

A mentally ill Colorado inmate is caught in a Catch-22 that has kept him in solitary confinement for 12 years, with little hope of ever getting out, one of his advocates told a federal judge Monday.

Troy Anderson suffers from attention deficit hyperactivity disorder, a diagnosis no one disputes, said Katy Hartigan, one of the law students handling his case. Without proper medication, she said, he cannot take the steps necessary to end his life of isolation in a concrete cell the size of two king-sized mattresses.

“Try as he might he cannot get better,” she said in her opening argument before U.S. District Court Judge R. Brooke Jackson. “He’s asking for the tools, the process, the chance to treat this mental illness and get out of this Catch-22.”

The trial began Monday over Anderson’s lawsuit against the Colorado Department of Corrections. He is represented by students from the University of Denver Sturm College of Law, who are being supervised by two professors. If Anderson wins his trial, the verdict could change the way inmates at Colorado State Penitentiary are treated.

Anderson’s first witness, a psychiatrist with expertise in treating ADHD, said that prison doctors have yet to to give Anderson any of the drugs known to be the most effective in treating his disorder, a situation he called tragic.

Anderson is serving time for a long list of offenses, including shootouts with police officers and two escape attempts while in custody. His aggressive behavior while in prison landed him in solitary confinement at the state penitentiary.

Anderson, 42, has a long history of mental illness going back to his early childhood. He attempted suicide at age 8 with his father’s gun. He was diagnosed with attention deficit disorder at age 10. He was placed in a mental health facility at age 13. Over the years, he has had numerous run-ins with the law.

Prison doctors have diagnosed Anderson with the disorder, a condition that interferes with his concentration, his ability to learn and to interact with others and his impulse control. Since his arrival at Colorado State Penitentiary 12 years ago, Anderson continues to behave in ways that keep him from earning his way out of solitary confinement, where he spends 24 hours a day indoors, his only human interaction with prison guards and the occasional visitor. He his allowed no physical contact.

In her opening argument, Jacquelynn Rich Fredericks, one of the attorneys defending the Department of Corrections, argued that Anderson has received extensive mental health care, along with regular reviews of his conduct and feedback on what he can do to progress toward getting out of solitary.

“This is no magic pill to address plaintiff’s mental health conditions,” she said. Anderson needs to do more to help himself, she said.

“Mr. Anderson has all the power,” she said. He is stuck in solitary, she said, because he “chooses to make poor choices.” He has a long history of violence and threats of violence against prison staff, she said.

“It is his own behavior, his violence, his threats that keep him here,” she said. “He has the ability to progress through the system.”

Every month, Anderson acts up in ways that send him back to square one on the path to getting out of solitary.

Prison doctors have experimented with several drugs to treat Anderson. None of the drugs prescribed have been approved by the U.S. Food and Drug Administration for treatment of ADHD, said witness Raymond Patterson, a psychiatrist who has worked for more than 30 years with prisons.

Without the proper drugs, most of them stimulants, Anderson cannot control his behavior well enough to participate in group therapy and other programs intended to help him progress out of solitary, Patterson said.

“This is not an unwillingness; this is an inability,” he said. “You can’t just say to someone with ADHD, ‘Well, just stop doing that.’”

Patterson agreed there is no magic pill to solve Anderson’s problems. But giving him the right pills is an essential first step, Patterson said. Until then, he said, Anderson does not hold the power to alter his fate. “Someone who has a serious mental illness does not have the power to say, ‘Illness, stop affecting me,’” Patterson said.

In his cross-examination, Christopher Alber, another of the prison’s attorneys, walked Patterson through dozens of doctors’ reports spanning several years to demonstrate the prison’s efforts to help Anderson. This review showed the doctors experimenting with different drugs and dosages, and modifying their prescriptions based on how well they seemed to be working.

Many of the reports indicated that Anderson’s condition was improving, usually noting that he was in a better mood and sleeping better. Anderson continued to complain that he had trouble concentrating and controlling his impulses.

The problem, Patterson said in response to questions from the judge about the reports, is that the drugs prescribed for Anderson are anti-depressants. They have been used to treat ADHD with limited success, he said, but this is not their intended purpose.

This explains the improvement in Anderson’s overall mood and sleep, because the drugs were helping with his depression, Patterson said. But they were not addressing the symptoms of his ADHD, he said, which the doctors’ reports clearly show.

Stimulants such as Ritalin are the most effective drugs for treating ADHD, Patterson said. But stimulants are not on the list of approved drugs in Colorado for treating inmates with ADHD, he said. Doctors who want to prescribe stimulants have to make a special request, which is then reviewed by a committee, but so far no doctor has submitted such a request for Anderson.

Prisons may be reluctant to dispense stimulants for safety reasons; for example, concern that inmates will pretend to take them, and then sell them to other inmates, Patterson said. One common solution to this problem is to grind up the pills and sprinkle the powder into a glass of water or some other liquid. This so-called “crush and float” method is used in Colorado prisons for other drugs given to inmates.

In any case, Anderson has no contact with other inmates, so there’s no risk that he’s going to sell the drugs, Patterson said.

The prison also may be reluctant to prescribe a stimulant to Anderson given his history of drug abuse, Patterson said. Methamphetamine, a powerful stimulant, was his recreational drug of choice. But Patterson dismissed this concern as well, saying that Anderson’s dosages would be tightly controlled.

Patterson said he’s not sure why doctors have not prescribed better drugs for Anderson, a situation that falls short of the prison’s obligation to provide prisoners with the community standard of care.

“In my opinion,” he said, “the department’s treatment (of Anderson) has been inadequate.”

Anderson’s lawsuit also objects to the prison’s policy of not permitting inmates in solitary to spend any time outdoors, claiming it violates the Eighth Amendment ban on cruel and unusual punishment.

The prison has a exercise area with an open roof, but it hasn’t been used in years. Instead, inmates spend their one hour a day outside their cells in another fully enclosed cell with some recreation equipment.

Regular exposure to the outdoors is therapeutic for people with mental illnesses, Patterson said. On the flip side, he said, being denied access to the outdoors can aggravate their conditions.

Patterson said he wasn’t aware of any other prison in the country that denied outdoor access to inmates, even for those on death row.

Rich Fredericks acknowledged that the state penitentiary is among a dwindling number of prisons that do not allow outdoor exercise.

Jackson noted that the 10th Circuit Court of Appeals has said that denial of outdoor access could be unconstitutional, and said that the Department of Corrections is taking a big gamble going to trial on this issue because a ruling against it could require significant changes.

Constitutional issues aside, Jackson had another question about the policy, which went unanswered: “From a humanitarian standpoint, how can you justify that?”

The trial is expected to continue through the middle of next week.

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