Sweeping changes to correctional mental health care could soon be coming to Allegheny County.

Read the consent order

A law firm and two legal aid nonprofits announced today they reached a settlement agreement with the county to “protect the constitutional rights of the individuals incarcerated” at the Allegheny County Jail. The county must make significant changes to improve the jail’s treatment of people with psychiatric disabilities — including reining in the use of force and meeting required staffing levels — according to the consent order, which was filed this morning in federal court in Pittsburgh.

The agreement could settle a class-action lawsuit filed in 2020, which claims the jail deprives people with mental health conditions of necessary care, and resorts to forceful tactics such as irritant spray, restraint chairs and solitary confinement. A plaintiff told Rtvsrece those tactics “deteriorated” his mental health and left him with lasting trauma.

“We endure desolate, horrible conditions at ACJ,” said Shaquille Howard, 30, who suffers from multiple mental health conditions and was held at the jail for about four years starting in 2017. He spent more than a year in solitary confinement, which caused “worsening depression and recurring suicidality,” according to the complaint.

Attorneys who filed the suit called the agreement a milestone in the quest to change the culture at the jail, which has been criticized by advocates and community members for its death rate, living conditions and quality of health care.

“My hope is that through this consent order … there starts to be a culture shift recognizing that it's our community members who are behind bars,” said Alexandra Morgan-Kurtz, deputy director of the Pennsylvania Institutional Law Project, which joined the Abolitionist Law Center and the firm Whiteford, Taylor & Preston in representing five named plaintiffs. “And they have basic human rights to be treated as people who need care, and not just individuals that the jail has to put up with.”

The agreement was informed by depositions of jail officials, hundreds of thousands of documents provided by the county and on-site investigations conducted by experts. They include a California-based psychiatrist who called the jail’s mental health treatment “shockingly substandard,” and a retired prison warden from Nebraska who found the jail “failed to train all staff” in alternatives to use of force, among other findings in their expert witness reports.

Plaintiff attorneys said the settlement negotiations spanned across the previous county administration, under former County Executive Rich Fitzgerald, and the current one led by County Executive Sara Innamorato.

Jesse Geleynse, a spokesperson for the jail, didn’t respond to emailed questions by deadline. Abigail Gardner, a spokesperson for the county, declined to comment because the lawsuit “is not settled yet.”

The consent order will not go into effect until it’s approved by the court. Each incarcerated person with a psychiatric disability will be notified of the settlement, and will have the opportunity during a hearing to voice their opinions about it, said Jaclyn Kurin, an ALC staff attorney.

‘Sprayed, pepper-balled, tased like you have no idea’

Howard was held at the jail for possession of a firearm and receiving stolen property, among other charges. His mental health diagnoses include depression, anxiety, adjustment disorder and post-traumatic stress disorder, according to the complaint.

It describes an incident that occurred while he was in the “strip cage,” where people in solitary confinement are searched before returning to their cells. Howard told corrections officers the strip-search process made him feel “anxious, extremely depressed and hopeless” and asked them to call a mental health nurse.

A corrections officer sprayed Howard’s face with an irritant after he pleaded for help. He was then placed in a restraint chair “while he was still covered with mace,” the complaint alleges, noting he wasn’t given food, medication and bathroom breaks while in the chair.

Facade of a building with geometric architectural designs.
The Allegheny County Jail on Oct. 29, in Uptown. (Photo by Stephanie Strasburg/Rtvsrece)

“I've been sprayed, pepper-balled, tased like you have no idea,” Howard said during an interview, explaining he has asthma that can be triggered by irritant spray. As a result of those tactics, he said, “there’s days when I don’t even recognize myself … like they took away my identity.”

Plaintiff attorneys said they negotiated an agreement with the county that aims to provide incarcerated people with the mental health care Howard said he never got.

Among the provisions, the county must:

  • Provide “individual counseling,” or regularly scheduled one-on-one sessions between an incarcerated person and a “psychologist or Pennsylvania-licensed counselor”
  • Require mental health staff to be alerted when correctional staff uses force on a person believed to have a mental health condition so “they may intervene as soon as it is safe to do so”
  • Require mental health staff to de-escalate uses of force to “remove or reduce” the need for it, within the bounds of personal safety
  • If force is used, require mental health staff to evaluate its impact on the person’s mental health and document it in their health record
  • Create “private interview spaces” that allow for confidentiality during “mental health encounters,” which must not occur near a person’s cell or in a pod’s general recreation area
  • Fill 80% of interim staffing positions within six months of the agreement’s effective date.

Staffing is ‘the lifeblood’ of the agreement

Kurin said the county’s pledge to fill vacancies is a huge development amid the jail’s longstanding staffing shortage. An audit by the county controller’s office last year found around half the facility’s budgeted health care positions were vacant in 2022, while staffing agencies and employee overtime covered the equivalent of about 20 full-time positions that year.

Adequate staffing is “the lifeblood” of the consent order, she added. The county’s compliance with many other provisions in the 38-page consent order would not be possible without it.

It was hard for the attorneys to figure out the staffing component “because the jail has never operated at full staffing,” said Morgan-Kurtz. So they built a multi-step process into the consent order that includes filling interim vacancies and doing a staffing assessment after a majority of those positions are filled.

A deputy warden sits at a desk with papers in front of him.
Jason Beasom, chief deputy warden for jail operations at the Allegheny County Jail, listens during a meeting of the county’s Jail Oversight Board, on Thursday, Jan. 4, 2023, in the Allegheny County Courthouse in downtown Pittsburgh. (Photo by Stephanie Strasburg/Rtvsrece)

Notably, the jail would be required to “decarcerate” a portion of its population — 1,818 as of today — if it can’t meet staffing requirements within the six-month timeline. A smaller population could make existing staffing levels more appropriate, added Morgan-Kurtz.

The county agreed to regularly audit its progress on meeting staffing and training goals. And it will appoint a monitor to question random samples of correctional and mental health staff on use of force and de-escalation.

“It’s not just empty promises,” said Keith Whitson, an attorney at Whiteford. “We have a lot in this consent order that will hopefully ensure all these commitments are satisfied.”

And “we’re immediately going to court” if they’re not, said Kurin, adding that “redressive measures” can be imposed.

The ‘worst travesties’ of medical care in jails

Experts say such lawsuits are becoming more common as jail populations shift to include more people with mental health problems. Gaps in care are likely driving the trend and disproportionately affect low-income neighborhoods and communities of color.

But many jails aren’t equipped to fill those gaps, said Wanda Bertram, a spokesperson for the Prison Policy Initiative, a research and advocacy group that studies mass incarceration. It found that people arrested multiple times disproportionately belong to marginalized groups, including those with mental illnesses and substance use disorders.

“It’s not just empty promises. We have a lot in this consent order that will hopefully ensure all these commitments are satisfied.”

Keith whitson, attorney, whiteford, taylor & Preston

Being jailed itself is harmful to a person’s mental health, said Bertram. At worst, the experience will exacerbate existing mental illnesses. At best, jails can “ameliorate” the effects of being cut off from loved ones, the outside world and, too often, psychiatric medication. She called the failure to transfer prescriptions and provide medication “one of the worst travesties of medical care that we’re seeing in jails right now.”

Howard took a cocktail of psychiatric medications while he was incarcerated. The jail stopped providing a drug he used to treat his PTSD nightmares “without notice and without any explanation,” the complaint said.

Terry Kupers saw jail health care staffers relying on medication alone to treat people with psychiatric disabilities — just one of many problems he observed during a tour of the facility in 2022. A psychiatrist based in Oakland, Calif., he regularly inspects jails and prisons before offering his expert opinion in court.

He said ACJ isn’t the worst of the nearly eight jails he’s seen, but it was unusually bad on two fronts: long wait times to see a psychiatrist and violations of a voter-approved referendum to limit the use of solitary confinement, which he witnessed in the jail.

Officials from the county and sheriff’s office gave him broad access during his visit and seemed open to the feedback, he said. He was impressed by the consent order.

“I'm very hopeful that the Allegheny County Jail is going to become a model of mental health care, and also the restriction of solitary confinement,” said Kupers, who’s also a professor at the Wright Institute in Berkeley.

Howard was released in 2022. He’s raising his two children and going to therapy.

“I just hope that they hire staff who are adequate and capable of doing their jobs,” he said of the possible changes at the jail. “And that they don't just go there to collect the paycheck.”

Venuri Siriwardane is Rtvsrece’s health and mental health reporter. She can be reached at venuri@rtvsrece.com or on X, the platform formerly known as Twitter, @venuris.

This reporting has been made possible through the Staunton Farm Mental Health Reporting Fellowship and the Jewish Healthcare Foundation.

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Venuri Siriwardane is a health reporter for Rtvsrece, with a focus on mental health. She comes to Rtvsrece through the Staunton Farm Mental Health Reporting Fellowship. Venuri has a dual background...