COLUMBIA — Suicidal and mentally ill women at a South Carolina prison were denied hygiene products, given mashed loaves of food and had their mattress removed from their cell as a way to dissuade them from seeking help again, a psychiatrist who reported the abuse last summer told legislators on Wednesday.
Dr. Pamela Crawford said the appalling punishment at Camille Griffin Graham Correctional in Columbia stopped soon after she alerted the prison agency's upper echelon, but the prison system is still in desperate need of hospital beds for female inmates in severe psychiatric crisis.
"They were issued only pads and no way to secure that pad for feminine hygiene so women were freely bleeding in their uniforms in cells, and that was ordered by mental health staff. I have copies of order sheets saying 'no hygiene products,'" said Crawford, who began working part-time at Camille in May.
Legislators called it despicable that mental health officials would ever issue such orders.
"It's sickening when you look at what’s occurred here," said Rep. Gary Clary, R-Central, who sits on the House Oversight panel reviewing the Department of Corrections. "We’ve got to do better."
What became of the employees is unclear. The Department of Corrections will say only that multiple mental health employees either have been or are in the process of being disciplined.
Corrections Director Bryan Stirling told legislators at least one has already hired a lawyer, so he couldn't talk about the personnel issue publicly.
But he said he was horrified beyond words when told of the abuse and personally asked the State Law Enforcement Division to investigate.
SLED decided it was a "level of care" issue rather than a criminal offense, he said.
"There's no excuse for this," Stirling said. "It's just unbelievable."
Terre Marshall, the agency's deputy director for health services, tried to assure legislators the abuse was limited to Camille and won't happen again. She said she ordered a review of every prison and all 637 of their orders for crisis placement between May and July to "make sure the practice was occurring nowhere else."
Crawford, who previously worked full-time at Camille from 2006 to 2014, said the mental health team systematically punished inmates to reduce the number of people complaining about being suicidal. And it worked. When she arrived, few people were in the crisis unit, which requires stringent supervision. Patients told her it was so miserable, they would not tell medical staff if they were having problems and would hide symptoms.
Documented evidence of the abuse at Camille, one of only two state prisons for female inmates, goes back at least a year, she said.
"Some of the patients I used to treat who’d done fairly well had deteriorated," she said. "Patients I'd had for years with schizophrenia, their diagnoses had been revised. I’d never seen anything like this."
The women were selectively given "nutraloaf," essentially a day's worth of food blended together and baked into a loaf, which is supposed to be given only to inmates who have severely misbehaved by doing things like throwing feces at officers. Inmates who are suicidal can be given other food they can eat with their fingers, Crawford said.
The orchestration can't be blamed on the agency's chronic staffing problems, she said.
"Sure, they had staffing difficulties. But it was a coordinated attempt by everyone involved and it was known about," Crawford said. "How is it possible these things were going on and nobody (at the agency's helm) knew about them?"
But Marshall said she's in the prison regularly and had no inkling.
After Crawford reported it, Marshall said, and she began asking the prison's medical staff, they acknowledged they knew about it and "knew it seemed wrong, but they didn't bring it to me because the mental health staff was ordering it. They thought because staff ordered it, it must be OK."
"Now everybody knows, no, it's not, under no circumstances," Marshall said. "In my entire career I've never seen a mental health professional order anything like this."
While the punishment has stopped, the prison system still lacks a place to send females in "critical psychiatric condition," such as hallucinating and hearing voices telling them to kill themselves or others, Crawford said.
There are currently five women who have been waiting for months for a hospital bed at a private facility the agency contracts with who will only further deteriorate while locked in a room at the prison, she said. She suggested letting the women go to the psychiatric hospital for male prisoners.
But Stirling said emphatically that's not an option.
"It's a danger to them. They’ve already been traumatized in their life. I can’t guarantee their safety," he said. "If something happened, like they were raped ... There are a lot of things that could go wrong. I just don’t think that would be safe for anybody."