[NYAPRS Enews] WNYC: Voices From Inside; Solitary Confinement and the Mental Health Sysytem

[Briana Gilmore]

NYAPRS Note: WNYC will be profiling areas of mental health reform for the remainder of this week. Their article detailing the story of one man who has spent nine years in solitary confinement in NYC with a diagnosis of schizophrenia is below. To read more from the series, visit: http://www.wnyc.org/series/breaking-point-new-yorks-mental-health-crisis/

Voices From Inside
WNYC; Cindy Rodriguez, 2/2/2015

Sedlis Dowdy sat inside a quiet out-of-the-way room inside a maximum security prison in Elmira, New York, deep within layers of barbed wire and rings of heavy metal gates and guard stands.
To get here he had to pass in front of a row of noisy inmates locked in their cells. The skinny, 6-foot-2 inmate walked straight ahead and did not respond. Dowdy is 42 and mentally ill, and he doesn't like being around a lot of people.
"Now I'm just schizophrenic," he said. "But before I was schizo affective, bipolar, paranoid schizophrenic, depression."
Dowdy is one of the 9,000 inmates who the state Department of Corrections says are mentally ill, some of them more so than others.  Prisons and jails across the country have become the systems of last resort for thousands of people with psychiatric problems.  It is a difficult population to manage and when guards are not properly trained, the results can be devastating.
Dowdy's says he's had visions since he was a child. His route to prison began during his early twenties when he was "running wild" on the streets while at the same time hearing voices in his head.
"The things that were being said, the visions I was having were so gruesome that, you know, it terrified me," he explained.
Dowdy grew up poor in Harlem during the 70s and 80s, as the state's mental-health system went through a wrenching transformation away from large institutions to the underfunded, underperforming system that it is today.
The illness derailed what could've been the story of a young man who beat the odds.  Despite frequent fights and dropping out of high school, he did well on his GED and attended college at Morrisville State in central New York.
Longtime friend Myra Hutchinson remembers those years as a hopeful period. She met Dowdy in 1989 when he was 17 and dating her daughter.
"I'd tell him to stay for dinner and he'd say, 'Oh no-no-no, thank you,' " she recalled. "[He was] very, very, shy and that's why he was endearing. "
The relationship with her daughter fizzled out, but Hutchinson stayed in touch and drove him to that first year of college. A college transcript shows A's in biology, chemistry and child and adolescent development. He made the Dean's List three semesters in a row.
But after several semesters, his disease took hold. His grades plummeted and he was kicked out of school.  Hutchinson was soon visiting him in a hospital psychiatric ward.
The retired school teacher, who has since become a prison reform advocate because of her experience with Dowdy, said she tried to get him treatment but he didn't stick with it. Looking back, Dowdy said the medication he was given was too strong and left him unable to function.
And in February of 1996, he shot a man at St. Nicholas Park in Harlem.
"I didn't even know the guy," Dowdy said. "I couldn't take the voices no more and they was telling me to do it."
Dowdy's violent crime made him an outlier: Research suggests that only 4 percent of violence in the U.S. can be attributed to the mentally ill. He was sentenced to five to 10 years but ended up serving 14 because of the serious trouble he got into.  Within a 15 month period, starting in October of 1997, he became uncontrollable. The state Department of Corrections said he assaulted inmates and staff, had weapons and disobeyed direct orders.  Dowdy said he was off his meds and delusional at the time.
And as he acted out, the prison responded with more punishment.  Dowdy spent nine years, nearly a quarter of his life, in solitary confinement and was often only fed what's called "the loaf," which is a brick of baked bread and vegetables.
Experts say extreme isolation is like physical torture for someone who is mentally ill. Over the last four years, several states have scaled back their use of solitary for more vulnerable populations, including New York, which enacted a new policy last year as the result of a lawsuit.
Dowdy's situation got so bad, he took to throwing feces on guards. He was prosecuted for it and got four extra years added to his sentence. Soon, according to Dowdy, punishment turned into brutality by guards.  He described guards beating him, putting glass in his food and trying to break his legs.
"At the time I was just so angry I didn't know what to do," he explained. "And nobody was listening to me, so I would come out of my cell and not go back in."
When asked about the abuse, the state Department of Corrections said records show Dowdy spent nine months on the loaf and in 2000 was the subject of one excessive use of force report complaint, the details of which were lost when the agency changed computer systems.
The environment inside prisons and jails is known to exacerbate mental illness, making treatment that much more difficult to deliver.
"The more chaotic the environment, the harder it is for somebody who is already having trouble organizing their thoughts and organizing their behavior to deal with it," said Dr. Paul Appelbaum, a forensic psychiatrist at Columbia University.
Appelbaum said that environmental stressors - living in poverty, being in prison - are crucial to understanding how mental illness develops in the first place.
"We're all born with propensities for various sorts of disorders, and some of us are born with propensities for mental disorders," Appelbaum explained. "But most of us don't develop those disorders in the absence of some sort of external stressors that we have trouble dealing with."
Dowdy's environmental stressors began at an early age.  He was born to a mentally ill drug addicted mother with 11 kids.
"She used to never have food in the house," he said.  "I used to be hungry all the time. It was crazy."
Vickie Dowdy, an older sister, said mental illness runs in the family.
"One of my cousins on my aunt's side is mentally ill and also he did a crime and he's in prison now.  There are also a couple of other cousins that are either in the hospital or roaming the streets," she said.
Dowdy ultimately served out his 14 year prison term and was released straight into a hospital, Manhattan Psychiatric Center.
"They was giving me ECT's, like shocking you," he said.  "Electric Convulsion Therapy, they call it."
Dowdy said it was the first time he felt relief from his schizophrenia, and he received the treatment 32 times but eventually had to stop.
"I started getting anxiety from the anesthesia and I couldn't do it no more because I felt I was going to die," he said.
After two years, he was put in a transitional housing program within the hospital. It would be his first taste of independence in 16 years.
Hutchinson went to visit that day. She wanted to take Dowdy out to enjoy the warm summer day, but he was anxious about missing curfew so she dropped him back at the program. She didn't hear from him for several days. His sister had also been calling his phone but got no answer.
That's because Dowdy had been rearrested - this time for first degree assault. He had stabbed someone. Hutchinson was devastated.
"I could see recovery, going back to school, doing good things," she recalled. "And then to hear that he was out one day - it was awful."
Dowdy's lawyer wanted him to enter an insanity plea but he declined. Insanity pleas are rarely successful in New York but when they are it's true that a mentally ill person could be hospitalized indefinitely.
"That's a one to life they give you and you never know when you're going to get out," Dowdy explained.
It was a risk Dowdy did not want to take, so he pleaded guilty and received an eight-year sentence. So far, he's got no infractions. He's back on medication and staying in the prison's psychiatric unit. He's got five years left to go, and he's not sure about whether to return to a psychiatric hospital once he's released or try to make it on his own.
"I don't know what I want to do yet," he said. "I'm at a crossroads."
Just like prisons and jails across the state-systems of last resort struggling with what to do with thousands of inmates like Sedlis Dowdy.
http://www.wnyc.org/story/voices-inside/
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