Litigation and treatment issues surrounding maximum-security segregation inmates with personality disorders

The purpose of this research is to develop strategies to respond to lawsuits by prison inmates who suffer from personality disorders and are housed in a maximum-security segregation setting. Inmates with personality disorders consume a disproportionate share of psychological and legal resources. Many volitionally commit spectacular and repeated acts of self-harm, leading to diversion of mental health resources that could better be employed elsewhere. They then file lawsuits alleging deliberate indifference to their serious mental health needs, often leading to protracted, expensive litigation. The first phase of this project involves a systematic analysis of the law related to deliberate indifference to serious mental health needs. The second phase involves consultation with mental health professionals to develop an approach to identify disruptive inmates who may suffer from personality disorders, implement testing and other diagnostic procedures to reach a firm diagnosis, develop and implement appropriate treatment plans, and document the diagnosis, care, and treatment in a way that will withstand litigation. By strengthening documentation, employing targeted diagnostic testing, and developing appropriate treatment plans, staff will be able to allocate scare resources to needy patients, reduce the incidence of litigation based on self-harm, and have better outcomes when litigation ensues.