The long and unending battle for mental health care in Illinois prisons

The first report by a court-appointed monitor of mental health care inside Illinois prisons was authored in 2011 by Fred Cohen, a national expert on corrections.

Today, the 180-page report remains sealed, according to the terms of an agreement between the state and lawyers for inmates. In 2015, I interviewed Cohen in New York, and he let me know he did not agree with the decision to keep the report out of the public eye. Cohen complied with the mandate to keep the report under wraps, but he described the conditions he witnessed during his nine-month tour of eight facilities.

“What I saw beginning in reception, was about one of the worst prison mental health systems I ever saw. The system breaks down at the front door and never recovers,” Cohen told me.

Cohen described the condition of Ashoor Rasho, the inmate who wrote and filed the lawsuit decrying mental health care that would become a federal lawsuit on behalf of 12,000 mentally ill prisoners.

“He ate part of his own shoulder. I will never forget that,” Cohen told me.  Cohen, who died earlier this year, summarized his opinion: “We’re not talking about feelings here. You have people dying in there.”

As a journalist, I toured the newly renovated 422-bed Behavioral Health Unit in Joliet in 2017. Dr. Melvin Hinton, chief of mental health and addiction services for the Illinois Department of Corrections, told me “”We’re not rebuilding a system. We’re building one.”  Reports by plaintiffs’ attorneys in the Rasho lawsuit note that a low number of beds have been filled at the state’s first inpatient facility for mentally ill inmates.

In the final portion of documents provided by Harold Hirshman, one of several lawyers representing inmates, the history of the Rasho litigation is laid out in the Fall 2020 issue of Correctional Mental Health Report. Hirshman says in the article that “Rasho at its core is an attempt to relieve the suffering of the most damaged and despised of our fellow citizens. By trying to bring succor to their suffering, we are fulfilling the fundamental obligation to pursue a more just society.” The report includes commentary by Cohen.

The monitoring reports on mental health care ended in 2023 after a surprise ruling by U.S. District Court Judge Michael Mihm that he lacked jurisdiction to hear unresolved claims in the lawsuit. Arguments on the plaintiff’s appeal of Mihm’s dismissal of the lawsuit will be heard in November by the 7th Circuit Court of Appeals. The IDOC said the dismissal did not change the state’s commitment “to meeting its goals without the need for court oversight.”

Hirshman was skeptical of that commitment. Mentally ill inmates now “are left to the tender mercies of the IDOC,” he said.

For Hirshman’s insights on the history of the lawsuit, see the link below:

History of Rasho litigation.pdf