Dwight Correctional Center
Dwight Correctional Center
Dwight Correctional Center was the state’s only Level One maximum-security adult female facility. Dwight also housed medium and minimum-security inmates, and handled the intake, classification and processing center for adult female inmates for the entire state. The facility was located in Dwight, Illinois, about one and one half hours southwest of Chicago. It is now closed.
Like other Illinois correctional facilities, Dwight struggles under the burdens of overcrowding, physical plant deterioration, understaffing of mental health, medical, correctional and clerical positions, and limited resources for education and programming. However, the management and supervision of female inmates present unique and, arguably, more complex challenges.
The vast majority of female inmates come from backgrounds of serious trauma and physical, sexual, and emotional abuse. Most inmates are also mothers, who were sole parent providers for their children prior to their incarceration, which raises complicated emotional and economic issues surrounding child placement, family dissolution and grief over separation from children. Female inmates also have substantially higher rates of mental illness, self-injuring behaviors, and drug abuse than male inmates. Indeed, more than half the inmate population at Dwight is receiving psychotropic medications. Given this exceedingly high number, it was plain that two full-time psychologists and three part-time psychiatrists were insufficient to meet the mental health needs of Dwight’s population.
Update: Since our visit, Dwight has increased its mental health staff to address these needs by hiring a licensed social worker, two psychologists, and receiving three interns from the Midwest University and Chicago School of Professional Psychology.
Despite understaffing and scarce resources, Dwight’s administration and staff do a commendable job in maintaining the facility and implementing policies that recognize gender differences. One of the remarkable things that JHA was struck by in speaking with Dwight’s Warden, Assistant Wardens, and administrators was their emphasis on the importance of acting with kindness, understanding, and compassion. This is significant because administrators in a correctional setting can have a profound impact in determining values and the culture of an organization. JHA saw the influence of these values in many of the programs at the facility. For instance, Dwight’s administration has implemented an individualized incentive program aimed at reducing segregation time that allows inmates to reduce their time in segregation and regain privileges through good behavior. Administration is also implementing a new hospice program, modeled on the hospice program at Dixon Correctional Center, which is designed to assist aging female inmates with chronic illness to die with dignity. Twelve inmates have gone through training to provide hospice care to these inmates, and the program will be running in 2012.
While JHA commends Dwight’s administration and staff for these efforts, we were concerned by the high volume of inmates who complained of feeling their bodies physically exposed to surveillance by male correctional officers in their living quarters. A significant number of inmates further reported instances of male correctional staff using excessive force or acting in a manner that was inappropriate or sexually suggestive. To the administration’s credit, the informational materials provided to Dwight inmates spell out, in no uncertain terms, that every inmate has the right to be free from abuse and sexual coercion. The materials also provide inmates with an extensive list of both formal and informal mechanisms for inmates to report instances of abuse, depending on what is most comfortable for them. Importantly, inmates that JHA interviewed also expressed that they felt strong personal trust and confidence in the Warden, and that they could report problems to her without fear of reprisal.
However, JHA believes that more can and should be done system-wide to acknowledge gender differences and the needs and vulnerabilities of female inmates under male correctional supervision. Specifically, JHA believes that efforts should be made to strictly limit direct supervision of female inmates by male correctional staff, particularly in female housing units. In accord with this position, JHA therefore strongly supports the efforts of DOC’s Director Godinez, who is exploring the possibility of hiring more female correctional staff and creating gender-specific assignments in female housing units.
On Oct. 12 a group of John Howard Association board members, staff and volunteers conducted a monitoring tour of Dwight Correctional Center. The prison is located 80 miles south and west of Chicago. Dwight is the main prison for women in Illinois. It also serves as the Reception & Classification unit for women entering prison. Much of this report will deal with problems in Reception & Classification.
When a person is sentenced to prison, they are first sent to Reception & Classification, more commonly referred to as R&C. Dwight’s R&C serves women exclusively.
Inmates undergo evaluation in R&C. They are examined for medical and psychological needs. Their security status is decided, which determines whether they will go to a maximum, medium or minimum security prison. They are also reviewed for a number of other factors. For example, staff tries to determine if an inmate is likely to be victimized or is likely to be a predator.
Currently inmates at Dwight’s R&C are denied previously prescribed psychotropic medication for approximately a month because of a shortage of psychological care. Such abrupt withdrawal of medication can trigger serious medical and mental health problems, including psychosis. Those inmates denied medication who develop acute mental illness are given expedited medical treatment and medication.
Put another way, some women with controlled psychiatric conditions are denied medication, undergo mental collapse, and then are immediately treated with medication they were first denied. Perversely, this further delays the treatment of women who need medication but have not yet become overtly psychotic.
The mental and medical health staff and prison management agree that the current situation runs counter to best practices but say it is beyond their control.
Several factors are to blame.
Dwight is authorized for four psychologists to provide 160 hours of service each week. The prison has just three psychologists and they are providing 120 hours of service a week.
Dwight’s psychiatrists will not accept the diagnosis and medical treatment of doctors at other institutions. For example, Dwight psychiatrists will not accept as valid diagnosis and medication orders for inmates arriving from the Cook County jail. In any case, it is difficult or impossible for Dwight medical staff to obtain health records of inmates.
Dwight’s R&C must now process more individuals than in the past. At the same time, mental health staff at Dwight and other prisons say the people they see now tend to have more serious psychiatric problems than in the past.
For example, in January approximately 220 Dwight inmates were receiving psychotropic medication. By early October the number was 438. The number of inmates receiving psychiatric care during that time has risen from 379 to 574. (All numbers in the report are provided by the Illinois Department of Corrections and fluctuate frequently.)
Dwight’s mental health staff used to have several pre-doctoral interns to help, but that program ended two or three years ago. Currently the unit has 24 women on suicide watch as compared to the usual 7 to 10 on observation.
Dwight’s R&C faces another problem.
In January the state ended a decade’s old early release program used to limit prison population.
The reasons for the termination of early release are beyond the bounds of this report. But the end of early release has caused a dramatic increase in the number of people in Illinois prisons.
In less than 10 months, the prison population has risen from approximately 45,000 to well over 48,000. This increase is equal to that of a large prison. Each week a new record is set in the number of people held in Illinois prisons. (To follow prison population trends, visit http://www.thejha.org)
As a result, there is a shortage of beds at the prisons. This means individuals who have completed the R&C process must remain in the R&C unit until a place for them can be found.
Before the early release program was terminated, it normally took about two or three weeks for a Dwight inmate to complete R&C and move on to her assigned housing. Now that same inmate may spend two or three months in R&C.
Because inmates are supposed to be in R&C for only a brief time, they have historically been denied the rights and privileges of other inmates. For example, they could not receive visitors, make phone calls, spend time outdoors or purchase items at the commissary.
Dwight’s management has moved to ease conditions for inmates. Warden Sheryl Thompson said R&C inmates are permitted to go outside, to make phone, calls, to receive visits and use the gym. Inmates do not get full commissary privileges because there is insufficient space to store their purchases.
On Jan. 26 a group of six John Howard Association board members, staff and volunteers conducted a monitoring tour of Dwight Correctional Center, the main prison for women in Illinois. Dwight is also the reception and classification center for all women entering the state prison system. Reception and classification is a key intake process in which inmates are given physical and mental evaluations and other diagnostic services.
Discussions and interviews with inmates, senior staff on site and the top medical officer for the Illinois Department of Corrections revealed a significant problem.
Inmates in the reception and classification center are waiting for weeks or months to see a psychiatrist and are deprived of needed psychotropic medication during that time. Ordinarily a psychiatric evaluation is one of the first procedures completed when a person enters prison.
Warden Carolyn Trancoso said the prison is currently authorized for 40 hours of on‐site psychiatry each week. Another 20 hours a week of care is provided via telepsychiatry.
But Trancoso said that since the summer of 2009, Dwight has had the services of a psychiatrist for just 20 hours a week and 20 hours of telepsychiatry. Psychiatric services are provided by a private company, Wexford Health Sources. Wexford did not respond to a request for comment.
Trancoso and other ranking prison officials acknowledged that there are troublesome delays in providing psychiatric treatment and psychotropic medication. They said it is mainly due to the fact that the prison does not have a psychiatrist on site 40 hours a week.
The reception and classification process is also taking longer to complete as Dwight is receiving a higher than normal number of new inmates. This is the result of a recent state clampdown on early release of inmates. (See section Population and Physical Plant below.)
The JHA group interviewed several dozen inmates at Dwight. Five inmates had remarkably similar complaints about their psychiatric care. They said they had been in the reception and classification center for as long as 10 weeks without seeing a psychiatrist and were without psychotropic medication. Others were not permitted to take medication prescribed for them when they were confined at other institutions prior to Dwight.
(JHA provided the names of the inmates to the warden, the medical director of the prison and the chief medical director of IDOC the day following the inspection. All three responded promptly saying they would investigate medical problems among inmates interviewed by JHA.)
The shortage of psychiatric care potentially affects a large number of people.
Psychiatric treatment is provided on‐site to 219 inmates and approximately 160 are served by telepsychiatry. Roughly 18% to 20% of the inmate population is receiving psychotropic medication. Recently 10 inmates were involuntarily receiving psychotropic medication.
Dr. Louis Shicker, the top medical officer at IDOC, said he is aware of the delays in psychiatric care and is working to end them.
He said he is coordinating with the Cook County Department of Corrections to obtain medication records of inmates as they are transferred from the jail to Dwight. This would reduce or end the delay in providing medication during reception and classification.
Shicker said he is also making progress in obtaining more hours of psychiatric care at Dwight.
“These hours will be specifically used for intake evaluations,” Shicker said in an e‐mail. “The psychiatrist will then be able to place the new (inmates) on the appropriate medication.”
The long delays in psychiatric treatment are unacceptable and pose a threat to the health and safety of inmates.
The John Howard Association is pleased, however, that IDOC and Warden Trancoso are attempting to resolve the problem of delayed psychiatric care, and will monitor their progress in coming months.
Update: Illinois Department of Corrections to Improve Psychiatric Care at Dwight, February 25, 2010
The Illinois Department of Corrections has moved to remedy a significant problem in psychiatric care provided to inmates at the Dwight Correctional Center following a report by the John Howard Association documenting the issue.
On January 26 a group of John Howard Association board members, staff and volunteers conducted a monitoring tour of Dwight, the state’s main prison for women. Although Dwight is authorized for 60 hours of psychiatric care a week, prison management said that since the summer it had been able to provide only 40 hours a week.
As a result, inmates were suffering unacceptably long delays in receiving psychiatric treatment and medication. The John Howard Association researched this problem by interviewing numerous inmates and then reported its findings to senior management of IDOC.
On Feb. 11 Dr. Wendy Blank, chief of mental health services for IDOC, said Dwight would begin providing the full 60 hours of psychiatric care effective Feb. 18. Blank said this will eliminate the backlog in psychiatric care and benefit inmates needing mental health treatment.
The John Howard Association is pleased that IDOC management acted promptly to resolve the problem of delayed psychiatric care, and will monitor their progress in coming months.