Forced Medication | AVID Jail Project

by Kim Mosolf
When the AVID Jail Project first began regularly visiting King County Correctional Facility (KCCF) last year, we had no idea that the jail was forcibly medicating some inmates. Then, one day while doing rounds in solitary confinement, we met Dwayne Stelivan. Mr. Stelivan spoke calmly and clearly about his mental health history and his experiences both inside and outside of jail. On the outside, he worked regularly with a doctor to make decisions about his treatment, including whether to take antipsychotic medications. But at KCCF, he told us, the decision was made for him. When Mr. Stelivan asked me to be present during a forced medication hearing at the jail, I agreed. As an attorney, I thought I knew what a hearing looked like. I was surprised when I found jail health staff standing informally outside Mr. Stelivan’s cell as he squatted down to talk through a thin slot in the metal door. Sensitive, confidential information about Mr. Stelivan’s mental health echoed around us as other inmates looked on and listened from mere feet away. We discussed the issues in no particular order for about ten minutes—the jail presented no witnesses or evidence for examination—and that was it. Much of what I observed that day, and in the numerous inmate records we reviewed as part of our subsequent investigation, was troubling. No confidentiality. No notification to the criminal defense attorney. No one to help the inmate identify evidence or make arguments. Witnesses appearing via cell phone. And never any mention of outside judicial review. When we shared these concerns with other attorneys and advocates, most did not know that the jail was even doing these hearings and many expressed bewilderment and doubt about their legality.
Our society has decided that we have a fundamental right to control the medical treatment we receive, including whether to take powerful antipsychotic medication. It is only under very limited circumstances, and after careful weighing of the evidence, that this fundamental right can be overruled. When the entity that wants to forcibly medicate is the very same entity conducting the hearing, adherence to due process is a critical safeguard. It is even more important when the decision involves a pre-trial detainee—someone presumed innocent and often held in jail only because he or she cannot afford even the lowest bail. If KCCF wants its forced medication process to consider all interests and respect due process rights, then the jail should have no objection to the following:
  • Notify criminal defense counsel. Even though the inmate cannot have an attorney represent them at the hearing, the results of the hearing can profoundly influence a criminal case. Notification poses little to no cost to the jail;
  • Provide an advocate for the inmate who can help meaningfully present the inmate’s position and has sufficient background to challenge psychiatric recommendations;
  • Hold hearings in a setting that promotes confidentiality and respect. Almost everyone, including inmates and staff, behaves differently in a courtroom-like setting; and
  • Ensure the inmate understands and has access to outside court review.
These changes will help ensure awareness and understanding of a complicated issue that implicates our most basic of rights: the right to control our mind and body. The AVID Jail Project continues to press the jail for these changes. Rooted in Rights, in partnership with the AVID Jail Project, shares these stories to bring attention to the crisis of mental health in our criminal justice system.

About AVID

The AVID Jail Project of Disability Rights Washington works on behalf of inmates with mental illness in several local jails. As Washington’s protection and advocacy agency, Disability Rights Washington is in a unique position to bring recording equipment into jails to capture and share the experiences of people with disabilities. Most members of the public will never enter a jail or have firsthand knowledge of how inmates with mental illness fare inside our jails. This video is a result of our ongoing efforts to give jail inmates with mental illness an opportunity to tell their own stories in their own words. The AVID Jail Project hopes that the images and stories we share will bring attention to the crisis of mental health in our criminal justice system. More importantly, we hope that these stories will humanize an issue that is all too easily ignored. These are the voices of citizens with mental illness. We will continue to visit jails and release these videos, so please follow our efforts and share them with others.
Unlike prisons, jails largely hold individuals who have not been convicted of a crime but are instead awaiting trial and unable to afford bail. The rate of individuals with mental illness in our jails is staggeringly high, with jails and prisons functioning as de facto psychiatric facilities. Since early this year, the AVID Jail Project has regularly been performing outreach and advocacy for inmates with mental illness at King County Correctional Facility in Seattle, Washington, and the SCORE Jail in Des Moines, Washington. We provide information and assistance to inmates and their advocates to help them exercise their right to access mental health treatment in jail, and avoid harmful conditions of confinement. We also work with jail administration to address systemic issues such as the use of solitary confinement, and timely access to psychiatric medication. For more information, please visit our web site for AVID Jail Project. This video was produced by Rooted in Rights for the AVID Jail Project at Disability Rights Washington
AVID Jail Project: Amplifying Voices of Inmates with Disabilities