Dirty Work

by Eyal Press

  After Harriet graduated from high school in 1998, she and her mother moved to Miami, where their financial situation improved. Her mother became a nurse, and Harriet enrolled at Florida International University. She decided to major in psychology, captivated by the idea of helping people rein in their destructive impulses so they could lead more fulfilling lives. For a while, though, Harriet struggled to control her own destructive impulses. She binge-ate and put on fifty pounds, then starved herself and lost sixty-five. She did a lot of clubbing and a lot of drugs, adjusting to the culture shock of Miami by plunging into its hedonistic nightlife. The experience was exhilarating at first, but the thrill eventually wore off. After one of her roommates burned through all his savings to service a raging drug habit, Harriet quit the party scene and spent a year focusing on taking better care of herself. One night, she had a dream about a childhood friend named Steven, whom she’d met at a bus stop in fifth grade. She got in touch with him, inviting him to visit. He showed up a few weeks later and ended up sticking around. In 2007, they exchanged wedding vows.

  By then, Harriet had earned a bachelor’s degree in psychology and enrolled in a master’s program in mental health counseling. She wanted to become a forensic psychologist. But Florida was in deep recession, racked by the collapse of the housing bubble and the 2008 financial crisis, which devastated an economy heavily dependent on real estate speculation. Harriet had no luck finding work until she spotted a listing posted by Corizon, the private contractor in charge of providing mental health services at Dade.

  Even at the height of the economic crisis, jobs in corrections were plentiful in Florida; the state had the third-largest prison population in the country, behind only Texas and California. Ensuring that these prisoners received psychiatric care was not a matter of choice. It was a constitutional obligation, thanks to Estelle v. Gamble, a 1976 case in which the Supreme Court held that “deliberate indifference to serious medical needs of prisoners” amounted to cruel and unusual punishment.

  Around the same time, in another case, O’Connor v. Donaldson, the Supreme Court ruled that a Florida man named Kenneth Donaldson had been confined for fifteen years in a state psychiatric hospital against his will, violating his constitutional rights. The ruling added momentum to the campaign to “deinstitutionalize” the mentally ill, whose plight was dramatized in a series of journalistic exposés that drew attention to the dismal conditions in the nation’s mental health hospitals, where catatonic patients in dingy rags were crammed into bleak, filth-strewn wards. Activists in the disability rights movement decried the existence of asylums filled with “naked humans herded like cattle,” as one account put it. In the decades that followed, states across the country began shutting down these facilities, both to save money and to appease advocates demanding reform.

  The reformers’ vision was a noble one, with origins that could be traced back to the 1963 Community Mental Health Act, signed by John F. Kennedy, who proposed creating a network of fifteen hundred community mental health centers so that the “cold mercy of custodial care would be replaced by the open warmth of community.” But fulfilling this vision proved more challenging, not because it was inherently flawed, but because of choices that politicians and the people who elected them made. As the sociologist Christopher Jencks noted in his book The Homeless, the money saved by closing state mental hospitals could have been used to fund affordable housing and outpatient services. Unfortunately for advocates of reform and deinstitutionalization, the closures coincided with a new climate of fiscal austerity and conservative tax revolts. In Washington, the Reagan administration tightened eligibility for federal disability benefits, pushing more than a million people off the rolls. Meanwhile, state legislators pressed hospitals to discharge even chronically ill patients, who soon began inundating the streets. By 1987, there were 100,000 mentally ill homeless people and 1.7 million others who were too sick to hold down jobs, a situation without parallel in other Western societies. “No other affluent country has abandoned its mentally ill to this extent,” Jencks observed.

  Deinstitutionalization coincided with another trend unique to America: a wave of punitive criminal justice measures—mandatory minimum sentences, truth-in-sentencing laws—that fueled an unprecedented expansion of the prison population. Mass incarceration would have a particularly devastating effect on African Americans, who were arrested, convicted, and imprisoned at vastly higher rates than whites. It would have equally devastating consequences for the mentally ill, who were ensnared in the criminal justice system at similarly alarming rates. In the decades to come, as many as one in two people with severe mental illnesses would get arrested in some parts of the country, often for minor offenses that were a direct result of their conditions. Instead of the open warmth of community, many were subjected to an even colder form of custodial care, in the nation’s growing archipelago of jails and prisons.

  By the 1990s, prisons were becoming America’s new asylums, warehousing more and more people in dire need of psychiatric care. The situation was particularly extreme in Florida, which spent less money per capita on mental health than any other state except Idaho. Meanwhile, between 1996 and 2014, the number of Florida prisoners with mental disabilities grew by 153 percent, three times faster than the overall prison population.

  In its Estelle decision, the Supreme Court determined that neglecting to furnish incarcerated people with psychiatric care violated their rights and was unacceptable. But the Court failed to clarify how such care could be delivered in a punitive environment where the paramount concern was security. According to medical ethicists, correctional psychiatrists often felt a “dual loyalty”—a tension between the impulse to defer to corrections officers and the duty to care for their clients. Because guards provided staff with crucial protection, it could be risky to defy them. Yet if mental health professionals were too acquiescent, they risked becoming complicit in practices that caused their patients grievous harm.

  “DON’T BE A WITNESS”

  After Harriet met with Dr. Perez, she told herself, “Maybe I’m being too sensitive—boys will be boys.” Aware that she was a newcomer to the world of prisons, she decided that the guards at Dade were far more qualified than she was to determine how to maintain order.

  At a morning staff meeting, a psychotherapist named George Mallinckrodt aired a different view. The day before, Mallinckrodt announced, a patient had shown him a collage of grisly bruises on his chest and back. The injuries had been sustained when a group of guards handcuffed him, dragged him into a narrow hallway, and stomped on him over and over again with their boots. Several other prisoners had corroborated this account, Mallinckrodt told his colleagues. At the meeting, he accused security of “sabotaging our caseload” and called for immediate action to be taken.

  Harriet did not attend this meeting, but she heard about Mallinckrodt’s allegations and, like the rest of her peers, dismissed them as exaggerated. “I thought ‘sabotaging’ was a pretty strong word, a loaded word,” she said. Mallinckrodt was known to be on chummy terms with some of the men in the TCU—too chummy, she believed. “I thought, you’re just too enmeshed in your clients, you can’t see things objectively,” she said. “I thought he’d become an advocate. You know, a ‘hug-a-thug.’”

  Harriet had no intention of playing such a role. She just wanted to do her job. Yet she soon discovered that her power to make even basic decisions was extremely circumscribed. When she’d been hired, for example, Dr. Perez had told her that in addition to assisting with individual treatment plans, she would be responsible for helping people in the TCU participate in twenty hours of activity a week, as mandated by state law. Yet every time Harriet proposed something—music therapy, yoga—her superiors rejected the idea. Invariably, the reason cited was that it posed a risk to security, even when the activities were designed to alleviate aggression. One day, Harriet brought in a box of chalk, in the hope that prisoners could draw on the pavement in the rec yard. On another occasion, she gave
a red rubber ball to a man who had schizophrenia, thinking that he would benefit from tactile play. An officer returned both items to her, ostensibly because they posed safety hazards. Eventually, Harriet came to feel that she was being taught a lesson about knowing her place. “I kept getting the message that mental health doesn’t override security,” she said. “Whatever security says goes.”

  The restrictions frustrated Harriet, but she knew from experience how dangerous it could be to alienate security and work without protection, as had happened after the email she’d sent to Dr. Perez about the rec yard. One day, Harriet was in the yard when the guard on duty told her that he needed to step away. “I’ll be back,” he said. A short while later, a prisoner sidled up to her and put his hands on her backside. Harriet thought of screaming for help but feared further provoking the man, who was extremely psychotic. Instead, she froze. After a moment, she slipped away without looking back. The prisoner didn’t follow her. Even so, the incident left her deeply shaken. “He definitely could have overpowered me,” she said. “I could have been assaulted, raped—anything.”

  * * *

  Navigating such dangers would have been stressful enough in a tidy, well-run work environment. The setting in which Harriet worked was filthy and run-down—the walls coated in mildew, the hallways caked in grime. Cells in the TCU flooded and weren’t mopped up for days, creating appalling smells; ceilings routinely sprang leaks. In the staff break room, cockroaches had the run of the kitchen area, infesting even the microwave. To avoid using it, Harriet started making ramen noodles for lunch, which she prepared with water poured directly from the kitchen faucet (it was so hot that she didn’t have to boil or microwave it).

  One Saturday in June 2012, Harriet was finishing a shift when she heard that a prisoner in the TCU named Darren Rainey had defecated in his cell and was refusing to clean it up. Rainey was fifty years old, a tall, broad-shouldered man who sometimes gave people unnerving looks, Harriet later recalled, “as though he was trying to see inside you.” He had been convicted of cocaine possession and suffered from severe schizophrenia.

  “What’s going on with Rainey?” Harriet asked a guard.

  “Oh, don’t worry, we’ll put him in the shower,” he told her.

  Harriet heard this and felt reassured. “I was thinking, okay, lots of times people feel good after a shower, so maybe he will calm down. A nice, gentle shower with warm water.”

  The next day, Harriet returned to work and learned from some nurses that a couple of guards had indeed escorted Rainey to the shower the previous night. She also learned that he hadn’t made it back to his cell. He had collapsed in the stall while the water was running. At 10:07 p.m., he was pronounced dead.

  Harriet assumed that Rainey must have had a heart attack or somehow died by suicide. The nurses told her this was not what had happened, explaining that he had been deliberately locked in the shower by guards, who directed a stream of scalding water at him through a hose they controlled from the outside. The water flowing through the rigged-up hose was 180 degrees, hot enough to brew a cup of tea—or, it soon occurred to Harriet, to steam a bowl of ramen noodles. It would later be revealed that Rainey had burns on 90 percent of his body and that his skin fell off at the touch.

  Harriet was stunned. Surely, she told the nurses, the incident would prompt a criminal investigation.

  “No,” one of them told her. “They’re gonna cover this up.”

  In the days after Rainey’s death, Harriet heard from several prisoners in the TCU that Rainey was not the first person who had been locked in that shower. He was only the first person to die there. Earlier she would have rolled her eyes at such a claim. Now she wondered how she could have been so blind. Yet as distraught as she was, she did not file a report calling for the guards who killed Rainey to be held accountable. Neither did anyone else on the mental health staff. “I thought, somebody has to report it, and it has got to come from the inside, but it’s not going to be me,” she said. One reason was her memory of the backlash she’d provoked for reporting something incredibly minor by comparison. Another was her fear that any employee who became too vocal would end up getting fired.

  This was a legitimate concern. A year earlier, after George Mallinckrodt heard about the prisoner who’d been stomped on, he consulted the website of the Florida Department of Corrections. It stated that any employee who suspected abuse was obligated to report it. Mallinckrodt had first learned about the attack from a fellow counselor who had called him after she had witnessed it. Choking back tears, the counselor said that she had seen a group of guards batter the prisoner in a hallway, slamming their boots into his rib cage as he flailed on the ground. She had watched the assault through a window that faced onto the corridor, which had no cameras. The guards, she said, stopped pummeling the man only when she started yelling at them. (All of these details matched what Mallinckrodt subsequently heard from the participants in his group therapy session, where the victim lifted up his shirt to reveal his bruises.)

  The counselor who relayed this account to Mallinckrodt had attended the staff meeting where he had spoken out, but she had remained silent. As incensed as she was, she did not intend to report anything, out of fear that the guards would turn on her if she dared to cross them. Mallinckrodt’s other peers also did not respond to his call for action.

  Because no one else was willing to come forward, Mallinckrodt decided to act on his own. In July 2011, he filed an incident report with both the Florida Department of Corrections and the Florida inspector general’s office in Tallahassee. Around this time, a new warden, Jerry Cummings, arrived at Dade. Mallinckrodt arranged a meeting, at which he told Cummings about the beating and other abuses that his patients had described to him, including incidents of security officers’ taunting mentally ill prisoners until they screamed, banged their heads against the walls, or defecated in their cells—which, in turn, triggered more brutality from the guards. According to Mallinckrodt, Cummings seemed concerned and sympathetic, leaving him optimistic that changes would occur.

  Shortly thereafter, a change did occur, albeit not the one he was anticipating. One afternoon, an officer stopped Mallinckrodt at the entrance gate to the prison as he was returning from a lunch break. He had just been fired, the officer informed him, on the grounds that his lunch breaks had been stretching on for hours. Mallinckrodt did not deny that he took long lunches, but plenty of staff members did this. He was the only one who had started raising his voice about abuse.

  Harriet did not want to end up in a similar situation. “We couldn’t have afforded it,” she said. So she refrained from raising her voice, a decision that had other costs. At lunch, she rarely ate anything because, after a few hours in the TCU, she would feel queasy and lose her appetite. She also started losing her hair, which began to fall out in mysteriously large clumps. At first, Harriet thought she might be suffering from an iron deficiency. Eventually, it dawned on her that the cause was emotional stress. Embarrassed that her scalp was showing, she took to wrapping scarves around her head to cover up the bald spots.

  In addition to these symptoms, Harriet began to feel something else: a sense of powerlessness that recalled the darkest moments of her childhood, when she had witnessed the erratic behavior of her father and felt powerless to stop it. Her sister had occasionally stood up to his drunken tirades, whereas Harriet had always tried to win his affection by impressing him. When this failed, as it inevitably did, she retreated into herself. Now, once again, she was trapped in an environment where she was too afraid to speak out. Even observing misconduct in the TCU was risky, because the guards were on alert for anyone who might expose them. If abuse was happening, “the politically safest thing was to excuse yourself and go to the bathroom,” she said. “Don’t be a witness. Just do your job and go home.”

  In 2013, Harriet was promoted to staff counselor, at which point she began providing individual therapy for prisoners. One day, a patient of hers named Harold Hempstead told her that he
had become preoccupied with the murder of Darren Rainey. A wiry man with hazel eyes, Hempstead, who had been convicted of burglary, occupied the cell directly below the shower where Rainey had been tortured. That night, he heard Rainey scream repeatedly, “Please take me out! I can’t take it anymore!” He also heard him kick at the stall door. Eventually, there was a heavy thud—the sound of Rainey collapsing to the ground, Hempstead later surmised—followed by the voices of guards calling for medical help. A short while later, Hempstead watched as a gurney with Rainey’s naked body on it was wheeled past his cell.

  Hempstead kept a diary in which he had recorded the names of four other people who had been subjected to what he called the “shower treatment.” He had even noted the dimensions of the stall. In the weeks after Rainey’s death, Hempstead told several mental health counselors in the TCU that he felt haunted by what he had heard and seen. They warned him that if he told them too much, they would have to write an incident report that would be forwarded to security officials, exposing him—and, by implication, them—to retaliation. Around this time, two of the guards who took Rainey to the shower, including a former football player named Roland Clarke, were promoted. (Both officers later resigned; their files included no indication of wrongdoing.) But Hempstead, who had been diagnosed with obsessive-compulsive disorder, refused to let the matter drop. He told Harriet that he had begun filing grievance reports about Rainey’s murder, in the hope of triggering an investigation.

  Harriet wasn’t sure if Hempstead, who professed to be a devout Christian, was motivated by compassion for Rainey or by a less high-minded impulse—a desire to embarrass the guards at Dade or to leverage a transfer out of the TCU. In the end, however, she encouraged him. “I thought that, therapeutically, writing it all down would be good for him,” she said. This advice was consistent with her general approach to her job, which was to try to make small differences in the lives of the people under her care while ignoring the problems that she lacked the power to alter. Harriet was the only mental health counselor at Dade who did not pressure Hempstead to remain silent about Rainey’s death, and he was grateful to her. But when he asked her whether she would back him up if he succeeded in drawing attention to the abuses at Dade, she hesitated. “I said, ‘Well, yeah.’ But I didn’t honestly know if I would honor that.”