NASHVILLE, Tenn. -- Tennessee death row inmate Henry Hodges' fellow prisoner Jon Hall warned long ago that he was at risk due to severe neglect by prison authorities, having spent three decades in solitary confinement with very little human contact or interaction.
In a federal lawsuit Hall filed in 2019 complaining that he too had been in solitary for nearly six years with no viable way to leave, he said of Hodges: “He’s suffered the most adverse unecessary (sic) & wanton neglect, deprivals, & mistreatment I’ve seen on death row. It’s a miracle he’s not committed suicide.”
The warning went unheeded, and last month Hodges cut off his own penis during what his lawyer called a “psychiatric disturbance.”
Hodges’ self-mutilation was an extreme incident but not without precedent in U.S. penitentiaries: Texas inmate Andre Thomas plucked out one of his eyes five days after his 2004 arrest for murdering his wife and children, and while on death row in 2009, he removed his remaining eye and told prison officials he ate it.
Although most cases fall short of those grisly examples, they underscore the significant, growing and unaddressed mental health care needs of prisoners.
A study released last year from the U.S. Bureau of Justice Statistics that compiled data from 2016 found 41% of federal and state prisoners reported a history of mental illness, and 13% had experienced serious psychological distress over the previous 30 days. Among the latter group, only 41% of state prisoners said they were currently receiving any kind of mental health treatment. The treatment rate for federal prisoners was even lower, at just 26%.
“Our prisons are not set up to provide mental health care, and they don’t do it very well,” said Craig Haney, a professor of psychology at the University of California, Santa Cruz, who has studied the effects of solitary confinement for decades.
Without enough resources to care for mentally ill prisoners, the sickest are sometimes treated with punitive measures, like solitary confinement, that only exacerbate the problem.
In Tennessee, Hall's lawsuit pointed to the vicious cycle he faced.
“To get out of solitary confinement he must be psychologically healthy, but the conditions of his confinement cause him psychological damage, and the lack of psychological treatment means he cannot recover sufficiently to get out of solitary confinement,” Hall’s attorneys wrote.
The annual report from the Tennessee Department of Correction shows the number of inmates categorized as having a “serious and persistent mental illness” rose from around 5% of the population in 2002 to nearly 23% in 2022. Nearly 19% more are listed as having other mental illnesses.
Questions abound as to whether the state is doing enough to confront the crisis.
Centurion of Tennessee, which won a five-year, $123 million contract in 2020 to administer state-run prisons’ mental health services, has been accused by rival Corizon of colluding with penitentiary officials to rig the bid. A lawsuit was settled out of court, and the Department of Correction said in May 2021 that it would rebid the contract. As of last week, one had not been awarded.
Meanwhile, a state comptroller’s audit in January 2020 found both Centurion — which has administered medical services since 2013 — and Corizon were unable to consistently meet contractually required staffing levels. The audit also found problems with medical documentation.
“We could not locate mental health evaluations for all inmates with documented mental health conditions in our sample; medical staff did not always include physician’s orders in patient files; we could not locate mental health treatment plans for all inmates with documented mental health conditions in our sample,” the audit reads.
The Correction Department blamed the record-keeping problems on a cumbersome paper-based records system. The department called transitioning to electronic health records a “top priority” in 2020, but last week said it’s still developing a request for proposals and hasn’t determined when it will go out.
The department said the staffing vacancies did not affect inmate care because the shifts were generally filled by other staffers.
Haney, the psychology professor, said it likely wouldn't matter for Hodges if Tennessee prisons had the best mental health care in the world as long as he remained in lockdown. It is well established that even short periods of solitary confinement are detrimental to a person’s mental health, he said.
“What’s a therapist going to be able to do if, at the end of an hour, you are put back in an empty cell where you are going to stay 23 hours a day?” he said.
When inmates are isolated for weeks, they can become “out of touch with reality and do things that are inexplicable in any other context,” Haney continued. “We’re dependent as human beings on connections to and contact with other people. When you take that away, it becomes very destabilizing.”
Hodges was sentenced to die in 1992 for the murder of a telephone repairman and immediately put in solitary confinement. Before he mutilated himself on Oct. 7, his behavior escalated over several days. Hodges went from smearing feces on his cell wall to slitting one of his wrists with a razor, according to court filings. When he was taken to the infirmary, he asked to go on suicide watch. But within a couple of hours he was back in a cell where he again used a razor, this time to cut off his penis.
After being released from the hospital, Hodges was returned to the infirmary. There he was kept naked and restrained by his arms and legs on a thin mattress over a concrete slab in a room that was lit 24 hours a day, with no mental stimulation such as a radio or television, his attorney said in a lawsuit filed Oct. 28. She compared his treatment to torture and said it violated constitutional protections against cruel and unusual punishment.
Lawyers for the state defended Hodges’ treatment at a hearing the same day, with Deputy Attorney General Scott Sutherland arguing that he was receiving “around-the-clock care.”
Nashville Chancellor I’Ashea Myles ordered the Correction Department to provide better care, including providing Hodges with clothing and mental stimuli.
Hodges' attorney is trying to get him transferred to the Middle Tennessee Mental Health Institute. A preliminary injunction hearing in his case is scheduled for Nov. 28.
Meanwhile his fellow inmates continue to be concerned. Hall filed a grievance on his behalf Oct. 13 requesting that Hodges receive special relief from prolonged solitary confinement. “After thirty years of sensory deprivation seclusions you have deprived that man of his sanity,” Hall wrote.
The grievance was rejected as inappropriate, with the unit manager writing that Hall was not an official inmate advocate.