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Time has come to save mentally ill inmates from solitary confinement


The first thing that hits you is the smell—an acrid stench that knocks you back a few paces.

When you see inside the cells, you understand. Men, often nude, are covered in filth. Their cell floors are littered with rancid milk cartons and food containers. Their stopped-up toilets overflow with waste.

These are the living conditions that prisoners with acute mental illness endure in the Maricopa County Jail’s Special Management Unit (SMU) in downtown Phoenix. In my 23 years of visiting prisons and jails nationwide, it is the single worst unit I have ever seen.

Eric Balaban

Eric Balaban

The SMU is designed to cut prisoners off from human contact. Each man is caged for at least 22 hours daily in a windowless cell a little bigger than a parking space. The unit is quiet except for periodic incoherent screaming from acutely ill prisoners locked down in their cells. The only time prisoners are allowed to see sunlight and get fresh air is for one hour on weekdays inside a recreation cage. There, they can walk in circles alone.

The SMU is supposed to be reserved for those prisoners who are so dangerous they cannot be safely managed elsewhere. Instead, it has become a dumping ground for those who are acutely mentally ill. The behavior that lands these men in the SMU is often the product of their untreated or mismanaged illness—like repeated outbursts or refusing orders. During the tenure of Sheriff Joseph Arpaio, prisoners with serious mental illnesses were put in solitary confinement for cutting themselves and spreading blood on their cell walls, and for trivial offenses, such as removing American flag stickers the sheriff ordered be placed in every cell.

Once in solitary, prisoners with severe mental illnesses begin a cruel cycle. The relentless isolation they endure in the SMU causes them to deteriorate, making them more unstable. They become more disassociated from reality. They refuse to eat, and refuse medications and treatment. As a result, they are more prone to making outbursts or threatening staff, which the jail then uses to justify keeping them in the SMU.

The risks that isolation poses to people with serious mental illnesses are well-known. Jails and prisons around the country have heeded the evidence and barred long-term placement of people with serious mental illnesses in their most restrictive units. The results have been striking: In Michigan and Massachusetts, the number of violent and disciplinary incidents dropped substantially, as did instances of self-harm and suicide attempts. Illinois, Colorado, and Mississippi closed entire supermax prisons and saved millions.

Maricopa has refused to budge. For the past nine years, I have represented the jail’s pretrial detainees in a federal lawsuit challenging unconstitutional conditions. In 2008, U.S. District Court Judge Neil Wake found the jail’s health care system unconstitutional, noting the detrimental effects of extended lockdown on prisoners with serious mental illnesses. Over the next six years, the psychiatrist appointed by Judge Wake to monitor the jail’s mental health system documented the life-threatening harm being done to prisoners who are warehoused in the SMU. Yet, the jail still has not excluded these men from this unit.

After Maricopa citizens voted Joe Arpaio out of office last fall, we hoped that Sheriff Paul Penzone would join the movement away from these supermax units to safer and less costly models. We were encouraged as Sheriff Penzone dismantled parts of Sheriff Arpaio’s inhumane jail system, including closing the notorious Tent City. Yet, a year after Sheriff Penzone took office, the SMU remains one of the most brutalizing correctional units in the United States. The time has long passed for this relic of Sheriff Arpaio’s regime to be closed down. Sheriff Penzone has shown he is willing to reform the jail to bring it in line with sound correctional practices, and to enhance public safety. The next step on this path is to shutter the SMU.

Eric Balaban is a senior staff counsel with the National Prison Project of the American Civil Liberties Union and lead counsel for the Maricopa County Jail detainees in Graves v. Penzone.



The views expressed in guest commentaries are those of the author and are not the views of the Arizona Capitol Times.


  1. I was with you until “closing the notorious tent city.” Did not tent city allow the maximum possible social interaction of inmates?

    Wasn’t the suicide rate in tent city close to zero? Based on the writer’s theory of mental health, we would expect the jail suicide rate to go up since tent city was closed.

    Arpaio’s overall suicide rate was hugely, 60%, below the national suicide rate, despite the New Times fake news story saying it was hugely above.

    Where are your facts? What is the suicide rate now? The national jail suicide rate has averaged 42 deaths per 100,000 inmates; what is the jail suicide rate now? Arpaio averaged a suicide rate of 17 suicides per 100,000.

    The writer is to be commended for looking out for the absolute “least of us.” But, we are left with a lingering suspicion that he is writing a story, not the truth.

  2. The mentally ill are the new witches for white christians.

    Just like black youths were superpredators that must be brought to heel to keep America white and christian, the mentally ill are the supposed cause of violence in white Christian america.

    Please tell me which mental illness causes murder. In the meantime, I can run off hundreds of instances of I situational abuses that cause what is deemed mental illness.

    The fact that the so called mentally ill are discriminated against and ab7sed adls if they were old school lepers while they are far more likely to be abused is almost genocide or cleansing that has deep roots in religion, not civil society..

  3. bradley taylor hudson

    The writer is telling the truth. I experienced Maricopa County jail. I’ll tell you only the worst story. 44 people were kept in a cell designed for 12 people for 10 hours. It was standing-room only, except for those who collapsed to the floor. There was one air vent, about 8″ square, and little air was coming out. The only toilet was clogged and overflowing with urine and feces. A man, presumably going through heroin withdrawal, spent those hours leaning into this toilet. This was not necessary. There were other cells nearby that were empty. This was sadistic expression from the guards, our County employees. This was not the only act of sadism I saw. Remember, most people in County jail are innocent. In this country we are innocent until proven guilty, yet subject to inhumane treatment from a culture of hate. One can imagine how much worse it is for the mentally ill, who are often unable to respond the way that sadistic guards want them to.

  4. My daughter is in a county jail in Ohio and was put in isolation after cutting herself with a razor the jail provided her. She is still there after 2 1/2 weeks. She is mentally ill and suffers fro schizophrenia. I cant get anyone to help me and they will not let her even wear underwear or clothing. She is in a protective vest and not allowed any phone calls. She is only serving a 90 day misdemeanor. I am so afraid she won’t survive

  5. You think those are bad look at Utah county jail and Draper prison both are horrible to the people in there but county jail is very corrupt and they do worse things that jail needs to be looked at

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