BIRMINGHAM, Ala. (AP) — If any one witness led to a sweeping court order demanding that Alabama improve psychiatric care in state prisons, it was Jamie Wallace.
Diagnosed with bipolar disorder and schizophrenia and imprisoned in Alabama for killing his mother, Michelle Franklin Wallace, the inmate said he sometimes heard the voice of the dead woman and others telling him to harm himself.
He did, with fatal consequences, just 10 days after testifying as the first witness in a trial over mental health care in state prisons.
The story of Wallace's hanging while in state custody served as the backdrop for a federal judge's ruling on Tuesday that Alabama's psychiatric care for inmates is "horrendously inadequate" and violates constitutional standards.
U.S. District Myron Thompson, in a 302-page decision outlining multiple deficiencies in the state system, wrote of being "extremely concerned" after Wallace showed him scars from past suicide attempts and testified about a lack of psychiatric treatment while in state custody.
"Without question, Wallace's testimony and the tragic event that followed darkly draped all the subsequent testimony like a pall," said the judge, who repeatedly cited Wallace's treatment to depict a system that locks away troubled inmates with only sporadic psychiatric care.
It's unclear exactly what sort of changes will occur because of the decision: Rather than mandating specific actions, Thompson ordered the state to meet with inmates' lawyers to work on reforms. A special legislative session, additional funding and more hiring are possible.
Whatever the solution, Thompson made clear he doesn't want a repeat of what happened to the 24-year-old Wallace.
Already suffering from psychiatric problems as a teenager, Wallace was released from a mental facility only weeks before shooting his mother and trying to kill his grandfather in 2009. He pleaded guilty in 2011, rejecting a defense lawyer's suggestions that he plead not guilty by reason of mental illness.
Sentenced to 25 years, Wallace entered an Alabama Department of Corrections wracked by longstanding problems of inmate overcrowding, understaffing and funding that critics say is inadequate. Wallace talked about being suicidal and made multiple attempts on his life, the judge said, but received inconsistent, insufficient care in prison.
In December, Thompson began a non-jury trial to air claims in a class action filed by inmates who say the state's mental health care is so bad, it's unconstitutional. State attorneys didn't deny problems, but said the troubles weren't bad enough to violate the Constitution.
Wallace took the stand as the first witness. Less than two months earlier, Thompson's order said, the state had ignored recommendations from prison psychiatric contractors to transfer Wallace to a hospital. Rather than receive treatment, sometimes Wallace was punished for suicide attempts by being placed in a sparse, one-person cell, Thompson said.
Wallace testified that voices in his head told him to kill himself, and he became so agitated the judge recessed temporarily and let him continue in a quiet chambers library after Wallace was coaxed, "as if he were a fearful child," Thompson wrote.
Wallace's condition remained poor after his court appearance, the judge said, yet he was allowed to languish with little care.
"His medical records for his final 10 days reflected no group activities, one cell-side treatment plan note, and two psychiatric progress notes," Thompson wrote. Five days before the suicide, a worker wrote that Wallace was using threats "to get what he wants," the judge noted.
The Bullock County prison where Wallace was incarcerated has suicide prevention cells called "stabilization units," evidence showed, but Thompson said the rooms had sprinkler heads directly above sinks and toilets that make it easy for a suicidal prisoner to climb atop a fixture and hang himself.
"In fact, that is how Jamie Wallace committed suicide," the judge said. Wallace died on Dec. 15.
With nearly 20,000 state inmates, about 3,400 of whom are supposed to be receiving mental care, Alabama now faces a court order to provide better psychiatric care in its prisons.
The state agreed to some new suicide prevention measures during the trial after Wallace's death, including additional medical staff and more observation of troubled inmates, but Thompson said sweeping reforms are required.
"The case of Jamie Wallace is powerful evidence of the real, concrete and terribly permanent harms that woefully inadequate mental-health care inflicts on mentally ill prisoners in Alabama," Thompson wrote.