Bedlam Behind Bars Panorama

More than a million Americans

with mental health problems are behind bars.

He's asleep. I don't know how he could sleep in this noise.

Some are abused, beaten and sprayed with chemicals

by the very people paid to look after them.

I'm done! I'm done!

Some have even died.

I swear this world has gone mad.

Nobody seems to care about anybody.

Especially a person with mental illness.

These are leg irons and this is the belly chain.

They face indefinite periods of solitary confinement.

It's abundantly clear that we have criminalised mental illness.

Tonight, Panorama goes behind closed doors

to uncover America's new Bedlam.

SHOUTING

In a prison in Michigan, a man is in trouble.

This is Tim Souders.

He's being taken to solitary for breaking prison rules.

The guards are filming all this, as is standard practice.

Tim was jailed after stealing paintball guns.

He is bipolar and suicidal.

From the very first, Tim started going downhill.

He started writing letters home about how difficult it was.

He wasn't seeing a doctor regularly, a psychiatrist.

Tim was complaining he couldn't sleep,

that he was having trouble with his medication.

A heat wave is on.

Tim flooded his cell,

so the guards began to chain him to a concrete slab.

By the next day, Tim's clothes were soaked in urine.

He'd tried to rip them off. He became delusional.

11 more hours passed without a break.

I want pictures before I'm going to answer.

That evening, Tim somehow freed his arms.

The guards chained him back down.

No handling! No!

Did you hear me? Did you... Hear me?!

On the fifth day of this, Tim was moved to another cell.

He was fed with his chains on.

We couldn't treat an animal the way they treated Tim.

They would put the food on his chest

and he would try to move his hand to be able to feed his mouth.

And in the video, it shows his food

falling off his chest, onto the floor.

That afternoon, Tim died of heat and dehydration.

His mother didn't find out how he had died until weeks later.

The Department of Corrections kept telling us

Tim had passed away in his sleep.

They never told us he was in observation,

they never told us that he was in four-point restraints.

They never admitted to anything.

Eight years later and few Americans have heard of Tim Souders.

In 21st-century America,

you'd think his death would've changed the system.

But we have heard otherwise. And set out to investigate.

First stop, Chicago.

And Cook County Jail.

Home to 10,000 inmates.

We were given access.

Every morning, about 250 new inmates

are processed into the largest jail complex in America.

But they are not quite the criminals you might expect.

By accident, this jail is also now

one of the largest mental institutions in the country.

Do you hear voices when you are very, very depressed?

Staff screen inmates to see how many have serious mental conditions.

Today, it was 30%.

Yesterday, it was 50.

You are mopping up all the people

who can't get mental health care elsewhere?

Yes. They can't get in anywhere because there's no room.

There's no beds, all of the community resources have dried up,

as well as the hospitals.

Every inmate in this unit has a severe mental health problem.

It's the new habit!

This man told us he paces to drown out the voices in his head.

30,000 mentally-troubled people pass through this jail every year,

mostly for petty crimes.

At least here in jail, they can get some care.

But the man who runs the jail, Sheriff Dart,

says it is no place to get well.

It's abundantly clear that we have criminalised mental illness.

Do you think there is any psychologist that would say,

"I am going to put you in a 4x8 room with a complete stranger

"suffering from some mental illness different from yours,

"feed you three meals a day

"while you're associating with people charged with various crimes?"

No-one in their right mind would say that's an acceptable treatment plan.

But that's what happens frequently throughout jails in the country.

This is a low security section of the jail.

We are here to be shown how staff cope with mentally-ill inmates.

But there are allegations of abuse.

Throughout the jail, there are security cameras.

Watch the officer coming around the corner.

He has been suspended and is being prosecuted

following an internal investigation.

We met Isaac, a 33-year-old schizophrenic.

As with all of those on remand,

we are not allowed to state details of his alleged offence.

He told us four guards assaulted him for standing up at the wrong time.

There was a struggle.

One guard pushed my head down really hard on, like, a metal armrest.

I had bruises around my ankles because they shackled me

and I had, like, a bruise over here

and a bruise over here somewhere

and a bruise over here.

And when they finally took the handcuffs off,

the handcuffs were bloody.

The jail told us Isaac has never filed any complaint

about the alleged incident.

A legal case against the jail

alleges 45 assaults by officers on inmates last year.

Many against inmates with severe mental health problems.

Most are said to have taken place behind the walls of the jail's

two maximum-security divisions, 9 and 10.

We were given rare access to Division 10.

600 prisoners in this division have mental health problems.

They can be hard to manage.

This unit is where they are disciplined.

SHOUTING

Inmates call it The Hole.

Men often spend 23 hours a day locked in.

We could film, but not speak to the inmates.

Sorry. We'd like to talk to you, but we're not allowed to.

The lawyers behind the class action

have spent hundreds of hours with inmates,

cataloguing their allegations.

The use of pepper spray on people who are handcuffed,

beating people who are handcuffed on the ground,

kicking them, stomping them,

having large numbers of officers congregate and attack detainees.

All of that is occurring with regularity

in Divisions 9 and 10.

They're saying there's mould in the cell.

The prisoners have complained to the lawyers

of raw sewage in the cells, of filth and vermin.

He's asleep.

BANGING AND SHOUTING

I don't know how he could sleep in this noise.

We met a prisoner released from Cook County's

Maximum Security Division in 2012.

Kyle Pillischafske has been diagnosed with bipolar disorder.

He'd been driving recklessly and injured another driver.

He says guards, angry at him for allegedly causing a power cut,

got inmates to beat him up.

One of the inmates just punched me in the face.

And I fall to the side.

Because I was sitting on my bunk.

And they just start hitting me and kicking me.

And I ended up with my eyes swollen shut,

my entire head basically purple.

The prison guards basically did everything.

In charge of everything.

They just got a couple of lackeys with them to help out.

Cook County Jail paid Kyle compensation, suspended the guards

and referred them to prosecutors.

It says it is working with the Department of Justice

to ensure the wellbeing of inmates,

adding that the majority of its officers

act in a professional manner.

We are constantly monitoring our system

and when we may have any instances that require our special attention,

we place the focus there.

And this is a system that is built on people

that want to do the right thing.

We provide services, we provide programmes above and beyond

what the Department of Justice agreed order requires us to do.

So I would ask, if that was an institution

that was bent on, you know, torturing inmates,

then why would we provide such services?

But the class action that alleges 45 assaults last year

claims there is a culture of brutality in Cook County Jail.

I put that to Sheriff Dart.

-There have been a lot of accusations.

-Yeah, there have been.

What I'm asking you is, do you think this is untrue?

Absolutely, this stuff is untrue!

And the parts of it we've been piecing together, mind you,

we feel very comfortable

that the allegations are not going to be sustained.

The work of running a jail is very complicated and very difficult, OK?

And do we have instances

where employees don't always follow all the rules?

Yes. And when we find out that information, we pursue them

and depending on what the conduct is,

we give the discipline appropriate

or we attempt to fire people, whatever it may be.

Are there issues throughout the place? Yeah.

Because I challenge you to try to run a place of this size.

You couldn't do it.

Allegations of violence against inmates

aren't confined to Cook County Jail.

Across the country, one of the most contentious issues

is the use of force in cell extractions

when prisoners refuse to leave their cells.

A cell extraction is underway

in the California State Prison in Corcoran.

There is a 31-year-old man behind this door.

He was hearing voices and refused to take his medicine.

To get him out, they pumped pepper spray into his cell repeatedly.

YELLING

Help!

Oh, no!

YELLING

A federal judge has just ruled this was cruel and unconstitutional.

The prison told us it was proper procedure at the time,

adding that it has since tightened its rules

on the use of pepper spray.

Why has it come to this?

What are more than a million Americans

with mental health problems

doing in jails and prisons in the first place?

The country is littered with closed asylums,

like this one in Peoria, built in 1902.

Half a million souls were once abandoned, many abused

in various facilities around the country.

Take your clothes off.

Scenes like this came to symbolise a failing system

and prompted widespread closures.

Come here!

A better system was planned, based on community care.

We travelled hundreds of miles down to Texas,

where the historic failure of those grand plans is glaring.

This oil-rich state has almost

the lowest mental care budget per head in the country.

DISPATCHER: "There's an unauthorised person at an apartment..."

We went on patrol with the Houston Police,

who are picking up the pieces of a broken system.

RADIO BEEPS

An emergency call comes in.

We are going to call for additional backup on this call.

A man with severe mental problems has been behaving erratically.

He is in a property with guns.

We're going to set you down on the back seat of my car.

This man was released from a psychiatric hospital this morning.

With an acute shortage of hospital beds here, short stays are the norm.

Long-term care programmes are scarce, too.

That's pretty loose.

OK. But I'm scared. Please, please!

I've got my eye on you, bro.

You're not in trouble, OK? We're just trying to work it out.

He'd been hallucinating, seeing people in the trees.

Without beds or adequate community care in today's America,

an entire section of the population has been neglected.

There's about 4% to 5% of Americans

who experience serious mental illness in any given year.

We know that approximately one half of those individuals

do not receive needed services.

So, half of the people in this country with mental problems

can't get the care they need? That's appalling, isn't it?

That's approximately. And, you know, we need to do a much better job

and have the will and the desire, frankly,

to increase the community capacity to provide services.

This man needs long-term care, not handcuffs.

One of America's leading psychiatrists believes

the plan to prioritise community care

over modern hospitals was flawed from the start.

It is appalling. They have subscribed to the political correctness

that the old mental hospitals were terrible places

and they can't be any worse off in the community.

Well, it turns out they can be

if they end up in jails and prisons.

We were allowed inside Houston's main jail, Harris County,

and into one of its mental health units, considered a model facility.

These inmates, deemed relatively stable, live observed behind glass.

Set apart from the rest of the facility is the suicide unit.

This man, an acute case, has been stripped naked and put in a smock.

He will be locked in a tiny cell alone.

Around 24,000 Americans with mental health problems

are being held in solitary confinement.

Not so different from the old days.

These are leg irons

and this is the belly chain.

And it goes around the waist.

It has two cuffs and it keeps his hands in this position here.

So hopefully, if he's in a single cell, isolation cell,

he can't do anything to himself.

In here, the temperature was frigid.

Seclusion, the jail said, can keep inmates safe and be therapeutic.

Again, we weren't able to speak with the inmates to ask how they felt.

The UN says more than 15 days of solitary

may amount to torture, even if you're of sound mind.

For people with severe mental illness, it appears it's much worse.

You have hallucinations, delusions.

You have disordered thoughts going on.

For that reason, a lot of the examples of self-mutilation

come from people who are in isolation with severe mental illness.

This inmate, we were told, had been in a single cell for 109 days.

We're not allowed to name her.

Down the hall, another inmate had been segregated for 387 days.

The average time in solitary in Texas is three years.

Some Americans have been held in segregation for decades.

Is there a limit as to how long an individual inmate

can spend in one of those cells?

Everything is on a case-by-case basis.

But by and far, the greatest number of those individuals

are in multi-cell units.

So the population you're talking about

is truly a fraction of the overall number.

We saw some individuals today

who had been in these single-cell units for months.

What benefit is it to these inmates to keep them for so long?

I am the keeper of bodies

that the criminal justice system brings to me.

Ultimately, it's a question better posed to the district attorney.

The district attorney wouldn't comment,

but the Texas Commission on Jail Standards told us

inmates can be held in segregation indefinitely.

This is Paul Schlosser.

We were given access to him in a prison in Maine.

Paul, a former army medic convicted of armed robbery, is bipolar.

When this video was taken, he had spent two months in segregation

in the Maine Correctional Centre in Windham.

The medicine he'd had wasn't working. He begged for more.

..I end up getting about four a day

instead of the six I should be getting.

Well, there's a solution to that.

Oh, God, tell me, please!

OK. The solution is, right,

stay out of prison.

Paul began to mutilate himself.

You need to leave the bandages alone on your arm.

Well, if you don't give me my medication on time...!

I would cut up because of the depression

and not seeing really any end in sight.

A couple of times, it was with razors.

If, you know, they allowed us to shave, I'd break a razor.

It was to cause, you know, serious injury.

I'm going to take one out and cut myself with it!

The guards taunted him.

Cutters don't die, that's my personal experience.

You just wait until they drop and then sweep them up.

LAUGHTER

Instantly, when I cut up, it's this total, um...like, almost at peace.

You don't feel that emotional pain

and then it just gets to a point where

you feel that's really your only out.

Paul kept pulling the bandages off his wounds and demanding medication.

So staff moved him, saying later it was to was to get him treatment.

They put him in a restraint chair. The Devil's Chair, as some call it.

-Argh! Watch my

-BLEEP

-arm!

And wheeled him into another room.

Paul has hepatitis. He spits at a guard.

Drop!

That liquid they sprayed in his face is a highly-potent pepper spray.

The manufacturers say it should only be used

at a minimum distance of six feet.

I can't breathe!

'I started panicking. You're immobilised,

'so you have no way to cover your face.'

And it's just very claustrophobic,

not being able to breathe and being strapped in.

-Let me know when you're all done playing games.

-I'm done! I'm done!

It burns your eyes, it burns your ears.

It burns any sensitive areas on your body.

It definitely seemed like I was tortured.

Keep talking, keep breathing. Keep talking.

Let go of my head, then!

Maine's Department of Corrections declined to comment on the incident,

but told us that the captain in charge

still works as a corrections officer and has direct contact with inmates.

Paul Schlosser survived his ordeal.

But we had started cataloguing cases of other mentally-troubled inmates

across the country who'd been subjected to chemical sprays,

restraint chairs or beatings and who had died.

Your eye colour is really hard to get.

-Let go of him.

-LAUGHTER

Cases like that of Joshua Messier from Boston.

He showed no signs of mental problems as a boy.

In his late teens, though, he became delusional.

During a schizophrenic episode

in a psychiatric hospital, he struck a nurse.

He was sent here, to Bridgwater, Massachusetts,

a prison for the criminally insane.

One night, Joshua's mother came for visiting hours.

She said Joshua was terrified.

He was a shy country kid.

And him saying to me, "Mum,

"there's people in here that have killed their grandparents."

And he was scared.

He was scared.

Joshua said goodbye to his mother

and left the visiting area unescorted.

The guards ran to restrain him.

Some of what happened next was captured on security cameras.

Joshua screamed he was having a schizophrenic episode.

The prison says he lashed out.

But in the end, there were at least four guards restraining him.

He was beaten so badly that on autopsy,

he had something known as subdural haematomas,

which are bleeds on his brain.

In another room, they started strapping Joshua down to a bed.

First his legs.

They don't stop there.

They take his torso and press it into the tops of his legs,

compressing his diaphragm. You can't breathe like that.

And then one guard, I think he weighed about 235lbs,

he was about 6'2", lays on his back.

And they hold him that way for minutes.

Until there's not a sound.

And they lay his lifeless body back.

Joshua died after his chest was compressed and his heart stopped.

The state's chief medical examiner first declared it a homicide.

But then, things changed.

The corrections commissioner at the time

said everything was appropriately and professionally done.

The authorities later said one of the officers

who had put his weight on Joshua had lost his balance.

You got the evidence of a death certificate saying it's homicide.

You have the evidence that it's on video.

A kid walks into a room, call it a cell, call it a room, alive.

There's six people there that get on his back and he's dead.

How are those people not in jail?

The authorities have acknowledged

that the officers shouldn't have compressed Joshua's back

and say they've improved staff training.

But five years on, the officers have yet to be prosecuted

and were recently put on leave, pending further investigations.

I swear this world's gone mad.

Nobody seems to care about anybody.

Especially a person with mental illness.

Nothing's been done.

Nobody's been prosecuted.

And I heard that some of them,

their punishment was they had some time off. Paid time off.

They got a vacation for killing my son.

Across America, in virtually

all the cases of death and abuse we've recounted here,

mistreatment was initially either denied, sanctioned or covered up.

So, how far does this go?

The US government couldn't tell us

how many inmates with mental problems have died,

so we did some research of our own.

Over the course of making this programme,

we've collected the names of almost 100 such individuals

who've died of abuse or neglect since 2003.

The actual number is likely to be much higher.

We put our findings to the Justice Department in Washington,

but they declined to be interviewed for this programme.

Instead, they pointed us to a number of facilities around the country

which they're investigating for the abuse and neglect of inmates.

But there are wider questions to answer

about the failures of the mental health care system.

The man in charge of federal mental health programmes

says there's a limit to what he can do.

Everyone in America blames everybody else for this problem.

No-one wants to take responsibility for it.

We will take responsibility

and we're doing all that we can

in order to do it.

But within the resources that we have,

again, 80% of our funding going to people with serious mental illness,

we need to do a lot more and this country needs to do a lot more.

In Boston, Joshua's mother, Lisa Brown is seeking justice for her son

and for the hundreds of thousands of Americans

with severe mental health conditions behind bars.

What makes anybody think that we're going to fix this crisis

by throwing them in jail?

It's not going to fix the crisis, it's just going to make it worse.

Most Americans think of widespread brutality

against the mentally troubled

as just a shame of the past, but it's not.

I think in terms of the history of 20th century America,

our failure to treat people with severe mental illnesses

and the consequences is one of

the great social disasters of the century.

I think it will be regarded in retrospect

as something we'll be very ashamed of.

One evil has given way to another.

America's jails and prisons have become its new asylums.

SHOUTING

Next Monday - ISIS, terror in Iraq.

Panorama witnesses the fighting

and investigates the terrorist organisation

that has declared an Islamic state

and is recruiting British jihadists to join it.