At the United States Penitentiary at Lewisburg, Pa., prisoners with serious mental illness are handed crossword and sudoku puzzles instead of counseling, according to a lawsuit that says prisoners at one of the most violent federal prisons are denied routine mental health care.

The lawsuit also alleges that prisoners at Lewisburg are cut off from the medications they were given at other prisons and housed in small cells, where they often spend up to 24 hours a day with other prisoners, who also often have serious mental illnesses.

Filed on June 9, McCreary v. The Federal Bureau of Prisons says the meager mental health treatment violates the U.S. Constitution's protections against cruel and unusual punishment. It also says the inadequate treatment is in violation of the Bureau of Prisons' own rules, which say men with serious mental illness should, in most cases, be removed from the Special Management Unit for violent prisoners at Lewisburg.

A spokesman for the Bureau of Prisons declined to respond to the lawsuit, saying in an email, "the Bureau of Prisons cannot comment on matters that are the subject of legal proceedings."

Last year, an investigation by NPR and the Marshall Project showed high rates of violence at Lewisburg, where inmate-on-inmate assaults are six times more common than at all federal prisons. The investigation linked the heightened violence to the lack of mental health care, the practice of double-cell solitary confinement — putting two men in one small cell — and the frequent use of restraints.

The lawsuit — filed by pro-bono legal group Washington Lawyers' Committee for Civil Rights and Urban Affairs, the Pennsylvania Institutional Law Project and the law firm Latham and Watkins — finds those problems, too.

Attorney Philip Fornaci, project director of the D.C. Prisoners' Project of the Washington Lawyers' Committee, says it's dangerous for mentally ill prisoners to live in double-cell solitary confinement.

"For a person with a serious mental health issue — particularly paranoia, schizophrenia, things of that nature — it's almost completely intolerable to be caged in that kind of situation indefinitely," he says.

The lawsuit is based on three years of visits to Lewisburg; interviews and correspondence with scores of inmates; and prison documents including medical records.

The Special Management Unit at Lewisburg was created in 2009 for what the Bureau of Prisons defines as "dangerously violent, confrontational, defiant, antagonistic inmates." It was set up as a 24-month program, but last year, the Bureau of Prisons changed the rules to make it a 12-month program.

But Stacey Litner, the advocacy director for the D.C. Prisoners' Rights Project, says several of the men she has met over three years of visits to the Pennsylvania prison have been there for several years.

"During the course of my visits, I've seen people deteriorate fairly significantly in terms of their mental health," says Litner, as she explains the claims in the lawsuit. People who arrived at Lewisburg with medications they got at other prisons were taken off, she says, "with little or no explanation. They can't get access to the therapy they are desperately seeking. When they tell staff they are suicidal, there is no recourse."

The NPR/Marshall Project investigation reported that men whose conditions were made worse by the isolation of solitary confinement often attacked their cellmates, and in some cases, there were serious injuries or killings.

In October 2015, Gerardo Arche was killed in his cell, strangled with a bedsheet, court documents show. Arche had a long history of serious mental illness, according to his prison medical records, but when he arrived at Lewisburg he was taken off his antipsychotic medications and given no therapy, he told his family. His daughter and sister say that in his calls and letters, he sounded increasingly depressed or detached from reality. The family pleaded with prison officials to give him medication and treatment. Instead, when he acted agitated or paranoid, he sometimes was placed in tight handcuffs and restraints, his family said.

Prison documents obtained by NPR and the Marshall Project show that psychology staff at Lewisburg repeatedly found that he had "no significant mental health issues."

Arche's death had been overlooked by the U.S. Attorney's Office for the Middle District of Pennsylvania until the NPR/Marshall Project investigation. But last month, the Department of Justice announced that a federal grand jury had indicted Arche's cellmate, Jose Hernandez-Vasquez, on a charge of first-degree murder.

In 2014, the federal Bureau of Prisons issued a policy: Men with serious mental illness did not belong in a Special Management Unit for dangerous prisoners.

This month's lawsuit says Lewisburg got around that rule, because around that same time, many prisoners there with serious mental illness were taken off medications and given a lesser diagnosis.

Andra Gray, a former Lewisburg inmate who is not included in the lawsuit because he was released last year, says he, too, was denied medications — even though at other prisons he was treated for depression and schizophrenia.

"They cut it off when I got to Lewisburg," he says. "I was getting medication until I got to Lewisburg."

Gray says when he asked for counseling, he was given the self-help packets, with puzzles and coloring-book pages, instead.

"And then they give you a book and say color this or draw this picture or cross this word out, because it's usually sudokus and Word Search. You're not thinking about searching a word out. You're thinking about, you know, life or death. So how do a word or a puzzle help you, at that point?"

Gray says only after he returned home to Washington, D.C., did he get the medications and therapy that now enable him to try to get his life back on track.

Last year, new federal rules called for more mental health screening of inmates in solitary confinement. The lawsuit says men at Lewisburg still get little to no counseling. But there has been some change: The number of men in the program at Lewisburg has dropped by about half in just the last year.

Copyright 2017 NPR. To see more, visit

300x250 Ad

Support quality journalism, like the story above, with your gift right now.