January 18, 2014. Associated Press. By Meg Kinnard. Civil liberties and mental health advocates say the South Carolina Department of Corrections shouldn't challenge a court order that the agency come up with a plan to better deal with its mentally ill inmates, agreeing with the judge that more proceedings just mean more taxpayer dollars spent in court and not on inmate care.

But, almost a decade into the litigation, prisons officials say they're sticking with their decision to appeal — while continuing to work on ways to improve conditions.

Earlier this month, Circuit Judge Michael Baxley sided with a group of mentally ill inmates who sued the agency in 2005 over alleged constitutional violations. Among their complaints was a lack of effective counseling and overreliance on tactics like isolation and pepper spray to subdue unruly, mentally ill prisoners.

Baxley's 45-page ruling castigated the department for failures in a number of areas — from screening new inmates for mental health problems to properly administering medication and preventing suicide — and gave the agency six months to come up with a plan to fix them. Court-appointed monitors would report back on progress.

"The evidence is overwhelming that SCDC has known for over a decade that its system exposes seriously mentally ill inmates to a substantial risk of serious harm," Baxley wrote, chronicling warnings and reports dating back to 2000, when an expert hired by Corrections told the agency its mental health program was in a state of "profound crisis."

Similar warnings, Baxley noted, came in reports from a legislative committee, a special task force and the state Department of Mental Health. In 2003, then-agency Director Jon Ozmint, according to Baxley, said inmate mental health was "at a crisis level." Two years later, the lawsuit was filed.

Until that point, Baxley wrote, the department "did virtually nothing to address, much less eliminate, the substantial risks of serious harm to which class members were exposed."

One mentally ill inmate, he wrote, cut his abdomen and was put in a restraint chair, his intestines spilling out as guards tightened the straps. After a schizophrenic man was transferred to an isolation unit and died 11 days later, Baxley wrote, an internal review found that guards had tried to cover up filthy conditions at that prison before taking photographs to document the cell where the man had been held.

"Despite its knowledge of the grave risks these deficiencies pose to mentally ill inmates, SCDC has failed through the years to take reasonable steps to abate those risks," Baxley wrote.

During a 2012 trial lasting more than a month, Corrections' attorneys disputed those claims, denying that inmates' rights were being violated. Officials said last week they will appeal, issuing a statement that called mental health "a national problem that all sectors of society are working to address."

A mental health advocate in Greenville has launched an online petition effort calling on Corrections to drop its appeal. Baxley wrote that continuing to litigate will only cost the state more money that it should be spending to fix the problems, a sentiment with which Vickie Middleton of the American Civil Liberties Union agreed.

"It's disappointing to hear that the state may spend more years and tax dollars to fight proving constitutional care despite this ruling, which is a clarion call to action to remedy these horrendous abuses of the most vulnerable people in the system," Middleton said. "It also puts lives in further danger, if they do go down that road."

Agency officials declined to discuss the case, citing the ongoing litigation. But in documents provided to The Associated Press, the Corrections Department says the agency will continue ongoing efforts to improve its mental health care as the appeal proceeds. That includes consulting with the state Department of Mental Health on evaluating Corrections' policies and using $1 million in recurring funds to pay for more staff, training and specialized programming to, hopefully, reduce mentally ill inmates' time in isolation units due to disciplinary infractions.

In his order, Baxley wrote about two mentally inmates who were held in isolation for about seven years each.

The department says it has reviewed and revised the agency's overall disciplinary process for mentally ill inmates. Since last year, Corrections officials say they have also been working to come up with better ways to make sure inmates get mental health treatment even after they leave the prison system.

That sort of community-based treatment on the front end, before someone ends up in prison, could lead to a reduction in the number of mentally ill inmates in prison altogether, Middleton said.

"It's a systemic failure and a crisis in the community," Middleton said. "We're putting people in a punitive environment, not a therapeutic environment, and clearly subjecting them to all kinds of abuses and neglect."

Amy Fettig, an attorney with ACLU's National Prison Project, agreed, adding that the public also needs to pressure legislators to allocate more funding to Corrections. In her budget proposal, Gov. Nikki Haley has asked for about $3 million more than lawmakers gave the agency last year, saying that she will continue to push for mental health funding for the prisons agency. In documents submitted as part of the trial, experts estimated adding new facilities and staff in those areas could cost $40 million or more.

"These are institutions that are set up to punish and contain and control. They are not set up to treat," Fettig said. "That is not an excuse for the abuse that is happening in South Carolina, but it is a warning for the public and our leaders that we have not created community systems that can treat our citizens. ... When you don't provide mental health care, people end up dying as a result."