Not Forgotten

Megan Rodriguez tries to visit her brother Matthew every Friday at the Santa Fe County jail, where he's awaiting trial on a first-degree murder charge. She laments that a man is dead, yet she's worried now about what's happening to her brother as he waits in jail to be tried for the crime.

Matthew Rodriguez, then 34, told police he stabbed Mitchell Daniel with a steak knife in March of 2017 because he was "angry at the voices in my head." Daniel, 64, had been living in a van and was found lying outside an apartment complex. After his arrest, Rodriguez began to punch himself in the face in the back of a squad car. Once officers restrained his hands, they say he banged his head against the protective barrier.

Police took him to the hospital to get treatment for those self-inflicted injuries, where he said that he did not mean to hurt Daniel. He asked hospital staff about Daniel's recovery. But Daniel died, setting in motion a criminal case against Rodriguez, who has pleaded not guilty and is now incarcerated in a jail unit where he's alone 20 hours a day or more.

His sister and father maintain a weekly visiting schedule because, she says, "nobody wants to be forgotten." Matthew Rodriguez has bipolar disorder and schizophrenia, his sister says, diseases that have put him into Northern New Mexico's threadbare system of mental health care for years. That system's diminished capacity to treat the most severe cases of mental illness has often landed people such as Rodriguez in jail—and when they get there, the illness often worsens.

A judge denied bail for Rodriguez, leaving him in the care of the jail as the criminal proceedings against him moved forward. Because of the legal complications inherent in a first-degree murder case, he has been one of the jail's longer-term inmates. And since September, Fridays have been the only days he gets company—that's when inmates housed in so-called segregation units can receive visitors.

A stocky 36-year-old with a beard, Matthew Rodriguez has been housed in a solitary cell since Sept. 21. That's when, in the early morning hours in a general population unit, he kicked and punched two inmates in their heads, sending them to the hospital with severe injuries and faces marked with bruises and cuts.

Megan Rodriguez says she's seen her brother's condition deteriorate after months in a cell by himself. He receives at most four hours a day outside his cell for showers, recreation, visitation, phone calls and meetings with behavioral health staff.

"It's not healthy for him to be stuck for that many hours alone," Megan Rodriguez says. "My brother's severely sick, and we've been complaining for a year."

The public defender assigned to represent Matthew in court did not return a voicemail from SFR.

Derek Williams, the jail warden, says Rodriguez "did good all the way to the point where he reached population. And then, unfortunately, we had that incident. We had to go back to square one."

While he has proven to be a faithful messenger for the county, highlighting in the press its efforts to reform mental health care in the year and half that he's been at the helm, Williams also has to deal with the day-to-day realities of running a jail which, by its very nature, is detrimental to the mental health of anyone who ends up inside its thick concrete walls. The ongoing care of inmates such as Rodriguez captures the difficult balance jails across the state must strike in protecting public safety without worsening the mental health of the inmates inside.

At any given time, about 2 percent of inmates, or about 12 people, are similarly situated in solitary housing in the Santa Fe County jail, according to figures from Williams. It's impossible to tell how Santa Fe County jail stats stacks up to jails across the state; there is no requirement for them to track how they practice solitary confinement.

In fact, corrections officials no longer use the phrase "solitary confinement." It is now "special management" or "restricted housing." They say the shift in rhetoric surrounding the practice reflects a move to more humane practices. At the same time, the Santa Fe jail also stopped providing a unit for inmates transitioning from solitary units to general population (though Williams says the jail is trying to get it back up and running again). But experts agree that involuntary isolation, however you put it, can have devastating impacts on anyone's state of mind.

An Old Problem

This year, the county jail reached a milestone: 10 years since it agreed to a settlement with the US Department of Justice, which claimed the jail was violating inmates' civil rights in part by not providing basic mental health care. The county denied the allegations, but nevertheless signed a 2008 settlement mandating certain staffing levels in mental health care and reforming some of its practices in that area.

"Incoming inmates who present with current risk of suicide or other acute mental health needs will be immediately referred for a mental health evaluation by a mental health professional," the agreement reads, in part. "Staff will observe such inmates until they are seen by mental health professionals. Incoming inmates reporting these conditions will be housed under appropriate conditions in the Health Services Unit unless and until a mental health care professional clears them for housing in segregation or with the general population."

Yet in the decade that's passed, what some (including Justice Department prosecutors) thought of as best practices for managing inmates' mental health care have been upended; a slate of new research now shows that putting people in an isolated cell for long periods of time can send their mental health into a spiral. Lack of human interaction and sensory deprivation can worsen conditions that already present significant challenges.

Speaking of Matthew Rodriguez' months-long placement in segregation, Peter Simonson, executive director of the American Civil Liberties Union of New Mexico, says: "Someone who has severe mental illness, the possible consequences of their experiencing long periods of isolation are pretty dramatic that, you know, an already serious illness can escalate pretty significantly in a pretty short period of time. So I think whatever conditions he's kept under have to account for that."

That's why placing inmates in any kind of segregated housing poses legal risks for the county. Judges in New Mexico have awarded multi-million-dollar judgments to inmates who say in lawsuits that the devastating mental health effects of isolation, as well as lack of avenues for inmates to petition against placement in segregated housing units, violate their constitutional rights. In 2011, a United Nations expert argued solitary confinement practices in the United States can rise to the level of torture, and therefore should be banned in most cases, especially where the inmate already has a mental health condition.

21st-Century Solitary

But jail officials and others say segregation is not what it used to be; inmates are no longer thrown in the hole and "forgotten about," Williams says.

County jails and state prisons have multi-disciplinary teams composed of security, behavioral health workers and case managers "who go through every day and visually and vocally correspond, check on that person to make sure that they're getting those things. Making sure that every day they're going out to yard, they're communicating with their family and so forth," he says.

Rodriguez is one of the jail's inmates who, for a variety of reasons from discipline to protective custody, has been placed in one of the jail's solitary housing units, according to Williams. The number fluctuates from roughly a dozen to about 24 in the segregation unit, largely because of the the nature of jail itself—people are accused of, not convicted of, crimes.

That's a sliver of the total jail population, which typically hovers above 500, including federal inmates the US Marshals Service pays the county to house. The jail's capacity is 612 inmates.

Last year, Rodriguez was housed in the transitional unit, and Anne Ortiz, a psychologist at the jail, says he showed enough progress to get him placed in general population.

Despite his improvement, transitional care ultimately did not work for Rodriguez. His case illustrates how jails across the state must balance the care of one inmate against the safety of others.

Rodriguez' sister says the voices in her brother's head worsened after his incarceration. "I could tell he was totally out of it," she says.

Rodriguez brutally attacked two other inmates, according to video footage and incident reports released to SFR by Santa Fe County in response to public records requests.

Just before 3 am on Sept. 21, Rodriguez paced in the day room of the unit. Inmate Raymond Bernal walked to the bathroom. Rodriguez approached Bernal and pushed him to the ground. Bernal struggled to keep Rodriguez at bay by kicking him. But Rodriguez overpowered Bernal, kicking him in the head until he lay motionless. Other inmates in the pod intervened.

Rodriguez began pacing again, when another inmate, Jeff Spencer, walked up to a nearby window. Rodriguez approached Spencer and punched him in the head. Spencer fell to the ground.

A corrections officer wrote in an incident report that Rodriguez said he assaulted the two inmates because they "are mind-control freaks." Bernal's head and face were bruised, and he was bleeding from the mouth, according to the report, while Spencer sustained bruising on his face and a cut to his right eyebrow.

Both inmates declined to press charges against Rodriguez, and were taken to the hospital. A corrections officer handcuffed Rodriguez and took him to a segregation unit that morning, after the jail's chief of security found that he "poses [a] direct threat towards others by displaying aggressive and assaultive behavior."

On Feb. 19, jail staff reviewed Rodriguez' placement in segregation; a jail sergeant wrote in a special management placement form that Rodriguez was being involuntarily placed in segregation because he "poses a threat to the security of the facility." Williams says the jail cannot release him back into general population.

Population in Flux

Wary of photographs, Williams nevertheless flashes a smile for the camera while sitting next to an American flag that hangs in his dimly lit corner office at the jail. Early in life, he found a steady income to support his family in corrections administration; it's been his chosen field for some two decades in county, state and federal jails and prisons.

He and other New Mexico jailers have come around to the notion that segregation will only worsen certain mental health conditions. The county hired Williams at a $95,000 annual salary in December 2016; he currently makes $103,000. He was selected in part for his prior work in behavioral health care units at state prisons. One assignment was oversight of a treatment team that helped transition more than a dozen of the state's most dangerous inmates into general population from a mental healthcare unit.

The inmates were the "worst of the worst," Williams says, requiring five-point restraints, suicide watches and seclusion rooms. But a spate of new programming, including group therapy, helped transition many of the inmates to the general population, according to Ortiz, who was a psychologist on Williams' team in the state prison and who followed him across the highway to the county jail. She's now the highest-paid employee there, making $280,800 annually. She called the inmates' transition "miraculous."

But while Ortiz and Williams were able to work miracles on long-term inmates in the state penitentiary, they both say managing the mental health care of a constantly changing jail population poses unique challenges. Ortiz oversees a team that includes six therapists with masters degrees who conduct daily checks on inmates in each of the jail's six pods. At capacity, that's roughly one therapist for every 100 inmates.

Ortiz says the treatment plan to move Rodriguez into general population "failed," and so the jail had no choice but to put him in the special management unit following the attack. She notes that unlike a state prison, the Santa Fe County jail has no alternative placement unit for inmates with severe mental health issues.

Rodriguez' case has been particularly difficult for the jail to handle, Ortiz says, because of the complexity of his condition and the glacial pace of his criminal proceedings compared to that of most inmates.

"He's a long-termer in a jail equipped for a turnover population," Ortiz says of Rodriguez. "It's a special case, no doubt."

Williams says the goal with most inmates in segregated housing units is to transition them to general population.

"And that really makes sense," Williams says. "Because when you think about it, if people are coming in here and you're saying, 'Oh you're a sex offender, you should be over here. Oh, you're from this group? You should be over here.' You're teaching them something that's not going to be beneficial when they get released. Because when they get released, they don't get to pick who their neighbors are going to be, who they go to the store with and who's next to them in line. So in reality, you know, if we're really serious about preparing people to going back into the community, we have to have enhanced diversity. We've got to get them used to living with people of different backgrounds, different cultures and different beliefs."

Jail as Hospital

In many ways, Rodriguez' troubled tenure at the jail captures the nuances of both sides of a recent statewide debate about whether to severely restrict jails' ability to place inmates in solitary.

State Rep. Moe Maestas, an Albuquerque Democrat, co-authored a bill that would do just that in the 2017 legislative session. Lawmakers passed the bill. But Republican Gov. Susana Martinez vetoed it, citing public safety issues with such restrictions.

Maestas argues that keeping inmates in segregation only exacerbates threats to public safety—particularly in jails, where inmates have not yet been convicted of crimes and where the vast majority of inmates will be released back into the community.

"Folks [who] are housed in 23-hour lockdown for an extended period of time, they are completely dysfunctional in society and they are more likely to offend," Maestas says.

He says the county jails were some of the biggest opponents of the legislative measure, citing safety issues inherent in putting dangerous inmates into general population. Asked what jail wardens should do with inmates such as Rodriguez, Maestas says there's a gamut of management tools for such situations. Maestas could not name any specifics, but said jail wardens across the state should help provide solutions for the next legislative session with a new governor, when he'll reintroduce the legislation.

"The counties come to the table with some strong solutions or else we'll dictate the terms without their input," Maestas says.

Simonson, the executive director of the ACLU, which supports such legislation, also concedes that jails are in a difficult position. "We're not solving the problem," he says, adding that jails should take action to mitigate the impacts of segregated confinement through programming and social connections. "But keep in mind there's also a price to be paid on the impact you're having on his already-deteriorating state of mental health," he says of Rodriguez.

Grace Philips, general counsel for the New Mexico Association of Counties, says counties across the state are already addressing the impacts of segregated housing with such programming. She says that the Santa Fe County jail is one of about eight across the state that's accredited by the New Mexico Association of Counties. To attain such accreditation status, counties must have policies surrounding restrictive housing.

"Detainees with a known or suspected mental illness should be given a mental health assessment and their condition periodically reviewed to determine whether restrictive housing is affecting their mental health status and continues to be appropriate," says one of the association's auditing standards.

Philips argues that terms like "solitary confinement" and "segregation" do not do justice to the work accredited county jails do to care for inmates in such housing units through human contact, programming and other activities.

"The emphasis for someone who is separated from general population is to provide as much human interaction as can be," Philips says. The Santa Fe County jail policy manual requires routine checks on inmates in special management units and workers must fill out logs noting inmates' progress in daily living.

Miguel Chavez, a former Santa Fe County commissioner whose adult son's mental health issues led to a stint in jail, has been helping Megan Rodriguez try to get her brother care. Chavez said he understands the need for certain inmates to be removed from general population.

"And that needs to be done in a humane way," Chavez says. "But there's nothing humane in keeping someone in solitary confinement, especially when they're diagnosed with a mental health condition."

Both Williams and Ortiz say the Santa Fe County jail has put much effort into providing Rodriguez with hospital-level care—far from the notion that he's been "forgotten." But Ortiz says the jail is not a hospital, nor is it a prison. And so officials had a meeting on Tuesday to determine another way to care for him. Ortiz will not say what that is, citing privacy concerns, but an entry in his court docket says a hearing will determine whether to take Rodriguez to the New Mexico Corrections Department for "safe keeping."

Moving a jail inmate to the Behavioral Health Institute in Las Vegas or to a state prison is exceedingly rare because the county must pay the state for care, Williams says, as well as get lawyers involved to lay out the case for why the county jail cannot provide care.

Megan, Rodriguez' sister, says, "We need him to be safe and we need other inmates to be safe." The episode, to her, reflects that all people need adequate health care, even if they've committed a "horrible crime."

"We should hold ourselves to higher standards," Megan says, "and be humane to individuals in their worst times."