The 4th U.S. Circuit Court of Appeals has directed Virginia prison officials to provide psychiatric care for mentally ill prisoners, saying it can find "no underlying distinction" between a prisoner's right to care for physical or psychological ailments.
The court's opinion, released yesterday in Richmond, is the latest in a long series of federal court opinions ordering Virginia to improve conditions in its troubled prison system.
Yesterday's ruling was a victory for prison reform advocates and other critics of the Virginia system who have argued that the state spends too little money on attempting to rehabiliate its inmates.
Although the Virginia system has about 7,300 inmates, there are no prison psychiatrists and only nine psychologists in the system. The state has long admitted a need for a prison psychritrist, but has been unable to fill the position despite offering a $21,400 salary, a spokesman said.
Virginia prison officials declined to comment on the impact of the court ruling, but one state official who is knowledgeable on conditions within the Virginia system predicted that it could have a dramatic effect because of the low level of psychiatric services currently given prisoners.
Only one other appeals court in the country, the 5th Circuit, which covers several Southeastern states, has issued a similar opinion, the 4th Circuit justices said in their nine-page opinion. The 3-to-0 ruling also will affect prisons in West Virginia, Maryland, North Carolina and South Carolina, all states that come under the jurisdiction of the Richmond-based appeals court.
"The right to treatment is, of course, limited to that which may be provided upon a reasonable cost and time basis and the essential test . . . of medical necessity . . ." said Justice Harrison L. Winter, who wrote the court's opinion.
But the appeals court said there was no dispute that psychological and psychiatric care are considered part of modern-day health care. "This circult has consistently adhered to the prevaling view (of earlier court cases) in requiring reasonable medical treatment," Winter said.
The court's ruling overturned a decision by U.S. District Judge James C. Turk, who had held that the state did not have to provide psychiatric treatment for Larry Grant Bowring, a prisoner who is serving several sentences for kidnaping, robbery and attempted robbery.
The appeals court noted that the Virginia probation and Parole Board had refused him parole, partly on the grounds of a psychological evaluation.
After he was refused parole, Bowring sued the state, demanding he be given treatment that might qualify him for parole. The evaluation had said that "Bowring would not successfully complete a parole period," the appeals court said.
By failing to provide the psychiatric treatment, Virginia officials are subjecting him to "cruel and unusual punishment" and a denial of his "due process of law," Bowring claimed in his appeal.
Although the appeals court ruled in his favor, the ruling does not automatically require that Virginia officials treat Bowring. The appeals court said Bowring has "not yet established" that he is "in fact" suffering from a "qualified" mental illness and directed Turk to consider whether he is.
In its opinion, the appeals court said Bowring "or any other prison inmate" is entitled to psychological and psychiatric care if a physician or "other health care provider" can conclude "with reasonable medical certainty" that the prisoner meets several conditions.
To qualify, the prisoner must have symptoms of a "serious disease or injury," a condition that is potentially "curable or may be substantially alleviated" by treatment, and show that the damage he would suffer without prompt treatment would be "substantial," the appeals court said.
At the same time, the court refused to delve into particulars of what forms of psychiatric care might be needed under its ruling. ". . . We disavow any attempt to second-guess the propriety of a particular course of treatment," the court said. "Along with all other aspects of health care, this remains a question of sound professional judgement."