Petition for Appointment of Guardian outside the Nevada Dept of Corrections: plz help Mr Tragale

From: Nevada-Cure’s blog and added the petition text:

On August 20th 2012 Nevada-Cure sent this message out via email about retaliation against a prisoner held in NNCC (Carson City, NV). It appears Prisoner TRAGALE is being retaliated against for trying to help another prisoner, who is blind, mentally ill and unable to care for himself, have a guardian appointed to the prisoner to help him with his needs. 
Philip Tragale has asked the Courts for a Guardian and/or Lawyer to protect prisoner Daniel Stenner who is blind and mentally handicapped. Mr Tragale filed the text here underneath to the District Court in Nevada on June 6th 2012.

We have another case Mr Tragale filed which contains complaints about a few employees of NDOC who are alleged to be abusive towards prisoners. We will soon post that case here too.

Please write to your Legislator and Director Cox of NDOC to ask them to have an independent commission look into these alleged abuses, and have them stopped.

NV-CURE has not conducted an independent evaluation of Mr. Tragale’s claims.  However, such an investigation must be conducted by a person that is fair and impartial.  The truth and actual events must be made public and scrutinized by the Legislature. Please e-mail / write NDOC Director COX and members of the NV Legislature with your views and opinions on this matter.
Thank you.

Filed: 6-7-12
Case no. 12GRD0003D1B
Dept. no. 1
In the First Judicial District Court of the State of Nevada
In and for Carson City
In Re: Daniel Stenner

Petition for Appointment of Guardian outside the Nevada Dept of Corrections

Comes now, Petitioner, Philip Tragale, and requests this Court to appoint a guardian for inmate Daniel Stenner, outside the NV Dept. of Corrections to protect inmate Stenner from the immoral, neglectful and abusive actions and practices of NDOC staff as will more fully appeare herein.

Petitioner, Philip Tragale, is an inmate, #62163, incarcerated at the Northern Nevada Correctional Center in Carson City who has on three (3) occasions, for approx. one (1) week on each occasion witnessed the care of inmate Stenner. Petitioner now brings what he has witnessed before the Court for the Court to decide if action need be taken.

Daniel Stenner is blind and severely mentally handicapped to the point that he cannot do anything without assistance.

Petitioner believes Daniel Stenner is being abused for the following reasons:

1)      Daniel is never walked around or exercised in any way; he is removed from his cell to be fed and showered and done so in a special chair with wheels.

2)      Daniel is never taken outside for sun or fresh air.

3)      Daniel receives no therapy or rehabilitative training.

4)      Daniel is ignored, left in his cell naked and only paid attention to when he urinates (not in the toilet) or starts to scream, cry out or slap himself in the face and then he is told to lay down or he is offered food which is withheld for hours.

5)      Daniel is not given a radio or tv to keep him company or for mental stimulation nor does anyone spend time with Daniel just to try to engage him in conversation.

6)      Daniel’s meals are left to sit on the counter, in the open air, uncovered, for hours before it is fed to him cold, congealed, and dried out and only after hours of Daniel crying out and being told he’ll be fed soon over and over again.

7)      On one occasion Petitioner heard and saw Correctional Officer Cardella approach Daniel’s cell and in a low voice so no one could hear tell Daniel “You’re a F…ing” Cardella then went to the doorjam and repeated his comment. Petitioner was in the next cell and when he witnessed this he began to scream at c/o Cardella to leave Daniel alone. Petitioner reported this to all present staff.

8)      It appears to Petitioner that c/o Cardella has some weird fascination/fixation with Daniel as Petitioner has witnessed c/o Cardella become entranced, staring at Daniel with a strange look on his face many times when he thinks no one is paying attention and all other free staff are busy. [p. 3]

9)      Petitioner has heard c/o Cardella talk about “pile driving” inmates and fears that if c/o Cardella ever gets a chance he will severely injure Daniel.

10)   It appears to Petitioner that Daniel no longer even understands that he is in prison.

Petitioner submits this petition in good faith and swears to its contents under penalty of perjury. Further, Petitioner would polygraph and/or testify to these matters in any investigation or Court proceeding.

WHEREFORE, petitioner prays this Court will appoint a guardian and/or attorney to look into these allegations and continue to look out for Daniel Stenner’s safety and wellbeing.

Dated this 10th Day of May, 2012.

Respectfully Submitted,

[signed] Philip Tragale

Philip Tragale #62163
P.O. Box 7000
Carson City, NV 89702


Suicide raises questions about mental health care at jail

From: Las Vegas Sun
By Steve Kanigher
May 4th 2011

A suicide at the Clark County Detention Center in 2009 is kindling accusations that the downtown facility run by Metro Police is doing a poor job addressing mental health needs, an issue that prompted a Justice Department investigation of the facility a decade ago.

In a federal lawsuit, Las Vegas attorney Cal Potter III alleged on behalf of plaintiff Amanda Lou Cavalieri that the suicide of her husband, Michael Anthony Cavalieri, could have been prevented had the jail better screened and observed him.

Defendants include Metro and NaphCare, an Alabama company contracted by the jail to provide detainees with psychiatric and medical care. Metro spokesman officer Marcus Martin declined to comment on the lawsuit, filed in March, and a Las Vegas lawyer who represents NaphCare didn’t return calls seeking comment.

Cavalieri, 55, was an electrician booked in February 2009 on assault and weapons charges and was a pretrial detainee. According to the lawsuit, he suffered from bipolar disorder and was withdrawing from drug addiction.

He was initially placed in an observation cell and was to be housed in a unit with authorized suicide watch by jail staff at 15-minute intervals. But the lawsuit alleges that staff erroneously concluded he did not have suicidal thoughts and placed him in a cell within the general population.

On March 6, 2009, a correctional officer allegedly failed to perform a required twice hourly walk-through, and Cavalieri was discovered hanging from an air-conditioning vent. He was pronounced dead at University Medical Center.

Dr. Simone Russo of Las Vegas, retained by Potter, stated in an affidavit that Cavalieri “should have been admitted to a psychiatric ward for further observation and treatment.”

“Based upon my review of the record there does not appear to be any suicidal precautions taken after the decedent was placed in the general population, which is below the standard of care,” Russo said. He said that resulted in Cavalieri taking his life.

The lawsuit also stated that problems concerning suicide prevention and mental health care have been long-standing at the jail and it “has continued to be plagued by suicides.” According to Martin, one suicide occurred at the jail in 2008, but none in 2010 or so far this year.

After inspecting the jail in early 1998, the Justice Department issued a scathing report identifying numerous issues that it said violated the inmates’ constitutional rights. Among those issues were “inadequate mental health care and suicide prevention.” Investigators found inadequate suicide screening when individuals were first processed into jail, and poor supervision once they were placed in temporary holding areas, a combination they said posed “an especially dangerous inmate suicide risk.”

Read the rest here.

Nevada houses 10 times more people with mental illness in jails than in psychiatric facilities

New Report: Jail More Likely Than Treatment For Americans With Psychiatric Disorders

From: Disability Scoop
By Michelle Diament
May 13, 2010

Americans with severe mental illness are three times more likely to go to prison than to a psychiatric hospital, new research indicates.

While the likelihood varies by state, there is no state where individuals experiencing diagnoses like schizophrenia or bipolar disorder are more likely to be in a psychiatric hospital than a jail, the findings from a new report conducted by the Treatment Advocacy Center and the National Sheriffs’ Association indicate.

The best case scenario appears to be in North Dakota where the odds are one to one that a person with mental illness will be in prison or a psychiatric hospital. In contrast, Arizona and Nevada each host 10 times more people with mental illness in their jails than in psychiatric facilities.

Read more here

Report by the Treatment Advocacy Center (PDF).

Nevada houses 10 times more people with mental illness in jails than in psychiatric facilities

New Report: Jail More Likely Than Treatment For Americans With Psychiatric Disorders

From: Disability Scoop
By Michelle Diament
May 13, 2010

Americans with severe mental illness are three times more likely to go to prison than to a psychiatric hospital, new research indicates.

While the likelihood varies by state, there is no state where individuals experiencing diagnoses like schizophrenia or bipolar disorder are more likely to be in a psychiatric hospital than a jail, the findings from a new report conducted by the Treatment Advocacy Center and the National Sheriffs’ Association indicate.

The best case scenario appears to be in North Dakota where the odds are one to one that a person with mental illness will be in prison or a psychiatric hospital. In contrast, Arizona and Nevada each host 10 times more people with mental illness in their jails than in psychiatric facilities.

Read more here

Report by the Treatment Advocacy Center (PDF).

Investigation ordered into inmate death

From: Nevada Appeal:

Monday, December 7, 2009

Prison officials are investigating the death of an inmate at Northern Nevada Correctional Center over the Thanksgiving weekend.

Director of Corrections Howard Skolnik said inmate Jamie Kline’s death while he was in the prison Regional Medical Center is under investigation.

Skolnik said Kline habitually refused to take his psychotropic medicines which meant the medical staff had to make him take them.

“We had an individual who we have repeatedly had to give forced meds,” Skolnik said. “Apparently the last time we forced his meds, he died.”

He said the preliminary autopsy showed no bruising on the inmate’s body. He said a full autopsy including chemical testing will be conducted to determine the cause of death along with an investigation of the circumstances that led to his death.

Kline, 45, was serving a maximum 15 year sentence for a burglary and grand larceny conviction. He arrived at the prison in May 2007.

Note: what would an investigation done by the prison officials themselves be worth?


By Coyote Sheff
(Taken from: Make the Walls Transparent)
It is 3:07 a.m. as I sit here in this cold silence of another imprisoned November night, I can hear the echoes of the ghetto life ringing clearly in my head; the gunshots, the sirens, the dogs barking the helicopters. It has been years since I’ve been in the ghetto, but the memories are still with me. Living in the ghetto, to me, is like what I’d imagined it had been to be in the war in Vietnam, the sounds, the constant violence, the despair.

The cold silence is broken by the screams of a crazy Indian on the top tier and my “ghetto day dream” fades away. I tune in to the screams and the noise. There is a psych patient upstairs on the other end of the tier. He’s an Indian dude named Pacheco. He is always yelling out racial profanities like “Fuck all Niggers!” and other stupid shit like that.

Tonight he has a new mantra. I can’t make out his words though, but he keeps repeating it over and over again. It seems that he has succeeded in frustrating a couple cats up there in his area, because I can hear their angry responses. One of the cats comes to the door and tells Pacheco to shut the fuck up, so Pacheco repeats his mantra louder and then I hear another cat yell from the back of his cell, “I’m gonna smash your face in if I see ya!”

Pacheco is an old Indian with long grayish hair and I can tell by the nature of his speech that he is missing his teeth. Maybe that’s why he’s so bitter, who knows. His whole purpose, his whole intent is to make everyone around him miserable and unfortunately he does a good job at it. He’s a “terrorist”, using psychological warfare and mental torture as MO Modus operandi: In here we refer to people like that as “a piece of shit.” They like to terrorize everybody around them for no apparent reason other than the fact that misery loves company, I guess.

Pacheco was my neighbor once, five years ago on another unit back here in the hole. For no reason other than to disturb me, he’d bang on my wall and bang on the desk all day long and he’d yell over me when I was trying to talk to one of my comrades over the tier just to prevent me communicating with others. That’s something a hater would do.

I got fed up with his shit and one day I unattached the cable cord from my TV and stripped the cable cord completely so there was nothing left inside of it and I turned it into like a little hose and when Pacheco was sleeping I’d run the hose over to the front of his cell and I’d piss in the hose and I’d continue to do it all throughout the night. Every time I had to take a piss and it would create a good-sized puddle inside his cell and when he’d walk up to grab his breakfast tray, he’d step in a big puddle of piss! He would terrorize me, keep me from sleeping, keep me from socializing and communicating with others and he’d stress me out, making me angry and unable to think clearly, so this was all I had, this was all I could do to get back at him.

The cold part about it was that he had the choice of either getting down on the floor and cleaning up MY piss, or leaving it there and smelling it all day and all night, so it was a lose-lose situation for him. I pissed in his cell every night, for a whole week straight and then these guards hurried up and moved him to another unit. The officers didn’t know it was my piss, though, they thought he was pissing on his own floor. Oh well.

These aren’t the types of stories people are used to reading about prison, I’m sure. But I keep it real and tell it how it really is in here. These are the atrocities of life in a maximum-security prison. This is just a glimpse of the inhumanity, the suffering, and the torture. It’s just a small example of how we are reduced to such lows, such drastic measures just to try to keep a piece of our peace of mind. It is very sad, this solitary life of madness. How can one get out of here and expect to live a normal or at least a decent life after this? How can one go from living like an animal to living as a free person in society?

This is a sad, lonely, disgusting profane existence here in this world, behind these cold stone walls and chain link fences and people need to understand this they need to know what really goes on in these maximum security prisons, where surviving perpetual lockdown has become a way of life.

I write about these things so people can understand, because we need support from people on the outs. We need to be provided the tools that will help us adjust after being in prison, living like this, to becoming free and trying to live and maintain in society. Most of the people who are in prison already had it bad before they came to prison, they have it bad while in prison, and then they have to go out and try to make it good with strikes against them? How does that work? It was bad before, it’s bad now and it’s still going to be bad after they get out, so how is prison solving crime? How is prison helping society? We are caught in a system that was not designed to care about us; we are caught up in a system that was not designed to help us. This system has no mercy for the poor. It’s an atrocity.

So when I say that I’m greeting you from a graveyard, I think you know what I mean. We are traumatized by all of this, from the ghettos to these prisons; it’s a miserable existence. We need to come together and find ways to rise above this.


Ely State Prison
November 2, 2008

Mental Illness Keeps Many on Cycle Through Jail

From: Las Vegas Sun

Illness keeps many on cycle through jail
Committing crimes gets them treatment which ends with their release

By Timothy Pratt

Sunday, July 12, 2009 | 2 a.m.

If Nevada was willing to invest in providing more psychiatric care outside of jail, not only would it do more to help the mentally ill, it would also cost taxpayers less than arresting and incarcerating the mentally ill, experts say.

Consider the jail and medication costs for the following three mentally ill inmates — and this does not take into account the additional court costs and other bills.

Dr. Keith Courtney, chief psychiatrist at Clark County Detention Center, withheld the inmates’ names to comply with patient privacy laws.

Inmate No. 1 suffers from autism and occasional psychotic episodes. When he’s out on the street, he gets in fights, takes drugs, attempts robbery, winds up at the detention center. He has been in jail 539 days since 2006. That means taxpayers have spent about $123,000 on keeping him jailed and medicated.

Inmate No. 2 is a 20-year-old man who has spent at least 520 days behind bars, mainly for armed robberies, since coming of age two years ago. The system has spent more than $120,000 in incarceration and psychotropic medication costs, Courtney says. The young man also winds up in the hospital after suicide attempts, which costs taxpayers even more. He was raped at 15 and now hurts himself repeatedly in the same part of his body.

Inmate No. 3 is a 32-year-old woman whose 441 days behind bars cost an estimated $100,000-plus. She is a victim of severe abuse and suffers from borderline personality disorder, often attempting suicide, Courtney says. She only takes her prescribed medication when she is jailed, preferring methamphetamine when she is not. She is often arrested for prostitution, sometimes burglary.

“She’s never here long enough to get adequate care,” Courtney says. She needs a safe house, treatment for drug abuse, ongoing intensive therapy. There is no one place where she can get all that. “I fully expect her to die soon,” the doctor says with resignation.

Here he comes again, his hands covered in heavy black mittens, his head stuffed into a net that makes him look like a beekeeper, his legs and wrists closed in shackles.

Clark County Detention Center officers dress him this way because he has been known to spit, throw punches and kick.

The inmate shuffles through a sliding door, a large officer follows and, nearby, other members of the jail staff step back, as if sensing danger. The inmate, seemingly unaware, tells the officer, “I don’t want a plane crashing into me, you know.” The detention officer nods and nudges him toward an isolation cell, where the inmate will have to remove his clothes. He will be left with what’s known as a suicide blanket, which can’t be torn apart and used as a noose.

He is not yet 20, but he has been in jail three times, for 71 days, since coming of age last year.

The detention center’s chief psychiatrist, Keith Courtney, says the young man has what’s known as reactive attachment disorder. Those who suffer from the condition have trouble relating to others. It’s often a sign of early abuse.

The inmate who was moved into the isolation room doesn’t take medication for his condition when he is on the streets, but he does take illegal drugs. Then he gets in trouble and is locked up, mostly for crimes such as burglary, attempted robbery with a deadly weapon. In jail, he throws feces, attacks the staff. So he goes to one of the isolation rooms, for inmates who are a danger to themselves or others.

On a recent morning, the 19-year-old was one of 621 inmates at the detention center — of 3,066 total — diagnosed as mentally ill and prescribed psychotropic medications. That’s one in five. On some days, the ratio is closer to one in four.

By way of comparison, the state’s Rawson-Neal Psychiatric Hospital in Las Vegas has space for 204 patients.

So the jail, Courtney notes, is “the largest mental health facility in Southern Nevada.”

It is also the most expensive and least effective. Providing mental health care is not the purpose of a jail, after all.

The last hope for help

Nevada has always lagged other states in numbers of public psychiatric hospitals and clinics. But private hospitals in the Las Vegas Valley began closing their psychiatric wings in the 1980s. Jails have become the last hope for help, leading to a cycle of futility.

Psychologically troubled people who commit crimes are brought to the jail, where they are held, evaluated and medicated — and eventually returned to the streets, where they either stop taking the drugs that eased their troubles in jail or lose access to those drugs. Ongoing, intensive therapy is even more scarce. Their minds unravel again, they commit new crimes, go back to jail and the cycle continues.

The word for a system like this is “crazy.”

To be sure, Nevada is not alone in experiencing this problem. Most states closed public mental hospitals in recent decades, leaving many mentally ill patients to fend for themselves. The valley had none to close when this was happening, but the same thing occurred with private hospitals. Many states, however, have taken steps to break the cycle of crime, jail, treatment and release. Nevada has not.

The county spends $4 million a year on psychiatric treatment at the jail. It costs taxpayers $142 a day to keep an inmate at the jail and $85 on average to medicate each one diagnosed as mentally ill.

The inmate in the isolation room, for example, has cost the system at least $32,000 in the past year alone, which easily could have paid for his psychiatric care outside of prison.

Other costs, such as the cost society pays for their crimes, are harder to figure.

For many of the mentally ill behind bars, the doctor says, “there is a significant connection between their mental illness and their crimes.”

Courtney says most of the inmates with mental illnesses aren’t locked up long enough to get adequate care. And there is almost nowhere to send them outside the detention center’s walls. So their conditions will likely lead them to commit more crimes and be arrested again and again.

The result: Nevada taxpayers spend untold millions on incarcerating and temporarily caring for the mentally ill, the public suffers their crimes, and the mentally ill suffer their conditions, their lives becoming one long sentence in a prison of the mind.

Courtney points out that only four members of his staff of 13 can prescribe medications, a difficult situation when they are faced with hundreds of inmates. He notes that the most severely mentally ill among the prison’s population are “some of the sickest people in the city.” They are bipolar, schizophrenic, paranoid, delusional. In the absence of adequate care, many medicate themselves on the streets with drugs such as methamphetamine, or cocaine.

A rare case of success

Down a series of halls, in an auditorium-sized open room, some inmates shuffle around the 74 cots lined in rows. Others sit at a table playing cards or pop in and out of an adjacent room with a basketball hoop. About 20 of the 74 men who sleep in this unit are on psychotropic medications.

Down more halls, around more corners, another unit has separate cells with doors, a sign that the inmates housed there have more severe mental illnesses. A young, bearded inmate stands outside his cell, hand outstretched. He is in jail because, in a psychotic rage, he attacked a member of his family with a knife. “I thought people were trying to kill me,” he explains, slumping into a chair, his hands held together.

The soft-spoken inmate’s case appears to be the rare example of a mentally ill person’s life taking a turn for the better inside the system. Courtney has landed him one of the few spots in the Eighth District’s Mental Health Court, a program to substitute treatment for incarceration. The road that led to the mental health court, however, is typical of the path many have taken, slipping in and out of treatment, in and out of drugs, increasingly violent. Now barely out of his teens, the inmate took LSD when he was 17 and began hearing voices shortly afterward. He wound up at Monte Vista, a private psychiatric hospital, where he was an inpatient for a week and an outpatient for a month. But the medication that doctors prescribed knocked him out. He stopped taking it. He took cocaine instead. The voices got worse. He went back to a psychiatrist. But after one visit, he was at home and the voices started up again.

“I thought that what I was thinking was real,” he says calmly. Now, after a year behind bars, he says, “I didn’t get help until I got here.” The doctors at the jail worked through two prescriptions until they found a third medication that finally helped stabilize his mind.

And just as important, Courtney worked to develop a relationship with the young man. Recently, the inmate spoke to his mother for the first time since he was arrested.

Courtney hopes that when the young man gets out of jail, he gets into a Salvation Army-run program that includes group therapy. He has plans to attend college.

The inmate says he is certain of one thing. “I’m going to have to take medication for the rest of my life. If I don’t, it all comes slowly back.”

He says he wishes it was easier for people like him to get help, to know when something is really wrong.

Courtney says his case is an example of “when the system works right, when someone who’s mentally ill can be diverted to care in the community. But in my mind, he’s the minority.” Especially, he notes, because the Mental Health Court only has 75 slots.

A need for prevention

Metro Police Lt. Frank Reagan works at the detention center and serves as chairman of a coalition of mental health professionals that recently regrouped after several years of not meeting. At the beginning of its first meeting last month, Reagan urged the coalition to seek solutions to the large number of mentally ill inmates.

Reagan adds that public mental health care — the only choice for most inmates when they’re released because they lack health insurance — is often placed on the chopping block when states suffer budget crises — and based on what he sees at the jail, that’s a major mistake.

“We need to have preventive care, to maintain the mentally ill population as stable when they’re out of custody,” he says.

Stuart J. Ghertner, outpatient services agency director at Southern Nevada Adult Mental Health Services, says the state agency’s budget has been cut 15 percent this year. He points out that there tends to be two broad categories of people who wind up in jail instead of in treatment, and neither can find adequate care in the state system or the community at large.

One group usually has less severe conditions, such as depression, is often homeless and winds up arrested for such misdemeanors as trespassing or urinating in public.

Courtney had just seen a 70-year-old homeless man on the morning the Sun was allowed into the jail. The elderly man repeatedly gets arrested for such petty crimes and has nowhere to get treatment once he is released.

Ghertner’s other group winds up in the same unit as the inmate who attacked a member of his family, or in one of the isolation rooms. They suffer more severe mental illnesses and commit more severe crimes. Of course, the notion is a moving target, and the same person can belong to each group at different times.

But the point is the same, Ghertner says: The Las Vegas Valley doesn’t have enough hospital beds for the mentally ill, and the outpatient system is imperfect at best. Of the 8,000 outpatient clients the state sees at its four clinics, about 15 percent are homeless, he says.

“They lose contact with what care and services are available. These folks don’t always make appointments.” Then they “get in trouble on the streets” and wind up back in jail.

The more severely mentally ill with histories of violence also lack options. Many of them are also addicted to drugs or alcohol, “co-occurring disorders.” The state recently contracted with a private firm to open the first facility for treating the two problems together, but it has only 10 slots.

Rosanna Esposito, interim executive director of the Treatment Advocacy Center, an Arlington, Va.-based nonprofit organization, said one key way Nevada lags most of the nation is that it has yet to pass a law that would allow family or doctors to petition a special court to mandate outpatient treatment for mentally ill people with a history of avoiding treatment. The idea is to have a way to force people into treatment before they commit crimes or hurt themselves or others. Variations on this have become law in 43 states, and those laws have helped get people off the justice system treadmill and into clinics.

Many states passed their laws at least a decade ago, so Nevada “is far behind the curve,” Esposito says.

Lesley R. Dickson, past president and current treasurer of the Nevada Psychiatric Association, points to another ignominy: Nevada has 6.2 psychiatrists per 100,000 people, a rate that places the state 46th in the nation, the governor’s task force on health noted earlier this year.

So the state starts at a disadvantage because “we have nowhere near enough care,” Dickson says.

Whether it is through funding more hospitals, clinics or psychiatrists, making better use of existing services, or passing laws that mandate care, a consensus is building that communities must seek alternatives to incarcerating the mentally ill. The June issue of Psychiatric Services magazine focused on the issue and concluded, “jailing is failing people with mental illness.”

Ghertner belongs to the same local coalition as Reagan, but he is skeptical about the group having enough clout to effect the necessary budgetary or legislative change in Nevada.

“The movers and shakers need to get organized … and sit down and do some long-range planning,” he says.

Esposito is sharper-edged. “We know that treatment works,” she says. “It’s only because of a lack of will and due to bad policy that the treatment isn’t available.”