CHRISTOPHER BARKES
DAVID BENDER

DELAWARE'S DEADLY PRISONS

'I blame the system'

Inmates in Del. have twice U.S. average suicide rate

BY LEE WILLIAMS AND ESTEBAN PARRA
The News Journal
09/27/2005

As he was booked into Gander Hill prison, Christopher Barkes told the mental health screener that he had attempted suicide before -- when he had earlier served time in Gander Hill. Then he provided a list of drugs he was taking for depression, post-traumatic stress disorder and other forms of mental illness.

Instead of placing Barkes on suicide watch, prison officials put him in a cell, alone and unsupervised.

Hours later, Barkes hanged himself with a bedsheet.

On the day he died, Nov. 14, 2004, Barkes was in prison for a parole violation stemming from a drunken driving accident that killed two people. He was 37 years old.

Despite his previous suicide attempt, his history of mental illness and the admissions he gave to the screener, the official Department of Correction press release says Barkes was "not considered suicidal."

"It's a lie," said his widow, Karen Barkes. "I think Chris deserved to be protected from himself."

Chris Barkes called his wife before he took his life.

"He said he was sorry for hurting me, and that he didn't want to live like that anymore," she said. "When I hung up the phone, I thought, 'At least he's in a place where he can't hurt himself.' "

Suicide is the third-leading cause of death in prisons nationally -- behind natural causes and AIDS-related deaths, which are recorded separately from natural causes by the U.S. Bureau of Justice Statistics. According to the bureau's latest report, issued last month, Delaware's prisoner suicide rate for 2001 and 2002 was double the national average of 14 per 100,000 inmates.

According to the Department of Correction, nine inmates have killed themselves since January 2000 -- most by hanging.

Experts say effective mental health care can reduce the number of suicides in the state's nine prison facilities. In Delaware, the same private contractor that provides medical care also provides mental health treatment. First Correctional Medical of Tucson, Ariz., held the contract when Barkes took his life.

Karen Barkes said her husband didn't need immediate mental health treatment.

"All they had to do was watch him or just give him a cellmate," she said. "It wouldn't have cost them any money."

In 1997, Barkes was driving a car that rear-ended a pickup. The truck was forced into a head-on collision with another car. Both drivers died, and a passenger suffered leg injuries.

Barkes wasn't hurt.

He admitted drinking four shots of vodka before the accident. His blood-alcohol level was 0.12 after the crash. The legal limit in 1997 was 0.10. Barkes pleaded guilty to two counts of second-degree vehicular homicide and was sentenced to two years in prison and three years of probation.

After the accident, his widow said, he became self-destructive. When he went to prison in 1997, she said, he began stockpiling his daily psychotropic medication. The nurses gave him pills, but didn't make certain he took them, Karen said. Once he amassed a 10-day supply, he took them all, hoping to overdose.

"The hospital nurses said he was lucky to be alive," Karen Barkes said. "Chris felt like he had no reason to live. He was feeling guilty over the accident and thought everyone would be better off without him."

POLICY AND PROCEDURE

In a two-year study sponsored by the National Institute of Justice, researchers discovered that problems with the initial intake screening at prisons nationwide could lead to increased suicides.

The study, released in June, focused on whether Native American inmates were affected by cultural bias in the screening process. It also drew conclusions about inmate populations as a whole.

According to the study, most inmates were not candid when they answered the screeners' questions. The study blamed the screening process, which is usually rushed and not conducted in private.

The inmates in the study said they understood the questions, but they were afraid of the consequences if they admitted suicidal thoughts.

On the form used by Barkes' screener, there was a series of yes/no questions completed by an unidentified employee of First Correctional Medical. The only "yes" answer was to the question of previous suicide attempts.

First Correctional Medical relinquished its contract with the Department of Correction in July. The company was replaced by Correctional Medical Services, a St. Louis-based firm that held the prison medical services contract before FCM. Both vendors -- CMS and FCM -- relied on a "suicide contract" that at-risk inmates must sign, promising not to kill themselves.

That's a poor practice, said Dr. Carol A. Tavani, a board-certified neuropsychiatrist, executive director of Christiana Psychiatric Services and a former president of the Delaware medical and psychiatric associations.

"It's not as effective as a verbal exchange, and you have to remember that a lot of people in jail are functionally illiterate, and will sign anything put in front of them," Tavani said. "A written contract is never as effective as one person sitting down with another and saying, 'Do you promise not to hurt yourself, and to let me know if you're thinking about it?'

"It's an interpersonal exchange that lets them know someone cares. A piece of paper is rather cold."

SUICIDE PREVENTION

According to the FCM policy titled "Suicide Prevention and Intervention," obtained by The News Journal, Barkes' history and initial screening should have qualified him for a higher level of supervision than being placed in a cell by himself, unsupervised.

According to the policy: "When observation, history of interview information suggests that the inmate is potentially suicidal, Health Services and mental health services staff will be immediately informed. The following steps may be directed by the Health Service or mental health services staff and implemented by appropriate staff."

The policy includes three options.

•The inmate can be placed in a secure cell and checked every 15 minutes, or the inmate can be placed under continuous observation with a staffer placed in front of the cell.

•The inmate can be referred to a psychiatrist, psychologist or other mental health staffer for further evaluation.

•Assessment staff will consult with prison officials who are responsible for assigning cells.

Additional steps can include the use of surveillance cameras and a tear-proof garment known as the Ferguson gown that's used for suicidal inmates.

LAST MEAL David Bender was an alcoholic -- an angry man -- with a history of domestic violence and a host of internal demons, his family said.

Then he got involved with a 14-year-old girl. In May 1999, Bender was charged with three counts of first-degree rape, endangering the welfare of a child, possession of marijuana and resisting arrest. Police said he raped the teen who had been allowed to stay in his care. They also charged him with furnishing her alcohol.

"He was possibly mentally ill, though he had never been diagnosed, inside or outside of prison," said his sister Cheryl Wheeler. "He was angry, abusive and hostile for a long while."

He was sentenced to eight years in prison.

Bender tried to kill himself twice while in Gander Hill -- once in 2000 and again in 2001. He slit his wrists in one attempt and tried to hang himself with a sheet in another.

"The sheet broke," Wheeler said.

After the second attempt, Bender was sent to the Delaware Correctional Center near Smyrna. There, he fell afoul of other inmates.

"A bully can't handle being bullied," Wheeler said. "He got beat up. He had a broken nose."

On a Sunday in October 2002, Bender's mother and sisters went to see him on an honor visit. Inmates who have been in DCC for one year, and have had good behavior, are allowed to have a picnic with family on grounds inside the prison wire. The picnic area includes plastic children's playground equipment and wooden picnic tables. There are no trees or shade. The site's only amenity is a portable toilet.

Bender had arranged the menu, which his mother cooked -- London broil, bagels with cream cheese, scrambled eggs, a bottle of fresh milk and a baked potato. He'd asked for Jimmy Dean sausage, but settled for another brand.

He sent his family detailed instructions on how he wanted the food prepared, and was unconcerned about it being cold when it arrived. Everything had to be X-rayed.

Wheeler said her brother ate nonstop for 45 minutes, with a plastic knife and fork. "It was comfort food," Wheeler said.

MARIA E. SANTIAGO

INMATE GUILTY OF MURDER DIES IN PRISON

The News Journal
Posted Tuesday, February 20, 2007 at 6:02 pm

An inmate at the Baylor Women’s Correctional Facility near New Castle died earlier this month, officials reported.

Maria E. Santiago, 42, of Wilmington, was pronounced dead Feb. 10 at the correctional facility, according to a written release by Department of Correction spokeswoman Gail Stallings-Minor.

In 2000, Santiago was sentenced to 15 years imprisonment for second- degree murder.

Her body was released to the state Medical Examiner’s office to determine a cause of death.

According to the written statement, foul play is not suspected, and her family has been notified.

Santiago is one of more than 100 inmates who have died in a Delaware prison since 2000, a string that prompted a U.S. Justice Department investigation that last December found “substantial civil rights violations” in four Delaware prisons regarding inmate medical care.

DEMETRIUS CALDWELL

INMATE HAD BEEN ILL FOR A MONTH, BUT CAUSE OF DEATH IS A MYSTERY

By LEE WILLIAMS and ESTEBAN PARRA
The News Journal
Posted Saturday, January 13, 2007

Sen. Charles L. Copeland said Demetrius Caldwell should have been taken to a private hospital because of the length of his stay in the prison infirmary.

Demetrius Caldwell, a 24-year-old drug dealer, had been undergoing unspecified treatment for a month in the state's newest prison infirmary before he was found dead this week, laying on a mattress on the floor of his infirmary cell.

A medical staffer had checked on him 25 minutes before he died.

Prison officials ruled out meningococcal meningitis as the cause of death Friday, after naming it as a possibility Thursday evening. A less virulent strain of meningitis remains a slight possibility.

"Everything's negative," said James Welch, the Department of Correction's health services administrator. "There's no trauma, no heart problems, no brain tumor. We're still waiting on toxicology. We can't find anything. We're as concerned as anyone else is."

The length of time Caldwell spent in the state's prison infirmary and the lack of an explanation for his death point to the same medical deficiencies that prompted the U.S. Justice Department last month to find "substantial civil rights violations" in four Delaware prisons, said Senate Minority Leader Charles L. Copeland, R-West Farms.

The federal investigation was prompted by a series of articles in The News Journal that revealed inadequate health care and questionable treatment within the prisons. In their report, federal prison regulators found "consistent backlogs with the respect to the treatment of chronic care inmates."

Any inmate who has been in the infirmary for a month meets the "chronic care" definition and should have been taken to a private hospital, said Copeland, one of the co-founders of the Delaware Coalition for Prison Reform and Justice.

"Someone should have recognized that the prison infirmary was not the place for him to be," he said. "The fact they failed to identify that re-emphasizes the legitimacy of the constitutional violations of prison health care performance."

Federal investigators, who negotiated an 87-point settlement with the state to improve prison medical care, declined to comment about Caldwell's death.

Correction commissioner nominee Carl Danberg said Friday that doctors from Correctional Medical Service, or CMS, the prison's contract medical provider, along with the Department of Correction's medical team, the Chief Medical Examiner's Office and Public Health are reviewing the case.

"Additional outside expertise might be sought, depending upon what we find in the tests that are still pending," Danberg said. "We are following Department of Correction procedures and following Delaware law for a death in custody. All informa- tion is being turned over to the Medical Examiner."

The State Forensic Sciences Laboratory is conducting some tests, and additional testing has been outsourced to independent labs.

"I am not a medical person. I don't know why he died. I am waiting for the doctors to tell me why he died," Danberg said. "We are continuing our own internal evaluation and reviewing behavioral reports, to determine whether or not there are any clues in the documentation."

Just in case, the prison began "preventive antibiotic measures" Thursday evening for all inmates and staff that may have been in contact with Caldwell's bodily secretions.

Rather than using a ward setting similar to private hospitals, the infirmary at the Smyrna-area prison consists of separate cells with locked doors.

At the time of Caldwell's death, Welch said there were nurses in the infirmary. A doctor was at the prison, but not in the infirmary building when Caldwell was discovered. The entrances to the building are videotaped, Welch said, but the cells are not covered by a camera.

Ken Fields, spokesman for CMS, said federal privacy laws prevent him from discussing the condition or care of any inmate.

"Inmate patients housed in the medical housing unit of the prison facility are seen regularly by health care staff," Fields said. "Certainly, if an inmate patient displays symptoms of illness or otherwise indicates the need for urgent medical attention, those needs are addressed promptly by qualified medical staff."

Caldwell, of Dover, had been an inmate since Nov. 6 for violating his probation on a 2005 charge of possession with intent to deliver cocaine, to which he pleaded guilty. Nearly half of his incarceration was spent in the infirmary.

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