Working In the Hole

At Valdosta State Prison I work as a mental health counselor for the inmates "in the hole" or as it's more properly termed--the inmates who are housed in the isolation/segregation cells. There are a couple of ways they come to be here. About two thirds are there because of disciplinary reasons that can range from anything to assault on staff or other inmates to one of their favorite tricks of exposing themselves to female staff. The other third have placed themselves voluntarily because they do not feel safe in the general population. In a cell by yourself or with another inmate also housed on "protective custody" there's less chance of being stabbed with a shank or taking a shot to the head with a lock in a sock.

I'm charged with seeing all the inmates in segregation/isolation who are on the mental health caseload once a week. In J Building, where I work, there are usually between sixty and seventy inmates housed there in a given week. I walk around the building pretty much daily and speak to them through the door of their cell and if it's called for, I might have an officer take them out to see them in a cage where there's more privacy.

A typical interaction might go like this:

I knock on the cell door and open the door flap that is usually latched over the window of the cell.

"You guys doing okay?" I say. I peer inside and flip on their light. Usually the two inmates are lying in their bunks. Most of the time they don't want to be bothered to talk, but they've learned I won't leave them alone until they at least give me an indication they're alive.

"We're alright," they might say or they might flash me a peace sign or offer a thumbs up. If one is in a particularly surly mood they might say something like, "Get the Hell away from my door." When this happens I generally oblige them.

I always carry word puzzles like sudoku, crosswords, and word-finds to the hole with me and you would think they were as valuable as gold by the way the inmates beg for them. I also will sometimes throw in some literature about cognitive/behavioral therapy or something philosophical or thoughtful I've printed off online just in case they happen to be interested. I figure that if you're "in the hole" you have a lot of time to think and read if you choose to use it.

Another all too common interaction I have with the inmates in lockdown goes something like this:

I open the window flap and the inmate is standing in front of me either with a sheet tied around his neck or showing me a small piece of a razor blade.

"I can't take this shit any more," he says. "Get me out of here or I'm going to kill myself."

"Okay," I say. "Tell me exactly why you want to kill yourself."

"I already told you. Get me out of this room or I'll do something and then it's going to be on you. I ain't playing games."

But I've come to learn that they almost always are playing games. Generally it's the same group of inmates who engage in this kind of behavior. If I know the person and his pattern of behavior, I handle this situation much differently than if I don't. If I'm not familiar with him, I'll take the safe route. I'll immediately call one of the prison psychiatrists and tell them about the situation. The psychiatrist almost always orders that the inmate be placed in the crisis unit in a paper gown without any property that he might use to harm himself.

But the problem with this intervention is that in most cases the inmate does not genuinely want to harm himself at all, but is angling to be moved out of lockdown. Even though they're still restricted in the crisis unit, many of them prefer to be there for a number of reasons. They get to be in a cell by themselves there. They also have more contact with the female nurses, which is a strong motivation for many of them, and generally get a break from the rather oppressive environment that is endemic to being "in the hole".

It's not that I have any real objection to the inmate getting a break from his environment once in awhile, but there are only a limited number of crisis beds, and in my opinion, they should be saved for inmates with a genuine mental health related crisis rather than those who have learned to manipulate their environment by engaging in negative behaviors. It's always a judgment call and generally I'll still speak to the psychiatrist about it just so we're all on the same page, but if I think the inmate is pretty much just jerking my chain, I'll say something like: "Do you really want to kill yourself or are you just trying to get out of lockdown?"

Sometime they'll come clean at that point and admit that's exactly what they're trying to do. Other times they'll get angry that I've called their bluff and curse me up and down telling me how he's going to sue me, his family's going to sue me, and how I'm generally the most uncaring, horrible human being he's ever come into contact with. Or they might then claim that they are floridly psychotic. They are hearing the voice of their dead grandmother telling them to "go ahead and do it" or the walls are closing in on them and blood is pouring from them. What am I going to do about it?

In cases like these I'm generally less than impressed and I walk away. Mind you, I only do this is I'm completely confident the inmate's behavior is strictly manipulative. If I have the slightest suspicion that they're genuine, I take the appropriate measures. It's a fine line to walk sometimes but it's necessary. If every inmate who made bogus claims of suicidality were allowed to go to the crisis unit, the security officers would hate me and it would result in all kinds of chaos in the lockdown unit as the inmates would take advantage of my gullibility or chicken heartedness and constantly be claiming they were about to do themselves in.


The condition of many of the inmates in the hole is downright pitiful. There are some that stay locked down for over a year on protective custody or because they present particularly difficult disciplinary problems. They are allowed to stand outside in the "rec cages" outside the unit for up to an hour a day, but many choose not to even come out of their cells for that length of time. After such a long period of time existing behind a locked door you can see the color of their skin become more and more sallow and their general physical and mental well-being slowly deteriorate.

The inmates in lockdown often have all kinds of trouble getting basic things like clean clothing or a toothpaste at times. A prisoner there was recently punished by having all of his clothes and property removed for a day because he was screaming and kicking his door constantly while the warden was inspecting the unit. When asked why he was doing this, he said that he was just trying to get the warden's attention in hopes that he might be able to finally get some clean underwear from laundry.

Often when they speak to me through the crack in their door, their breath almost knocks me over, and there's no way it could be that bad if they were brushing their teeth at all regularly. Many tell me they don't brush because they can't get a toothbrush or they've run out of toothpaste, and haven't been able to get a new tube in months. There are certain inmates who also never take advantage of "shower call". They begin to exude a pungent odor after awhile that can be detected by my nose when I'm still two or three doors away from them. The lack of hygiene is also a factor in the constant problem of staph infections that is always present in the lockdown unit.

Speaking of a lack of hygiene, another one of the inmates' favorite tricks to force staff to pay attention to them is to flood the unit by jamming a shirt or a jumpsuit in their toilet, and then flushing it repeatedly until water flows under their door and throughout the entire unit. Once when I was there and this was occurring, I watched as several solid pieces of feces floated by my foot.

Speaking of feces, I am reminded of another occasion when I was sent to evaluate an irate inmate and found that he had spread this fragrant substance so thickly over his cell door window I couldn't see inside. Trying to hold my breath as I spoke, I asked him if he could kindly tell me why he was engaging in this behavior and could he take a moment to speak to me. This fellow did come to the door and with his finger, he traced the words FUCK YOU on the window. I saw through his letters that he was standing there naked and covered from head to toe in the stuff.

On yet another occasion, I was called to see a fellow and found him lying prone and naked on the concrete floor of the outside rec pen also covered from head to toe in his own feces. He began to tell me how aliens had invaded his body and the only way he could expel them was to cake his body in such a fashion as I now witnessed. In the midst of this explanation, another neighboring inmate's smart crack of some kind caused him to suddenly double over in laughter and lose his groove. When I accused him of faking, he said, "hey man just get me out of this hellhole alright?" Amused, but convinced the man was more actor than schizophrenic I left him to his devices.

Working in the lockdown unit on a daily basis as I have for over two years now has become a bit tiring and tedious and I often wonder if I'm really helping people at all by being there. It's certainly not a place conducive to accomplishing meaningful therapy. But on the plus side, it is always intriguing because you never know what's going to happen there and in some ways it's like taking a short walk to a third world country where an entirely different sub-culture exists. I also like to think that I do bring a little humanity to an inhumane place from time to time and do my best not to become jaded and insensitive in the process.


All in all, I suppose it's an interesting way to make a living.