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Helping those in distress at my South Carolina prison was much harder than I expected

Even after 23 years of witnessing brutal fights behind prison walls, I remained ignorant to the gravity of the prison mental health crisis. Then I decided to volunteer as a paraprofessional counselor in the Crisis Stabilization Unit (CSU) at Broad River Correctional Institution in Columbia, South Carolina, the prison I’d transferred out of. 

As a Gulf War veteran, I knew the brutalities of combat. I could recognize indifference to evil. I had overcome bouts with post-traumatic stress disorder after the war, but I had no encounters with other psychological illnesses. 

That changed when I began serving in the CSU as a watcher, providing observation and a calming presence to a person experiencing a mental health crisis.

My first months as a watcher, I discovered the challenges of my new responsibilities. What I saw in the CSU was something more severe and dire than I could have imagined: people who swallowed razors or batteries, lacerated their arms, even one person who shoved a colonoscopy bag into their abdomen.

What I saw helping people in crisis at my prison’s mental health unit initially surprised and horrified me. It’s challenging and gruesome work. But since I began nine years ago, I’ve felt a growing sense of purpose. I’ve learned that trauma affects us all. I’ve used this opportunity to improve people’s lives with compassion. The program has not only been helpful to those in distress, but also to me. 

The roots of the CSU

The CSU had its origin in a South Carolina courtroom in T.R. v. South Carolina Department of Corrections, a civil case involving about 3,500 state prisoners classified as seriously mentally ill that was originally filed in 2005.

The prisoners alleged the state prison system segregated, rather than treated, mentally ill prisoners and subjected them to inappropriate and excessive use of force. 

“We don’t even get evaluated by psychiatrists and there’s no real treatment plans or group therapy,” one person claimed in the lawsuit. 

Not surprisingly, court records also alleged that the state prison system failed to provide security monitoring on weekends and holidays, gave out the incorrect medication at times, and placed people in solitary confinement for years at a time.  Between 2008 and 2011, seven mentally ill prisoners died alone in lockup cells; six were by suicide, according to the lawsuit.

Nearly 10 years after the lawsuit was filed, Circuit Judge Michael Baxley ruled in 2014 that the prisoners had satisfied what’s known as “the deliberate indifference standard” because the agency inadequately classified prisoners in need of mental health care. Baxley’s findings revealed that the agency relied heavily on isolation in lockup cells, failed to follow its own prison mental health protocols and responded with disproportionate and excessive use of force, among other failures. 

In a nutshell, the conditions were “dehumanizing,” Baxley said, according to court records. He ordered the state prison system to make improvements to mental health care and gave them 180 days to do so.

A new system of treatment 

By fall 2015, prison authorities planned to renovate one wing of the vacant 256-bed Greenwood Unit at Broad River Correctional Institution into a new 64-bed mental health treatment program.

In September 2015, Paul Dennis, then-unit manager of the CSU, stood in the sanctuary of the Broad River chapel and shared the agency’s plan with people who had been brought in from six prisons across South Carolina. I was one of them. 

All of us gathered there that day had previously graduated from a state initiative, funded solely by Columbia International University, that trained us to be ministers in South Carolina prisons. Dennis thought this had prepared us well for our possible role observing mentally ill prisoners.

He told us that the plan was to house people in distress in “single-man, camera-monitored safety cells.” There would be 24-hour on-site mental health and medical staff. The staff would also include supervisors and security officers. He said they were seeking 32 volunteers “to live in single-man cells on the top tier to serve as paraprofessional counselors.” 

In that role, we would be expected to aid the medical and mental health staff by providing one-on-one observation and a calming presence to someone experiencing a mental health crisis.

“Many of y’all have already served decades in prison and so we believe y’all have the credibility to speak to these men in ways we can’t, to share your life experience and build genuine relationships,” Dennis said in 2015.

Also present at the two-hour meeting was a clinical psychiatrist, Dr. Reuben Ridgeway, who explained that volunteers would complete eight hours of intensive suicide prevention training designed to teach us to recognize symptoms of mental health disorders. 

A disturbing start

On my first shift, I sat in an elevated, black-cushioned chair in front of Cell 1115. A man in his 20s, named Kenneth, was lying on a clear, tear-resistant mattress on the floor next to the cell’s single-man steel bunk. Kenneth had a well-documented history of self-harm by cutting. 

After writing his information on my log form, I peered through the door’s safety glass window to introduce myself. 

“My name’s Derek,” I began, “and I’ll be your watcher for the next few hours. How are you?”

“Have you ever seen somebody put caulking in their stomach?” he asked.

“No,” I said, “and to be honest with you, I’d rather not.”

For the next 30 minutes, I tried to distract Kenneth. We talked about his favorite football team, the University of Oklahoma Sooners, his struggles with drug addiction and his difficulties trying to serve out the remainder of his prison sentence for a non-violent crime. My goal was to offer a sensitive ear, assuring him I genuinely cared about his welfare. 

He was barely responsive to me. A few moments later, I saw Kenneth remove a two-inch strip of white caulking from beneath the stainless-steel commode and sink fixture. He held it up with a wry grin. 

“Here it goes,” he said. Then he inserted the caulking into an open wound in his stomach.

I was shocked, and immediately yelled for help. After notifying staff, I sat speechless in my chair.

A lesson from the Gulf War

In 1991, on the outskirt desert plains of Al-Maqwa, Kuwait, I once observed a skirmish between a Marine infantry platoon and a small remnant of Iraq’s elite Republican Guard units. At one point a U.S. soldier stood enraged on a nearby sand dune and fired his semi-automatic weapon toward the Republican Guard soldiers. In an instant, the Marine’s body was blown to pieces from an AK-47 round that pierced a grenade attached to him.

Although a slender piece of caulking protruding from a person’s stomach pales in comparison to war, it can change an observer with equal force; it’s unnatural and unnerving. I was never the same after witnessing such otherworldly horrors.

But light sometimes penetrated the darkness. In the nine years I’ve served as a watcher, I have discovered that helping others overcome challenges can be rewarding, just as conquering the heart-pounding and suffocating symptoms of PTSD after the war was easier with the help of Marines who served alongside me. Familiarity eliminated stigmas and stereotypes.

Jason was the first patient in the CSU I shared that experience with. His family had recently lost everything in a hurricane around 2017. Hindered by the limitations of his imprisonment, he felt powerless to help them. 

As I shared my own stories of regrets and failures with Jason, he asked me: “How did you get through it?”

“Friends,” I replied. “I found out I wasn’t alone in the world.”

Creating compassion in prison mental health

According to state data, CSUs have admitted over 5,400 prisoners in crisis from across South Carolina since this program began in March 2016 — the CSU has since moved from Broad River Correctional Institution, my old prison, to Kirkland Correctional Institution, my current prison. 

In the nine years since it started, there have only been two completed suicides in the CSUs. That’s one-third of the six suicides that happened between 2008 to 2011 under the old state prison mental health treatment system. While this is an improvement, two suicides is still too high for the men serving in the CSU. 

“Whenever we lose a man,” one watcher said, “we feel like we failed the man’s family. Someone lost a father, a son, or a brother.”

According to the U.S. Bureau of Justice Statistics, suicide is the leading cause of unnatural deaths in prison. Between 2001 and 2019, more than 4,400 people killed themselves in state and federal prisons.    

The basic principles of my faith teach us to bear one another’s burdens and show tolerance for one another in love. As a combat veteran who has overcome my own battles with mental illness, I believe it would be selfish not to pay it forward to others in need. Many people serving in the CSU share this opinion.

“We can reach them through the empathy and understanding of walking in their shoes,” said Richard, another watcher. 

Unlike guards and medical staff in prison, the paraprofessional counselors in the CSU are also serving prison sentences. We face the same challenges associated with prison life: separation from family, shame, regret, loneliness and fear. And this, I believe, is the real success of the program. Healing becomes a mutual experience for both the person in distress and the watcher. 

Recently, while helping a man in his 20s named Chris, I shared some of my story. For many years following the Gulf War, I secluded myself from friends who were willing to help me through my struggles. Then, in 1995, I tried to kill myself.

Noticing bandages around Chris’ wrist, I asked him what happened. Chris told me he was an alcoholic for several years following the death of a close friend. His addiction eventually led to a DUI, and him killing another motorist. Now Chris was at the start of a 25-year prison sentence, depressed. He had tried to kill himself and was placed under 24-hour observation in the CSU. 

He told me that he had let his family down, and was unsure how he was going to keep going. I told him about abusing alcohol for many years after the Gulf War, and how it led to my prison sentence. 

“I came to prison with a 30-year sentence when I was about your age,” I said. “I’ve been locked up for 23 years now, and I’ve got just over two years to go.”

“How’d you do it?” he asked me. 

I shared my story, and we kept talking.