Colorado prisons’ restraint techniques amount to “torture” and need reform, lawmaker says

Tyler Himelstieb insisted he was OK: By the time he returned to San Carlos Correctional Facility from the hospital, the medications he’d been missing had kicked in. He was calm, he said. Stable.

Prison staff disagreed. Himelstieb had gone to the hospital hours before to get more than a dozen stitches in his forehead. He’d been off of his meds and had been transferred to San Carlos, where the state of Colorado incarcerates inmates with significant mental health concerns. The change in location and lack of medications were stressors that led him to resort to an old coping mechanism: smashing his head against a wall. When he returned from the hospital, a prison counselor spoke to him briefly — he estimates the conversation lasted three to five minutes — and determined Himelstieb was still a danger to himself.

That decision confined Himelstieb to an empty room and a mattress maybe an inch thick. Using metal cuffs, prison staff locked his wrists and ankles to the bed, his arms kept by his side and his legs shoulder-width apart. A strap across his chest held him flat on his back. His complaints that the restraints were too tight went unheeded. He described it as feeling “stretched,” his body positioned in a way that it naturally resisted. A nurse would later come and wrap his wrists and ankles — by that time blistered and bruised — in gauze before re-securing the metal cuffs.

The pain was “excruciating,” he said. At first, he thought it would only be for a few hours.

“I was just like, ‘Man, if I can get past these four hours, I’ll be OK, I’ll finally get out of these,’” Himelstieb, 35, said in early October from his father’s home in Aurora. He had been released three weeks earlier, more than six years after he was sent to prison for assaulting his then-girlfriend after he’d stopped taking his medications. “Another clinician came to the window (of the cell) and asked how I was doing. And I told her, ‘I’m in a lot of pain, but I’m calm and stable. Can I please get out of these restraints?’”

When another counselor checked on him later, Himelstieb said, the provider told him that he would be “in the restraints at least overnight.”

Himelstieb estimates that he spent roughly 20 hours in the metal restraints, with two breaks to use the bathroom. Himelstieb likened the experience to torture. That’s how Rep. Judy Amabile, a Boulder Democrat, described it, too. She’s now working to reform what she cast as Colorado’s “medieval” use of restraints.

The clinical use of four-point restraints — so-called because they’re applied to each limb — is generally noncontroversial for people who are a danger to themselves or others, experts said. But Colorado’s practice stands out, several told the Denver Post, for its use of metal restraints, its seemingly open-ended timeframe for restraining inmates and the apparent lack of associated treatment or oversight. One expert described Himelstieb’s experience as a “nightmare.”

“I think we really have to wonder in a big way about what are we doing to people with serious and persistent mental illness?” said Amabile, who’s sponsoring a bill to better regulate the use of four-point restraints in Colorado prisons. “And are we doing anything to try to help them, or are we doing things that really have the effect of making it so much worse?”

Department of Corrections spokeswoman Annie Skinner said in a statement that agency personnel only use four-point restraints when necessary and under the close monitoring of staff. Citing privacy laws, she declined to comment on Himelstieb’s account or other specific allegations. The agency, she continued, “welcomes the opportunity to examine our policies and procedures.”

Himelstieb is not the first to warn about the use of restraints in Colorado prisons. The American Civil Liberties Union wrote the department in 2011 about two inmates who were restrained for 14 hours, causing “swelling, bruising and numbness.” Between when Himelstieb was restrained in July 2020 and this past June, the Colorado Department of Corrections used four-point restraints 136 times at San Carlos and Colorado Territorial Correctional Facility, said Meghan Baker, an attorney for Disability Law Colorado. Ninety-six of those incidents — involving 28 different inmates — were at San Carlos, she said. Under department policy, four-point restraints can only be used at a handful of facilities, including San Carlos, the infirmary at Colorado Territorial, and the Denver Women’s Correctional Facility.

Amabile and Baker said one man was restrained for 39 consecutive days. Baker told lawmakers in September that she had interviewed an inmate who’d been restrained for a total of 60 days during a 10-month period. Another person, she said, reported spending a total of 90 days in restraints over a nine-month period. Though Himelstieb was allowed to use the bathroom, Baker and Amabile both said that some people are restrained in diapers (Skinner, the agency spokeswoman, said some inmates need “adult incontinence products” during their incarceration, regardless of whether they’re restrained or not. She declined to comment on the amount of time that specific inmates spent in restraints, citing privacy laws).

Baker said she’s flagged the state’s use of restraints to the U.S. Department of Justice and that she spoke with lawyers from the agency earlier this year. She told the Denver Post she’d been told of inmates being restrained with padlocks on their bodies, to keep other cuffs and restraints in place. Those padlocks, she said, then press into the person’s body while they’re chained to the bed. One inmate was given a Lidocaine patch — to treat the pain — because a padlock pressed into his spine, she said. Another man incarcerated at San Carlos, Manuel Joseph McGee, filed a lawsuit in 2020 alleging he’d been restrained in cuffs that were too tight for more than four hours. He accused staff of ignoring an existing injury to his forearm (that case went to trial in June and settled as a jury deliberated, according to court records).

Baker brought the issue to Amabile, the lawmaker said, and it “seemed like torture” to her. She wants the state prisons to fall in line with the state hospital’s use of restraints, and she’s sponsoring a bill to do that, which the broader legislature will consider this coming session.

The legislation would require prison staff to exhaust all other efforts before using restraints and that an inmate be released once their concerning behavior has ended. It would ban the use of metal, hard plastic and belly chains, and it would limit the amount of time a person could be restrained to four hours and the yearly use on one inmate to 240 hours. Initial restraint orders would be capped at 30 minutes, an inmate would have to be checked every 15 minutes, and mental health providers would have to assess the inmate every hour to decide if restraint is still needed. Every two hours, restrained inmates would be given 10 minutes to “move freely.”

The bill would also prohibit the use of diapers on restrained individuals.

If passed during the upcoming legislative session, the bill would bring Colorado law in line with national guidance and policies set out by other states and the federal government. The National Commission on Correctional Health Care, for instance, calls for inmates to be removed from the restraints as soon as possible, for restraint episodes to end at 12 hours and for inmates to be checked every 15 minutes. It also shuns the use of metal or hard plastic restraints, as does the Bureau of Prison’s regulations, which likewise require regular checks and has prescribed rules around timing.

Publicly available documents describing the Colorado corrections department’s policy for restraints do not describe time limits or observation requirements. Baker said she had a restricted policy document that she couldn’t provide to the Post, but she said it did not have prescribed time limits, either. She said people in restraints are supposed to be allowed up every two hours to move.

Asked if the agency had specific time limits on the use of restraints, Skinner, the agency spokeswoman, said they are used “for the shortest amount of time possible, in order to stabilize the individual so that they are no longer putting themselves or others at imminent risk.”

Himelstieb said he didn’t know how often staff looked into his cell to check on him because he was facing away from the door. He said he was never given the chance to stretch or move his muscles, beyond the two times he used the bathroom; the few times that a staff member called out to him, he asked to be released and emphasized that he had calmed down.

Many states — including Washington, Indiana, South Carolina and Maryland — don’t publicly release their prison restraint policies. In Kentucky, for instance, officials attempted to file their policy under seal in response to a lawsuit, arguing that releasing the policy risked harm to staff (a judge denied that request). Still, time constraints appear common: Tennessee, Wisconsin and New Mexico all require 15-minute checks. Wisconsin explicitly bans the use of metal or plastic restraints, and several states require that restraints be removed as soon as possible.

Terry Kupers, a Wright Institute psychiatrist who’s studied solitary confinement and mental health in jails and prisons, praised the proposed bill in Colorado. So, too, did Corene Kendrick, the deputy director of the ACLU’s National Prison Project. Jails and prisons, both said, have become the largest providers of mental health care in the nation, just as both are struggling with understaffing, and more focus is needed on how they treat the people in their custody.

“The basic issue in our society is we have an inadequate public mental health system in general,” Kupers said, “and we’re putting too many people in prison, which is causing the staff shortage. We don’t assign the staff that are needed to take care of them.”

Aaron Greco, the corrections department’s legislative liaison, told lawmakers last month that the agency was “very open” to changes to its policy and had started working on the issue in good faith. But he expressed some concern with the “prescriptive” nature of the bill, including limiting each restraint episode to four hours.

The department, he said, wanted to have “the right amount of flexibility in order to make sure we ensure safety of staff and offenders alike.”

Jeffrey Metzner, a forensic psychiatrist at the University of Colorado and an expert on the use of restraints, likewise raised concerns about the bill’s defined time limits.

“It’s way too prescriptive,” he said. ” … If you have a limit, but (the use of restraints) is still clinically indicated, what are you supposed to do?”

Kupers, the Wright Institute psychiatrist, said that the use of restraints can exacerbate someone’s crisis, and he argued that if someone is still struggling after four hours of restraint, they should be transferred to a psychiatric facility and that their treatment needed to be addressed. But Metzner disagreed and said more time was needed.

Amabile, the legislator sponsoring the bill, said she wanted to bring prison rules in line with the state hospital, which she said doesn’t restrain people for more than four hours. A spokesperson for the state hospital did not return a message seeking comment sent earlier this week. A spokeswoman for state Department of Human Services said the state hospital in Pueblo limited restraints to only when necessary and ended their use as soon as possible, sometimes within minutes. Patients are monitored at all times, and the use of restraints for more than four hours is “rare,” she said.

“But as always with any of these kinds of pieces of legislation,” Amabile said, “it’s a negotiation. It’s a back-and-forth.”

For Himelstieb, limiting the use of restraints has become a personal crusade. He had been out of prison for 15 days when he testified in front of lawmakers in support of Amabile’s bill in September, and he’s still litigating the lawsuit he filed two years ago against mental health providers at San Carlos.

He’s not bitter, overall: His adult life had been “devastated” by his illness by the time he entered prison in 2017. In the years since, he’s learned to take responsibility for it: He lives with his dad and a chirping African Gray parrot. He regularly takes a bus from Aurora to see his psychiatrist in Littleton. He attends group therapy, too. He called his parole officer “wonderful,” his transition plan from San Carlos “excellent.”

He’s found willing allies in Baker — whom he calls Miss Baker — and Amabile. The lawmaker said she can’t predict how her colleagues in the legislature will vote on the issue. Part of it depends on the election and who controls what chamber. But that shouldn’t really matter, either, she said.

“Nobody wants us to be doing these kinds of really harsh treatments of other people,” Amabile said. “I mean, this is America, after all, where we’re supposedly not willing to do those kinds of things.”

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