South Carolina must improve how it cares for mentally ill prisoners, and it’s happening broadly under a court order that arose from a decade of class-action litigation. But according to a psychiatrist who works at the Camille Graham women’s prison in Columbia, conditions worsened between 2014 when she regularly made rounds there and earlier this year when she returned as a contract doctor. That is both frustrating and disappointing.

According to her recent testimony before a House oversight committee, the abuse and neglect suffered by mentally ill women — isolation and deprivation — was intentional and meant to discourage them from seeking help.

“They punished those that would (seek crisis care) by these means and so that got the numbers down of people complaining about being suicidal,” Dr. Pamela Crawford told lawmakers. “So we had people that were afraid (of seeking help). ... It was, in my opinion, orchestrated to make it punitive for them to seek help.”

Dr. Crawford, a retired state psychiatrist who came back to work at the Department of Corrections in May, had testified in the agency’s defense in that class-action lawsuit. But last month, she described to lawmakers how patients she treated before 2014 had “deteriorated” greatly and how at least one schizophrenic inmate had been removed from mental health rolls and her diagnosis revised. And, worse, no one spoke up about the conditions until she did this past summer.

The good news is that the Department of Corrections quickly cleaned house, disciplining some staffers, including a supervisor in the mental health unit, and reversing what Dr. Crawford described as de facto policies that led to a few psychotic women sleeping on bare bunks and being deprived of basic hygiene — for up to two years.

The prison team responded in part by holding “mass mental health days” to clear backlogs of women awaiting help. No criminal charges arose from an investigation by the State Law Enforcement Division.

Separate but relevant, a correctional officer from another prison broke down in tears at the same hearing in describing how she tried to fight against a staff culture steeped in the “socialized normalization of deviance.” But she said she was demoted and labeled “insubordinate.” That speaks to what might have gone wrong at Camille Graham and what must change to ensure mentally ill prisoners are treated humanely.

Still, what Dr. Crawford described at Camille Graham as “abuse” and “neglect” has no easy solutions. The state, much less the DOC, simply doesn’t have the psychiatric hospital beds needed to treat its most seriously mentally ill patients, prisoners or not. That needs to change.

Dr. Crawford’s testimony was an eye-opener when it shouldn’t have been. Lawmakers must be told the truth about what happens behind prison walls, but they are too often insulated from the kind of raw facts the veteran psychiatrist delivered. A summary of her findings, for instance, somehow never made it to the committee before she began her public testimony.

– The Post and Courier of Charleston