Pennsylvania's Department of Corrections (PA DOC or PDOC) houses approximately 37,000-38,000 people in state prisons, roughly one-quarter of whom have some form of mental illness. About 4,000 are classified as seriously mentally ill (SMI).
Pennsylvania's prison mental health story was shaped by federal intervention. In 2011, the U.S. Department of Justice launched an investigation into conditions at SCI Cresson. In 2013, DOJ found constitutional violations. PDOC expanded the investigation statewide and DOJ found the same pattern of violations across all 28 prisons. In 2014, PDOC and the Disability Rights Network of Pennsylvania reached a settlement. DOJ closed its investigation in 2016, acknowledging that Pennsylvania had made meaningful reforms.
The reforms that emerged from this process define the current mental health framework: Residential Treatment Units (RTUs) at designated facilities; at least 20 hours per week of out-of-cell time for SMI prisoners; a prohibition on disciplining prisoners for self-injurious behavior; expanded mental health classification; crisis intervention training for officers; and an enhanced system for treating and classifying seriously mentally ill and intellectually disabled prisoners.
Pennsylvania does not have active federal court oversight of PDOC prison mental health care at this time. The DOJ investigation was closed, not converted to ongoing consent decree monitoring.
What Pennsylvania Prisoners Are Entitled To
Under Estelle v. Gamble (1976), the ADA, the 2014 DRN-PA/PDOC settlement, and PA DOC policies:
- Mental health screening at intake.
- Enhanced mental health classification for prisoners with a current or past mental illness diagnosis.
- At least 20 hours per week of out-of-cell time for activities and treatment for prisoners with SMI or intellectual disabilities.
- RTU placement for prisoners requiring that level of structured mental health care.
- A prohibition on disciplinary action for self-injurious behavior.
- Crisis intervention responses to mental health emergencies rather than purely disciplinary responses.
Mental Health Screening at Intake
All incoming PDOC prisoners receive mental health screening as part of the intake process. The classification process has been expanded to include all prisoners with a current or past mental illness diagnosis -- a result of the DOJ investigation and settlement. This means prisoners who had a mental illness diagnosis before entering prison are automatically captured in the mental health classification system, not only those showing acute symptoms at intake.
If your person has a psychiatric history, provide documentation at intake -- prior hospitalizations, diagnoses, and active medications -- to support accurate initial classification.
The Mental Health Classification System
As a direct result of the 2014 settlement and DOJ reforms, PDOC expanded its mental health classification system to include all prisoners with a current or past mental illness diagnosis. This expansion means:
- Prisoners who disclosed a prior mental illness diagnosis at intake are classified in the mental health system.
- This protects them from placement in restrictive housing without consideration of their mental health needs.
- The expanded classification provides a basis for referring prisoners to RTUs and other mental health housing.
If your person had a mental illness diagnosis before incarceration and was not classified in PDOC's mental health system, this may be a basis for appeal and reclassification.
Residential Treatment Units (RTUs)
As a result of the 2014 DRN-PA/PDOC settlement, PDOC established Residential Treatment Units (RTUs) at designated facilities. RTUs are specialized housing units with mental health staff, services, and programming for prisoners requiring that level of structured care due to a mental health condition.
RTUs are not available at every PA DOC facility. PDOC designates certain facilities to specialize in the treatment of prisoners with mental illness or intellectual disabilities. Prisoners who require RTU-level care may need to be transferred to a facility with an RTU.
The 20-Hour Weekly Out-of-Cell Guarantee
One of the most specific rights established by the 2014 settlement and PDOC reforms is a minimum of 20 hours per week of out-of-cell time for activities and treatment for prisoners with mental illness or intellectual disabilities. This is more than three hours per day -- a significant increase from the five hours per week that SMI prisoners were getting in restricted housing before the reforms.
PDOC describes treatment units as "less stark, featuring colorful murals and recovery-based messages, resulting in greater participation and fewer incidents of harm."
If your person is SMI-classified and is receiving fewer than 20 hours per week of out-of-cell time, this falls below the documented PDOC commitment. Document the specific weekly hours and file a grievance.
Prohibition on Discipline for Self-Injurious Behavior
Before the 2014 reforms, PDOC was disciplining prisoners for self-injurious behavior -- treating self-harm as a disciplinary matter rather than a mental health crisis. The 2014 settlement and DOJ reforms established that discipline is no longer permitted for self-injurious behavior.
This is a concrete, actionable protection. If your person with SMI is being disciplined (placed in restricted housing, losing privileges, receiving misconduct reports) for self-injurious behavior, this violates the PDOC policy commitment established through the DOJ process. Document the specific incident and file a grievance.
The DOJ Investigation and Reform History
The Pennsylvania DOJ investigation is one of the most significant federal-state correctional mental health investigations in the series. The sequence:
December 2011: DOJ initiates investigation of SCI Cresson under the Civil Rights of Institutionalized Persons Act (CRIPA) and the ADA.
June 2013: DOJ issues findings at SCI Cresson -- constitutional violations (Eighth Amendment) and ADA violations. DOJ finds SCI Cresson lacks a "functioning residential treatment unit" and that out-of-cell therapy, when provided, is conducted in conditions (including "therapy" through cell-door slots) that do not constitute meaningful treatment.
May 2013: DOJ expands investigation statewide to all 28 PDOC prisons.
February 2014: DOJ issues statewide findings -- the same pattern of violations present at Cresson found across the system.
2014: Settlement between PDOC and the Disability Rights Network of Pennsylvania (DRN-PA, now Disability Rights Pennsylvania). PDOC commits to RTUs, 20 hours out-of-cell, prohibition on discipline for self-harm, enhanced classification, crisis intervention training, and a central mental health care office.
April 2016: DOJ closes investigation, noting PDOC's cooperation and good-faith reform efforts. DOJ's Principal Deputy Assistant Attorney General Vanita Gupta stated: "Pennsylvania is headed in the right direction. We commend the state for beginning to reform its system to ensure that prisoners with serious mental illness and intellectual disabilities receive care, rather than suffer harm."
The DOJ closed -- not converted to consent decree -- the investigation. This means there is no ongoing federal court monitoring of PDOC's compliance with the reforms. Ongoing monitoring is conducted by Disability Rights Pennsylvania.
Specialty Facilities
As part of the reform framework, PDOC designated certain facilities to specialize in the treatment of prisoners with mental illness or intellectual disabilities. This allows for:
- Concentration of mental health staff, expertise, and programming.
- RTU housing at designated facilities.
- Recovery-based environments designed to reduce incidents and increase therapeutic engagement.
The specific list of facilities with RTUs and specialty mental health programming should be confirmed at publish from current PDOC facility information.
Pennsylvania State Psychiatric Hospitals
Pennsylvania operates state psychiatric hospitals through the Department of Human Services (DHS), Office of Mental Health and Substance Abuse Services (OMHSAS):
- Torrance State Hospital (Torrance, Westmoreland County).
- Norristown State Hospital (Norristown, Montgomery County).
- Clarks Summit State Hospital (Clarks Summit, Lackawanna County).
- Danville State Hospital (Danville, Montour County).
- Warren State Hospital (Warren, Warren County).
These hospitals serve civil commitment populations and forensic patients. For PDOC prisoners who require inpatient hospital-level psychiatric care beyond what RTUs and facility-level mental health services can provide, these state hospitals are the referral destinations.
The Disability Rights Pennsylvania Monitoring Role
Disability Rights Pennsylvania (formerly Disability Rights Network of Pennsylvania, DRN-PA) is the organization that sued PDOC in 2013, reached the 2014 settlement, and remains the federally mandated Protection and Advocacy organization for Pennsylvania. DRP monitors PDOC compliance with the settlement commitments.
PA Prison Society (prisonersofpennsylvania.org) is an independent organization that monitors conditions in PA DOC facilities and accepts concerns from prisoners and families.
What Families Can Do
If your person is in PDOC custody and has a mental illness:
Provide psychiatric history at intake. Supply documentation of prior hospitalizations, diagnoses, and active medications. PDOC's expanded classification system captures prisoners with current or past mental illness diagnoses -- documentation at intake triggers this classification.
Know the 20-hour weekly out-of-cell right. If your person is SMI-classified, they are entitled to at least 20 hours per week of out-of-cell time for activities and treatment. If they are receiving fewer than 20 hours, document the specific weekly totals and file a grievance.
Know the prohibition on discipline for self-harm. If your person has been disciplined (misconduct, restricted housing, lost privileges) for self-injurious behavior, this violates PDOC's post-settlement policy commitment. Document the specific incident and file a grievance.
Know the RTU right. If your person requires RTU-level mental health care and is not in an RTU, ask whether an RTU evaluation has been conducted and whether transfer to a facility with an RTU has been considered.
Know the classification right. If your person had a prior mental illness diagnosis and was not captured in PDOC's mental health classification system, ask for reclassification. The expanded classification covers all prisoners with a current or past diagnosis.
File a grievance. PDOC has an administrative grievance process. File formal grievances for: failure to conduct mental health screening, failure to classify under the expanded mental health system, fewer than 20 hours per week out-of-cell time for SMI prisoners, discipline for self-injurious behavior, failure to refer to RTU when warranted, and medication interruption.
Contact Disability Rights Pennsylvania. DRP (disabilityrightspa.org) is the federally mandated Protection and Advocacy organization and the organization that drove the original 2013 lawsuit and 2014 settlement. Contact DRP for advocacy and legal help.
Contact PA Prison Society. PA Prison Society (prisonersofpennsylvania.org) is an independent watchdog that monitors PDOC conditions and accepts concerns from prisoners and families.
Seek legal help. If your person's post-settlement rights are being violated -- fewer than 20 hours out of cell, discipline for self-harm, RTU denial -- consult a prisoner rights attorney with experience in Pennsylvania's federal courts (Eastern, Middle, and Western Districts of Pennsylvania).
Frequently asked questions
How does Pennsylvania screen prisoners for mental illness?
All incoming PDOC prisoners receive mental health screening at intake. PDOC's classification system, expanded as a result of the 2014 DRN-PA settlement and DOJ reforms, now captures all prisoners with a current or past mental illness diagnosis. This means prisoners who disclosed a prior diagnosis at intake are automatically placed in the mental health classification system, not only those showing acute symptoms. Provide psychiatric documentation at intake -- prior hospitalizations, diagnoses, and active medications.
What are Pennsylvania Residential Treatment Units?
RTUs (Residential Treatment Units) are specialized mental health housing units at designated PDOC facilities, established as part of the 2014 DRN-PA/PDOC settlement and DOJ reforms. RTUs provide mental health staff, services, and programming for prisoners requiring structured mental health care. PDOC designated certain facilities to specialize in SMI and intellectual disability treatment, with RTUs at those locations. Not all facilities have RTUs -- prisoners requiring RTU-level care may be transferred to a specialty facility.
What out-of-cell time do SMI prisoners get in Pennsylvania?
A minimum of 20 hours per week of out-of-cell time for activities and treatment for prisoners with mental illness or intellectual disabilities -- established through the 2014 DRN-PA/PDOC settlement and DOJ reforms. This replaced the prior practice of approximately five hours per week in restricted housing. PDOC describes its treatment units as featuring colorful murals and recovery-based messages resulting in greater participation and fewer incidents of harm.
What was the DOJ investigation of Pennsylvania prisons?
The DOJ launched a CRIPA/ADA investigation in December 2011 at SCI Cresson, finding constitutional violations and ADA violations in the treatment of SMI and intellectually disabled prisoners in solitary confinement. DOJ found no "functioning residential treatment unit" at Cresson and documented that "therapy" was conducted through cell-door slots. DOJ expanded the investigation statewide in May 2013 and found the same violations across all 28 PDOC prisons in February 2014. A settlement followed in 2014, and DOJ closed the investigation in April 2016.
What was the 2014 PA DOC mental health settlement?
The 2014 settlement between PDOC and Disability Rights Network of Pennsylvania (now Disability Rights Pennsylvania) resolved the federal lawsuit filed in March 2013. Key terms: establishment of RTUs at designated facilities; at least 20 hours/week out-of-cell time for SMI and ID prisoners; expanded mental health classification to include all prisoners with current or past diagnosis; prohibition on disciplining prisoners for self-injurious behavior; crisis intervention training for officers; a central mental health care office; and suicides prevention improvements. About 4,000 seriously mentally ill PDOC prisoners were covered.
Can PA DOC discipline prisoners for self-harm?
No. A direct result of the 2014 DRN-PA/PDOC settlement is that discipline is no longer permitted for self-injurious behavior. Before the reforms, PDOC was treating self-harm as a disciplinary matter rather than a mental health crisis. If your person is being disciplined -- placed in restricted housing, losing privileges, receiving misconduct reports -- for self-injurious behavior, this violates PDOC's post-settlement commitment. Document the specific incident with dates and actions taken, and file a grievance.
What mental health classification does PA DOC use?
PDOC's mental health classification system was expanded as a result of the 2014 settlement and DOJ reforms to include all prisoners with a current or past mental illness diagnosis -- not only those showing acute symptoms at intake. This expanded classification protects prisoners from restrictive housing placement without mental health consideration and provides the basis for RTU referrals. If your person had a prior diagnosis and was not classified in the mental health system, request reclassification.
How does Pennsylvania handle mental health care at release?
PDOC's mental health reentry planning includes discharge planning to connect prisoners with community mental health services. Pennsylvania DHS's Office of Mental Health and Substance Abuse Services (OMHSAS) coordinates community behavioral health through county mental health agencies. Upon release, prisoners with mental illness connect with their county's community mental health services, often through the county mental health/intellectual disability program. Ask what county mental health provider has been identified, whether a first appointment has been arranged, and whether Medicaid enrollment is underway.
What can families do if mental health care is denied in PA?
Provide psychiatric documentation at intake. Know the expanded classification right -- your person with any prior diagnosis should be in the mental health system. Know the 20-hour weekly out-of-cell minimum -- document any shortfall. Know the prohibition on discipline for self-harm -- document any violations. Know the RTU right -- ask whether transfer to a specialty facility has been considered. File PDOC grievances for all violations. Contact Disability Rights Pennsylvania (disabilityrightspa.org) -- the organization that drove the 2013 lawsuit and 2014 settlement. Contact PA Prison Society (prisonersofpennsylvania.org) for additional monitoring.
Who oversees mental health care in Pennsylvania prisons?
PDOC's Bureau of Health Care Services manages mental health care system-wide. No federal court currently exercises active oversight -- the DOJ investigation was closed in 2016, not converted to a consent decree. Disability Rights Pennsylvania (DRP, disabilityrightspa.org) is the federally mandated P&A organization -- it drove the 2013 litigation and 2014 settlement and continues to monitor PDOC compliance. PA Prison Society (prisonersofpennsylvania.org) is an independent watchdog. ---