Opinion
3:19-cv-05045-DGE-TLF
06-25-2023
JAMES ANTHONY WILLIAMS, Plaintiff, v. STEPHEN SINCLAIR, et al., Defendants.
THE HONORABLE THERESA L. FRICKE
THE HONORABLE DAVID G. ESTUDILLO
SECOND DECLARATION OF RYAN QUIRK, Ph.D. IN SUPPORT OF DEFENDANTS' THIRD MOTION FOR SUMMARY JUDGMENT
RYAN QUIRK, Ph.D. Chief of Forensic Psychology
I, RYAN QUIRK, Ph.D., make the following declaration:
1. I am not a Defendant in this lawsuit, have knowledge of the facts herein, am over eighteen years of age, and am competent to testify to such facts based upon my personal knowledge.
2. I am a Clinical Psychologist licensed in the state of Washington. I am currently the Chief of Forensic Psychology for the Washington Department of Corrections. This role was created in furtherance of the Department's efforts to reduce the use of maximum (MAX) custody. In this role I use actuarial tools and structured clinical judgement to evaluate individuals' future risk of dangerousness towards others to inform classification decisions about placement, continuation, and release from MAX custody. I was hired in this role in April 2023.
3. As noted in my previous declaration, prior to this role, I was the Psychiatric & Social Services Manager for King County Jail, employed by King County Public Health-Jail Health Services from July 2017 up to April 2023. In that role and in my previous positions, I provided direct mental health care to patients in jails and prisons, as well as having an administrative role and responsibilities. I have written correctional mental health policies and procedures and developed staffing plans for correctional psychiatric and social services. I have also written, been published, and presented on topics pertaining to correctional mental health care and correctional classification. I obtained my undergraduate degree in Psychology from Fordham University and MA and PhD from Hofstra University. A copy of my CV is attached to my previous declaration.
4. From August 2009 to July 2017, I worked as a Psychologist (first as a “Psychologist 3” and then “Psychologist 4”, once independently licensed in the State of Washington) with the Washington State Department of Corrections (Department or DOC). While with DOC during this time period, I provided mental health care to patients who were classified as “maximum custody.” I also supervised mental health staff who worked with these patients. During this time, I was also involved with the direct treatment of the Plaintiff, James Williams, DOC #740600, and had several personal encounters with him. Therefore, I am familiar with him and his mental health issues.
5. Before rejoining DOC, and in my role as an external expert in this matter, I reviewed the DOC mental health records of Mr. Williams, his infraction and incident reports, chronological entries and custody facility plans for the purpose of determining a mental health diagnosis of Mr. Williams and the nexus between his behavior and serious mental illness (specifically symptoms of a psychotic and/or mood disorder).
6. In my new role as the Chief of Forensic Psychology, I am familiar with the Department's efforts to reducing the use of MAX custody. The Department has a demonstrated track record of investing in safely reducing the use of MAX custody, improving conditions within MAX custody, and increasing out of cell time for incarcerated individuals placed in MAX custody. This includes increasing the type and duration of programming, including “step down” and other forms of transition to less restrictive settings. According to DOC data, there were 1,401 individuals who exited Administrative Segregation in the fourth quarter of 2022, alone (165 of whom had been in Administrative segregation for 60 days or longer). In addition, regarding Maximum custody exits, the fourth quarter of 2022 had 87 individuals statewide (6 of whom had been in maximum custody for 500 days or longer) transfer to less restrictive settings. According to DOC population data from December 31, 2022, there were 387 incarcerated individuals in “ADSEG”, in “MAX” custody, and 12,800 in General Population. Nationally, the percentage of individuals in restrictive housing in DOC (of the total prison population) is very low relative to other systems.
7. I previously provided a declaration in support of Defendants' Second Motion for Summary Judgment. I signed this declaration January 26, 2022. In it I opined that Mr. Williams' behavior is willful and organized and does not have a nexus with serious mental illness. Specifically, in my opinion, Mr. Williams victimizes Department staff as a result of his anger and desire for vengeance/retribution/punishment.
8. Since my initial review of Mr. Williams's records in late 2021 and early 2022, I have reviewed additional records and interviewed a number of individuals related to Mr. Williams and his most recent behavior. These additional records and interviews include the deposition of James Williams in this matter, his available mental health file, a 13 page undated letter Mr. Williams sent to the Washington Correction Center-Intensive Management Unit's (WCC-IMU) unit supervisor (CUS), and conducted interviews with WCC-IMU custody staff and WCC mental health staff. In addition, I also conducted interviews with Monroe Correctional Complex (MCC) IMU mental health staff (where Mr. Williams had been housed prior to his transfer to WCC-IMU). I also attempted to meet with Mr. Williams for the purposes of evaluating him for risk of future dangerousness towards others and discuss a pathway for him out of maximum custody. A true and correct copy of this 13 page undated letter from Mr. William is attached to this Declaration as Exhibit 1.
9. On June 8, 2023, I attempted to meet with Mr. Williams at WCC-IMU in Shelton, Washington. Leading up to my in-person attempt to meet with Mr. Williams, I had contacted WCC mental health staff and requested that Mr. Williams be notified of my request to meet with him and that it would be scheduled for June 8, 2023. I understand that Mr. Williams was notified, at cell-front, by Psychology Associate N. Buckingham of my visit and my request to meet with him to evaluate him for risk of future dangerousness towards others and to discuss a pathway for him out of maximum custody. I asked Psychology Associate Buckingham to convey to Mr. Williams that I am currently the Chief of Forensic Psychology for DOC and I am also a State's (defense) expert in Mr. Williams' civil case against WADOC. In addition, I asked Psychology Associate Buckingham to share with Mr. Williams that I would be reviewing informed consent when I meet with him and review that the content of the evaluation is not confidential and would be used to inform both HQ MAX custody committee decisions and in defense response to his civil litigation. Psychology Associate Buckingham informed me, on June 1, 2023 (via electronic communication) that she had met with Mr. Williams and informed him of the information described above. Psychology Associate Buckingham wrote the following regarding Mr. Williams' response:
“First he said he knew exactly who you were and blames you for the marks on his arms which were caused by self-harming after you convinced the doctor to involuntary medicate him. He then stated he has to check with his legal team to see what they say, because as of right now he can win his lawsuit. He then bounced back and forth between needing to think about it, and dead set on no. He will talk to anyone else about MAX custody placement but you.”Psychology Associate Buckingham added that Mr. Williams had requested articles on the subjects of “TBI” and “Developmental Disabilities”, which were not provided to him. In response, Psychology Associate Buckingham wrote that Mr. Williams had, “called me a liar and told me to enjoy his feces.”
10. During my visit to WCC on 06/08/2023, I learned from WCC-IMU mental health staff that Mr. Williams had smeared feces in his cell (since his arrival on May 15, 2023) and has made sexually explicit statements to female staff (which have entailed Mr. Williams describing, in detail, what he intends to do to their body). WCC-IMU mental health staff also shared that Mr. Williams had expressed the belief that his lawsuit against WADOC was not just going to lead a monetary award for Mr. Williams, but actually lead to his release from prison to the community.
11. I was escorted to WCC-IMU and met with a unit Sergeant. The WCC-IMU unit Sergeant informed me that Mr. Williams currently had feces smeared in his cell and that the disruptive hygiene behavior response protocol had been initiated. He told me that Williams had placed feces in hard-to-reach places along the cell door (the WCC-IMU unit Sergeant commented that in order to fully clean the cell doors, they may need to be disassembled). The sergeant reported that Mr. Williams has harassed the incarcerated individual porters who have been tasked with cleaning Mr. Williams' feces. The report from the WCC-IMU unit Sergeant was that the porters had said Mr. Williams has made continuous comments and made taunts to the porters about having to clean up his feces, and in at least one case a porter requested to stop cleaning as they reported that Mr. Williams' harassment was too difficult to endure.
12. When I arrived at Mr. Williams' cell-front, I observed the odor of feces coming from his cell and I saw Mr. Williams reclining on his bunk appearing to calmly read and/or write. Upon knocking on the cell door and attempting to introduce myself, Mr. Williams quickly rushed to the door and informed me that he would not engage with me. I attempted to further engage with Mr. Williams but he would not let me speak. Instead, he yelled for me to get away from his door, said that he was pursuing a “restraining order” against me, and said, “Anything you have to say to me; say it through the courts.” At one point, Mr. Williams turned his attention to the WCC-IMU unit Sergeant who had accompanied me and threatened, “If you don't get him away from here, I'm going to smear feces on the window.” I ended my attempts to engage, and Mr. Williams stared at me intensely and then either kicked or banged on his cell door as I passed in front of it. I had observed some feces smeared on his interior cell wall, and I did not see any feces smeared on any other locations (including his body or reading/writing materials). Notably, in my clinical opinion, during this cell-front interaction, Mr. Williams presented as alert and oriented; he was immediately aware of my identity, the reason and purpose of my visit, and the identity and role of the WCC-IMU unit Sergeant. There was no evidence, in my clinical opinion, of behavioral disorganization or associated signs or symptoms of a psychotic and/or mood disorder evidenced by Mr. Williams. Further, he made a conditional threat in the form of threatening to smear feces if I did not leave his cell-front.
13. Following the above attempt, this writer reviewed Mr. Williams' available medical record (which included an updated Mental Health Update and Treatment Plan and a letter written by Mr. Williams). In addition, I reviewed a video record of the deposition of Mr. Williams in this matter.
14. Based on the above, my clinical opinion is unchanged from my original report. Since the time of my report, there is additional evidence supporting my clinical opinions. While Mr. Williams continues to state that his confinement in MAX by DOC is responsible for his behavior, and that he has no control over his actions, his own statements and associated actions indicate otherwise. For example, Mr. Williams continues to use threats of feces smearing behavior in an effort to intimidate and influence staff behavior (as he did when I was at his cell front), and engaging in feces smearing behavior to punish DOC staff. At times, Mr. Williams is also inconsistent in his responses. For example, during his deposition, he claimed (at approximately 01:44:00) that he often does not recall smearing feces. This self-report is belied by previous statements he has made, as documented in a Mental Health Encounter Report (Khounphixay, 12/08/2022), when Mr. Williams was quoted as threatening, “I'll kill them doctors when I get out...I have a good memory.. .each and every one of them will pay.”
15. According to the most recent Mental Health Update and Treatment Plan for Mr. Williams (Psych. Assoc. Beirman, 06/06/2023):
05/15/2023: “Transported to WCC IMU without all of his legal mail. When informed his legal mail was not transported Mr. Williams began yelling while in the holding cell and smearing feces on the walls/cell door while refusing to leave the holding cell until he obtained the items.”
05/21/2023: “Behavior observation Mr. William [sic] reported to IMU SGT beliefs legal paperwork was stolen and if not given to him by a certain sate [sic]
he ‘will be shit bombing us.' Mr. Williams further states ‘you guys (DOC) steal our shit, that's why we want to kill you.'”
05/26/2023: “WCC IMU CUS informed this writer of conversation with Mr. Williams cell front where Mr. Williams stated he ‘did not want to meet with those bitches (Mental health)' and that he ‘will kill someone when I get out of here because DOC messed me up so bad.'”
16. Also included within the Mental Health Update and Treatment Plan was the following in the case conceptualization and diagnostic rationale:
“.Given Mr. Williams refused to meet with mental health, the PCL-R was administered via records review and yield a score of 32.9 which according to Dr. R. Hare Ph.D [sic] and the technical manual of administering the PCL-R indicates high levels of psychopathy with cut score of30 being used to classify an individual as a psychopath. When interpreting the scores of the PCL-R it was found that on a scale 0-2 with 0 indicating no presence of the item and 2 meaning the item assessed fully applies to the individual, Mr. Williams scored 2's in twelve of the twenty assessed areas to include: Grandiose Sense of Self-worth; Pathological Lying; Conning/Manipulative; Lack of Remorse or Guilt; Shallow Affect; Callous/Lack of Empathy; Poor Behavioral controls; Early Behavioral Problems; Lack of Realistic, Long term Goals; Impulsivity; Failure to Accept Responsibility for Own Actions; and Criminal Versatility. His factor one score which assess [sic] Selfishness, callousness, and remorseless for others was a 15 and factor two score which assesses chronically unstable and antisocial lifestyle or social deviance Mr. Williams scored a 13. A total of three areas (Promiscuous Sexual Behavior, Many short-term Marital (relationships), and Juvenile Delinquency) had to be omitted due to not enough sufficient information available to fully assess those area [sic].”, and, “What is evident is Mr. Williams [sic] failure to conform to societal norms in respects to lawful behaviors, deceitfulness, impulsivity, aggressiveness and irritability, reckless regard for safety of others, and lack of remorse which is all indicative of Antisocial Personality disorder; this will continue as his primary diagnosis at this time. All of his exhibited behaviors appears [sic] to be directly related to this disorder and are behavioral in nature rather than being related to disorganized behaviors of SMI diagnosis.”The PCL-R information contained in this evaluation confirms my clinical opinion, included in my original report, that Mr. Williams evidences psychopathic traits and research has indicated that psychopathy is associated with increased risk of future dangerousness towards others.
17. As cited above, Mr. Williams continues to report that he is not responsible for his behaviors due to MAX custody and reported related mental health concerns. However, as explained in my previous declaration, his history, including responses to previous mental health interventions, is not consistent with the attribution of his behavior to mental illness. Again, I would cite Mr. Williams' past responses to involuntary antipsychotic medications, an intervention that would be reasonably expected to lead to improvement based on his claims of mental health concerns. Instead, as reviewed in my original report, his feces smearing increased (since it actually represents protest behavior and it is not the result of a serious mental illness) and he did not progress through the Step program at the Intensive Treatment Unit (ITU) at MCC-SOU. Instead the associated pattern (advancement in the program, nearing consideration for release, and then engaging in threats to harm others and/or feces smearing behavior) appears to be consistent with individuals who self-sabotage their prospect of release MAX custody.
18. In terms of any mental health treatment in the form of talk therapy, as recently as June 6, 2023, the Mental Health Update and Treatment plan included the following on this subject:
“Since his transfer to the WCC IMU Mr. Williams has primarily engaged in mental health services via weekly check in's cell front during rounds. He refuses to meet for in depth conversations with mental health providers to discuss his continued behaviors in his cell despite his demanding [sic] for creation of an updated Individual Behavior Management Plan that would allow for him to obtain additional snacks throughout the day to consume ‘1800 more calories so I can build muscle'...”
19. Consistent with my original report, Mr. Williams, in my clinical opinion, continues to view his interactions with WADOC mental health staff as transactional. In his view, mental health staff are not of benefit to him because they provide mental health treatment or other clinical interventions (he has declined those services). Instead, he views their role as individuals who can provide him with items he wants, such as handouts, articles, food, and other items. This transactional relationship represents his disinterest in mental health treatment and that he does not see any potential for meaningful progress with his mental health. This is consistent with someone with antisocial personality order.
20. While at WCC-IMU, Mr. Williams had written a thirteen-page letter to CUS Bailey. Of particular interest, Mr. Williams described his feces smearing behavior as “semi-volitional.” On page 4 of the undated letter, Mr. Williams wrote, “And so you see that the smearing self-harming threats to staff is not pure 100% manipulation, but it's not purely out of the inmates [sic] control. It lies in an area between being 100% unable to control it and 100% able to control it. It is overpowering to me. It is like my will power (my thinking mind in this case-my logic driven will power) just becomes unable to overrule my emotions.” This letter is essentially Mr. Williams attempting to bargain with CUS Bailey, with Mr. Williams offering the promise of refraining the behaviors of concern if provided with the items he is requesting (the majority of this is him describing his version of past IBMP's). Mr. Williams presented the following to CUS Bailey:
“If I can get my weekly bag of Keefee coffee, and the 2 extra hot trays at dinner and have a radio and TV- then I will be able to maintain my behavior long enough for you to transfer me to a prison where I can get a job at $55 a month” (p. 12).
21. As in the past, Mr. Williams again presents a conditional offer, one in which he would obtain requested items in exchange for the cessation of feces smearing, self-harm, and threats to staff. Within the letter he writes that these behaviors are the result of a serious mental illness (and not “manipulation”) and therefore should be met with “treatment.” The “treatment” that Mr. Williams writes that he needs is “food medication” (p. 6); not actual forms of mental health treatment. Mr. Williams wrote, “What I mean is when I am given an IBMP for an extra lunch every day, and a bag of coffee every week, it should be looked at as therapy...” (p. 6). Of course, being provided with incentives is not mental health treatment, but is an aspect of behavior modification plans. If Mr. Williams' behaviors were the result of a serious mental illness (in particular, feces smearing behavior) then food and coffee incentives would not be expected to reduce the behaviors. Instead, the frontline treatment for such psychiatric decompensation would be antipsychotic medications. It is necessary, in other words, to align the intervention with the motivation of the behavior - meaning that it is important to use the right tool to meet the driving force of the behavior. With his request, Mr. Williams is affirming that his behaviors are not the result of a serious mental illness.
22. Since my original report, there have been some successes for Mr. Williams. For example, while at MCC-IMU, the mental health staff I consulted with in person on June 14, 2023 reported that with the implementation of an IBMP (incentives included printouts of requested articles, snacks, and coffee) there had been observed, incremental improvements in his behavior. Mr. Williams was described as polite and cooperative at times. There had been instances in which he had damaged incentives he had been provided (table top radios), the destruction of which he blamed on the actions of other individuals, which is a recurring theme for Mr. Williams.
23. For all of the reasons included in my original report and with the added information above, it remains my clinical opinion that the method in which Mr. William is safely progressed to a less restrictive setting remains elusive. This is because, the Department has attempted a number of interventions and they have been unsuccessful to date. Ultimately the measure of success lies within Mr. Williams. Mr. Williams remains dangerous around others and his repeat threats are concerning. In my opinion his behaviors are the result of the combined presence of psychopathic traits and antisocial and narcissistic personality disorders. With this clinical background and Mr. Williams history of extreme violence, the risk of harm he presents to others is significant in my opinion.
24. During Mr. Williams deposition, he reported an interest in releasing from MAX custody to go to “protective custody” at the Washington State Penitentiary (approximately 17:10). To my knowledge, this is the first time Mr. Williams has expressed a desire to leave MAX custody and provided a specific location to transition.
25. In my clinical opinion, Mr. William's potential risk of danger towards others remains high. I was attempting to re-evaluate Mr. Williams' risk of danger towards others with actuarial methods, but Mr. Williams declined to meet with me. There is the presence of the PCL-R data that had been recently completed via chart review, since Mr. Williams declined to meet with them too. Again, an elevated PCL-R score, which Mr. Williams was evaluated to have, is correlated with risk of violence towards others. In addition, generally, a history of prior institutional violence (and Mr. Williams has also engaged in serious, stranger violence in the community), is associated with increased rates of future assaultive behaviors. Given the combination of his past institutional and community violence, severe character pathology, presence of emotion dysregulation, his frequent statements of homicidal intent over the years, and continued threats to harm staff, there is a very high probability, in my opinion, that if Mr. Williams is immediately, directly released to a less restrictive setting at this time then he will represent a high risk of danger towards others. He has not evidenced any improvement in these identified areas of concern. Further, he has not participated in mental health treatment nor available offender change programming which, if he did, could contribute to reducing his future risk of danger towards others. There is no evidence, that I am aware of at this time, to suggest that Mr. Williams could safely navigate a less restrictive setting at this time. I offer this opinion with a high degree of clinical confidence given the risk factors and concerns listed above and described throughout this declaration and in my prior report.
26. Despite these significant barriers to Mr. Williams's progression to a less restrictive setting, I know the Department is committed to continuing to work with Mr. Williams to mitigate the potential risk of danger to allow him to promote to a less restrictive setting.
I declare under the laws of the United States of America that the foregoing is true and correct.
EXHIBIT 1
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