In most parts of Men's Central Jail, there is no natural light, only views of cell bars or scrums of inmates crowded in bunk beds pushed together end to end.
Toilets back up because of the antiquated 50-year-old plumbing system. Many men get out of their cells for only three hours a week. All the while, they have to remain vigilant to avoid attacks from other prisoners and, in some cases, the deputies who guard them.
For people who already are mentally ill, as more than 10% of Men's Central Jail inmates are, the overcrowded, dungeon-like environment can push them closer to the edge of suicide.
Under a settlement reached with the federal government this week, the Los Angeles County Sheriff's Department agreed to sweeping reforms of the county's jails in an effort to end deputy abuse and improve conditions for the mentally ill.
But, jail officials say, they won't be able to eliminate the suicide risks caused by the aging and poorly designed Men's Central Jail, which houses 4,000 of the county's 17,000 inmates.
"MCJ in and of itself is a risk factor. It's a depressive environment," said Assistant Sheriff Terri McDonald, who is in charge of the jails.
Currently, there is a shortage of mental health beds throughout the jail system. County supervisors plan to eventually replace Men's Central Jail with a new facility focused on mental health treatment, but they have delayed the process to reconsider its size.
Until the new jail is built, thousands of inmates remain at risk in an environment described in a 2014 federal report on suicides as "dimly lit, vermin-infested, noisy, unsanitary, cramped and crowded."
"I believe the conditions at MCJ are indefensible," said Supervisor
There were 10 suicides in the county jails in 2013, a twofold increase over the previous year. Almost all were hangings, and most took place in Men's Central Jail, according to coroner's reports.
As part of the settlement agreement, which will be overseen by an independent monitor and a federal judge, the Sheriff's Department must reduce suicide hazards — for example, by getting rid of ventilation grates or light fixtures where an inmate could loop a noose.
McDonald hopes that sprucing up Men's Central Jail will relieve some of the oppressiveness that can worsen the despair of suicidal inmates. In a recently renovated wing, she pointed to the freshly painted baby-blue cell bars and the new toilets.
"We're trying to not make the inmates feel it's so hopeless down in the tiers," she said during an April tour of the jail.
But for all the improvements, Men's Central Jail will still resemble a medieval dungeon more than a modern correctional facility.
While some inmates are housed in dorms, others are in cells fronted by old-fashioned metal bars that can be used as anchors for hangings. The cells are lined up side by side along narrow tiers, making it difficult for guards to keep an eye on inmates.
The new jail will be designed with fewer suicide hazards and be configured around central observation areas where guards can monitor many inmates at once.
There is also the question of who should be in Men's Central Jail in the first place. In anticipation of the federal settlement, the Sheriff's Department improved its sharing of arrest records and mental health histories with jail staff to make sure that inmates at risk of committing suicide are properly identified.
Such measures might have prevented the death of an LAPD detective's 23-year-old son who told intake staffers of a previous suicide attempt and his history of psychosis and hallucinations only to be assigned to Men's Central Jail rather than mental health housing. After other inmates complained twice about his strange behavior, a deputy put him in a single-man cell, where he hung himself on Sept. 30, 2013, using a sheet wrapped around an air purifier, according to a lawsuit filed by his family.
In a similar case, a 58-year-old former NASA engineer who had threatened suicide before he was arrested did not receive psychiatric medication and was eventually moved to an isolation cell, where he used a torn blanket hanging from a light fixture to kill himself on April 25, 2013.
The families of both men recently reached tentative settlements with the county in civil litigation for undisclosed amounts.
After the Department of Justice came out with its June 2014 report on preventable jail suicides, the pattern continued, according to coroner's records, even though there were fewer suicides overall. Of the five suicides that occurred in 2014, three involved inmates who were placed in the general population at Men's Central Jail despite histories of mental illness and prior suicide attempts, according to coroner's records.
Among other things, the federal settlement requires training for jail staff on how to identify and handle suicidal inmates, safety checks every 15 or 30 minutes in mental health wards, and 20 hours of out-of-cell time per week for mentally ill inmates. The Board of Supervisors has approved funding for hundreds of additional jail deputies, but it will take time to hire them.
County officials are pushing for more programs that would divert some people to treatment centers instead of jail, but in the meantime there are not enough mental health beds in the jails. About 20% of county jail inmates are classified as mentally ill, and the number is growing.
Psychiatric beds are allocated to the sickest, while some inmates on psychiatric medication are placed in the general population at Men's Central Jail. Some parts of the Twin Towers Correctional Facility, the county's main mental health jail, are overcrowded, putting troubled inmates under stress that they are not equipped to handle.
"They're already rather fragile and don't have good problem-solving skills, and the crowding causes them to act out and become suicidal or self-abusive," McDonald said.
The new Men's Central Jail will have a different and kinder name: Consolidated Correctional Treatment Facility.
Its design, too, will be radically different from the current facility. Instead of cells with bars on the doors, there will be open areas and classrooms with a focus on helping inmates with the mental health and substance abuse problems that may have led them to commit crimes.
But the new jail will take six to eight years to complete and about $2 billion to build. The supervisors are still deciding how big it should be as they develop alternatives to incarceration, including mental health facilities in the community.
"There can be a discussion about what to do with the mentally ill who are in the jails, but the superior discussion, I believe, is how to keep mentally ill persons from being incarcerated in the first place," Ridley-Thomas said.
The challenges of caring for inmates in the existing jail facilities are real, but those physical limitations should not be used as an excuse, and the county needs to get serious about mental health diversion programs, said Peter Eliasberg, legal director of the ACLU of Southern California.
"These are constitutional minimums. I don't accept that you can't get to those constitutional floors with the facilities that currently exist," he said.