Opinion ID: 4531499
Heading Depth: 3
Heading Rank: 1

Heading: Official Policy

Text: “[W]hen an injury is caused by the straightforward carrying out of a municipal policy or custom, the determination of causation is easy.” Morgan, 903 F.3d at 566 (citing Garner v. Memphis Police Dep’t, 8 F.3d 358, 364–65 (6th Cir. 1993)). The plaintiff must “identify the policy, connect the policy to the [municipality] itself and show that the particular injury was incurred because of the execution of that policy.” Garner, 8 F.3d at 364 (quoting Coogan v. City of Wixom, 820 F.2d 170, 176 (6th Cir. 1987)); Morgan, 903 F.3d at 566 (same). Andrews offers several arguments for why the 2012 KOP Policy was “clearly constitutionally defective and just as plainly caused [White’s] death.” 4 The County’s argument that the deliberate indifference standard applies to official policy claims is untenable, as Arrington-Bey and Morgan make clear. No. 19-1992 Andrews v. Wayne Cty., Mich. Page 10
Andrews argues that the KOP Policy is defective on its face for three reasons. First, it is based on where the inmate is housed and not upon the inmate’s condition. Second, the KOP Policy does not require a suicide risk assessment prior to participation in the program. Third, the policy does not contain an automatic exclusion for individuals with a mental health history or who have previously attempted suicide. Andrews’ first assertion is flawed because, as the district court observed, it glosses over the fact that the KOP Policy does not dictate where an inmate is housed; the Jail staff make that decision, based upon an individualized assessment of the inmate. And, even if a patient otherwise qualifies for the program because she is housed in the general population, the Policy allows the Jail personnel “to restrict self administration privileges to any inmate if necessary, to assure the safety and security of the patient.” Dr. Clafton also attested to this discretion. Carnill said the same—that the KOP did not restrict him from deeming White ineligible for the KOP if he perceived that White might be a danger to herself. The district court correctly rejected this argument. Andrews’ second argument fails because, as noted, a pretrial detainee does not have an automatic right to a suicide screening. See Gray, 399 F.3d at 616. As for the third argument, Andrews offers no explanation why a past suicide attempt makes a current one “clearly foreseeable” such that an automatic exclusion was required.6 In fact, this court has held that a prison official’s duty to recognize an inmate’s risk of committing suicide has a temporal component. See Linden v. Washtenaw Cty., 167 F. App’x 410, 421 (6th Cir. 2006) (holding that to be held liable, “a prison official must be cognizant of the significant likelihood that an inmate may imminently seek to take his own life”) (quoting Estate of Novack ex rel. Turbin v. Cty. of Wood, 226 F.3d 525, 529 (7th Cir. 2000)). In short, the KOP Policy is not defective on its face. 5 We have reordered Andrews’ arguments somewhat. 6 The Jail did not have White’s mental health history. No. 19-1992 Andrews v. Wayne Cty., Mich. Page 11
Andrews contends that the County deliberately changed its KOP policy in 2012 without justification or basis to allow individuals taking psychotropic drugs to participate. Under the 2009 version, White would have been automatically excluded from the KOP program because she was taking two psychotropic medications, Klonopin and Lexapro. Andrews points out that Dr. Clafton, the Jail’s Medical Director, thought that the policy change was probably to clarify a “poorly worded” policy which according to Andrews is a poor reason to implement a policy that allows vulnerable persons to retain dangerous medications. But Dr. Dlugokinski, who also signed off on the 2012 policy change along with Dr. Clafton, explained that the revision was a conscious, collective decision by the policy team, who wanted to “include the mental health patients and provide them with a greater opportunity to participate in their own treatment, . . . [and] be responsible and accountable as they do now on the outside to take their own medication if they were not ill such that they needed housing on the mental health unit.” Dr. Clafton also confirmed that the intake staff have discretion to exclude persons from the KOP program. This was Carnill’s understanding as well. Furthermore, the explicit exclusion for safety purposes in the 2012 KOP Policy adds an important safeguard. Thus, although the 2012 version of the KOP Policy is more inclusive than the 2009 version, it cannot be said that the revision was constitutionally irresponsible. Thus, as the district court held, the County provided an adequate reason for changing the KOP policy. 3. Allowing Participation Before a Mental Health Evaluation Andrews contends that the KOP Policy is deficient because it allows inmates in need of a psychological evaluation like White to participate prior to the psychiatrist’s assessment of proper housing. Only a psychiatrist can place an inmate on the mental health unit. But Carnill testified that he referred White for further mental health evaluation with a social worker because “she was on medication for depression and anxiety,” not because she reported or exhibited any psychiatric distress. Carnill could have restricted access to all No. 19-1992 Andrews v. Wayne Cty., Mich. Page 12 medications under the KOP Policy but exercised his discretion not to. Again, White did not have an automatic right to a suicide screening. The absence of a blanket exclusion for “unsettled” inmates does not render the KOP Policy constitutionally defective. 4. Failure to Act as a Backstop Andrews maintains that the KOP Policy is constitutionally defective because it did not catch mistakes in the intake process. He points out that had Carnill reviewed the intake form, he would have learned that White had attempted suicide in the past. Furthermore, the answers recorded on White’s intake form were incomplete or inconsistent. This argument fails to persuade because it is essentially a repurposing of Andrews’ arguments that the KOP Policy should require suicide risk assessments as a matter of course and should automatically exclude persons with any sort of mental health history. What Andrews is really complaining about is the adequacy of the intake screening process. This allegation is better characterized as a failure to train claim against the County, and to that extent will be addressed infra. 5. Restricted Drug List Andrews argues that the 2012 KOP policy ignored the serious medical needs of inmates because it restricted Catapres but not Verapamil. Dr. Dlugokinski testified that Catapres was on the list because it was a hot commodity in the prison due to its sedative effects. Both Dr. Dlugokinski and Dr. Clafton testified that Verapamil, while also a blood pressure medication, did not share the same side effect, so it was not considered subject to abuse by inmates. Andrews did not offer any evidence to the contrary. Thus, its absence from the restricted drug list cannot be characterized as a constitutional violation. In sum, none of the foregoing factors, individually or collectively, create a genuine issue of fact regarding the constitutionality of the KOP policy and its application to White. The district court did not err in granting summary judgment to the County on Andrews’ official policy claim. No. 19-1992 Andrews v. Wayne Cty., Mich. Page 13