They were sexually assaulted in prison. An overwhelmed mental health system failed to help

On the back of a sexual abuse pamphlet, Amanda Cortez wrote a letter about the man she says raped her.

Cortez was incarcerated at FMC Carswell, a federal prison in Fort Worth, when she says a lieutenant at the facility raped her repeatedly from May to August 2019.

“Please let the world know what happens behind bars,” she wrote in the letter to the Star-Telegram. “I am a victim and I want to give a message.”

In a manila envelope, Cortez included copies of emails she wrote to family members and staff at Carswell and FPC Alderson — the West Virginia federal prison she was transferred to in November 2019. Cortez reported the lieutenant she says sexually assaulted her, and, according to emails she wrote to family members at the time, he was walked off the compound in February 2020.

Cortez, who was incarcerated at FCI Tallahassee as of July 2022, still does not know what happened to her alleged abuser. The Star-Telegram did not locate any records indicating the man was ever charged.

In response to questions about the lieutenant and whether he was investigated for sexual misconduct, the Bureau of Prisons said the agency “does not provide information relating to investigations.”

According to Bureau of Prisons policy, victims of sexual abuse should receive timely and effective responses to “their physical, psychological, and security needs.” In response to questions from the Star-Telegram, a Bureau of Prisons spokesperson said in an emailed statement that the bureau provides mental health treatment through psychologists including individual counseling, group therapy, assessment, and crisis intervention that may take place in outpatient, residential or inpatient settings.

“Every inmate and pretrial detainee in a BOP facility has daily and regular access to Health Services and Psychology Services staff,” the statement said.

But Cortez, and other sexual assault survivors at Carswell, say the Bureau of Prisons failed them twice — first when they were sexually assaulted on the agency’s watch, and again when they did not receive mental health care to deal with trauma from the assaults.

“I feel that FBOP Carswell did not keep me safe,” Cortez wrote in a letter to the Star-Telegram dated Dec. 16, 2019. “And I had to deal with threats from my perpetrator… I felt completely helpless, frightened and numb.”

Advocates say prisons across the country often do not have the resources to provide mental health care for incarcerated people.

“What we hear from both incarcerated people and mental health staff working inside prisons is they do not have the staff they need,” said Linda McFarlane, executive director of the human rights organization Just Detention International. “They have huge caseloads. What people are able to access is basically triage — it’s suicide care for acute mental illness.”

Trauma for survivors

The Bureau of Prisons is required to provide mental health services to people who are incarcerated. According to the agency’s program statement on mental health needs, incarcerated people with mental illness should be identified and receive treatment to assist with their progress toward recovery, while reducing the frequency and severity of symptoms and negative outcomes, such as suicide attempts.

That treatment is essential for survivors of sexual assault, McFarlane said. After someone is assaulted, victims may experience a heightened state of anxiety and see potential danger everywhere.

Cortez described her worsening post-traumatic stress disorder symptoms from October 2019 to March 2020 in emails to staff and family members.

“I keep re-experiencing what happened to me,” she wrote in her letter to the Star-Telegram. “I have bad dreams, I have distressing memories of it and I do not understand why I sometimes feel like it’s happening again all over. My heart starts racing and I am emotional, sometimes physically distressed. I start crying out of nowhere uncontrollably and feel highly anxious.”

People who have been sexually assaulted may feel a loss of control, McFarlane said, and they might try to regain that control somehow. But when someone is assaulted in prison, their life remains dictated by others. If the victim remains in prison, the person may feel like they could be attacked again at any time. For example, Cortez described how even the sound of the jingling keys that staff carried in the facility triggered her anxiety, because the noise reminded her of her abuser.

Existing mental health issues may become worse for sexual assault survivors who do not receive mental health treatment, McFarlane said — people who have depression may become suicidal, for example.

“I am hopeless and sometimes I feel like giving up,” Cortez wrote in her letter to the Star-Telegram. “I think maybe if I just die I won’t have to deal with this pain, this hurt, this damage. But then my children… My family come to mind and I push through the thoughts. The truth is I have tried committing suicide. I told no one — only God knows. I feel so worthless, so dirty. I can still feel him. I hate it. Please. Help.”

Cry for help

After Cortez reported the assault, she said Carswell coordinated counseling for her with rape crisis counselors at the Tarrant County Women’s Center. But when Cortez transferred from FMC Carswell to FPC Alderson in late 2019, she was not able to talk with her counselor anymore, according to emails Cortez shared with the Star-Telegram.

According to emails to FPC Alderson staff that Cortez shared, she repeatedly asked to meet with a psychologist for over a month in December and January 2019.

In an email to FPC Alderson’s psychology department on Dec. 7, 2019, Cortez wrote she was a rape victim from Carswell and needed help; “Please let me know if you can see me asap,” she wrote.

Two days later, she received a response saying she would be put on a list to see the psychologist, but all “concerns related to the PREA incident” would need to be addressed with the associate warden. PREA, or the Prison Rape Elimination Act, is the reporting policy used in federal prisons for sexual assaults.

Three weeks later on Dec. 26, 2019, Cortez wrote another email to “all staff” at FPC Alderson. She said she still needed help with panic attacks and asked to talk to the counselor she previously spoke to while at FMC Carswell.

“Please I’m at your mercy and grace, and I’m asking for help,” she wrote in the email. “No one seems to hear me out and this trauma is getting too much for me to handle and I need professional help.”

The warden at FPC Alderson emailed Cortez back and said FPC Alderson “is in the final stages of renewing the agreement with the local rape crisis center,” and a meeting would be arranged when that was completed. He told Cortez to reach out to the facility’s psychologist, but Cortez wrote in a psychology request on Jan. 3, 2020, that she still had heard nothing from the psychology unit.

“I would like treatment not limited to only medication, but also psychology and direct treatment for PREA/Rape victims by adequate and trained professional in this field of health care,” she wrote in the request.

In a response to Cortez’s request, a staff member wrote that Cortez was prescribed medication on Jan. 6 and told her — once again — to follow up with psychology services.

‘No safety net’

Cortez was able to speak to a rape crisis counselor while she was at Carswell because the facility coordinated with the Tarrant County Women’s Center. Internal, in-person counseling services from Carswell’s psychology unit are more difficult to come by, according to women at the prison.

Carswell is the only federal medical facility for women in the country, and the prison’s mental health unit houses some of the most vulnerable and most mentally ill women in the federal prison system. But the prison has insufficient staffing and a lack of training for staff in the mental health unit, according to a whistleblower complaint filed by Carswell’s union president in July. Those issues have led to “several assaults, medical emergencies and disturbances” in the mental health unit in the past few months, according to the whistleblower complaint.

The facility also has a vacant forensic psychologist position that the Bureau of Prisons has refused to fill, according to the whistleblower complaint. The federal prison system as a whole has faced staff shortages for years, according to a report from the Government Accountability Office, resulting in fewer resources for those who need mental health care. From 2001 to 2019, suicides in federal prisons increased 61%, according to a 2021 report from the Department of Justice.

Windy Panzo, a woman incarcerated at FMC Carswell, said insufficient staffing at Carswell has kept her from being able to see a psychologist. Panzo, 54, requested to see a psychologist in June. She has been dealing with PTSD for four years, but her trauma worsened in June, when she found out the former Bureau of Prisons’ staffer who assaulted her had been charged with sexually assaulting another woman.

In February, James Theodore Highhouse was convicted of five felonies for sexually abusing a woman at FCI Dublin and lying to federal agents during their investigation into his misconduct. Highhouse was a chaplain at the California prison when Panzo was incarcerated there. He was tasked with providing spiritual guidance to women at FCI Dublin, but instead, Panzo said, he manipulated and took advantage of her emotionally and sexually from September 2017 through April 2018.

According to court documents, federal authorities said they have evidence that Highhouse subjected at least five women, including Panzo, to sexual abuse or unwanted sexual conduct. Because Highhouse took a plea deal related to one victim, he was not charged with assaulting Panzo or the other victims.

Panzo said federal investigators started interviewing her about Highhouse’s abuse in July, and she has been having increasing PTSD and anxiety about what happened to her.

“I can’t stop feeling like I am still trapped in (the) feeding grounds of predators who would love nothing more than to get a hold of me and rip me apart,” she wrote in an email to the Star-Telegram.

However, she said she has not been able to see a counselor at Carswell. Staff in the psychology unit, she said, have told her they have no room for her in the schedule.

On Wednesday, Panzo was preparing to listen to Highhouse’s sentencing hearing over the phone. She was anxious, but had no one at the prison to talk to about her mental health.

“They dropped the ball,” she said. “So I’m walking around with no safety net.”

At about 4 p.m., Panzo — after stressing throughout the day — found out Highhouse’s sentencing had been rescheduled to Aug. 31.

Needed policy changes

People with ongoing trauma do not often have the consistent care from experts that they need, McFarlane said, and some Bureau of Prisons policies actually further traumatize victims.

For example, when the lieutenant who raped Betzabel Banda-Martinez at FMC Carswell in 2021 was investigated, Banda-Martinez was transferred to another facility. She was not able to grab her belongings, tell her family she was being transferred or say no to the transfer, she said. Banda-Martinez was incarcerated at a prison in Alabama as of August 2022, far from from her family in Dallas-Fort Worth. Lt. Luis Curiel pleaded guilty to sexually assaulting Banda-Martinez and two other women in October 2021.

Cortez, on the other hand, requested to transfer to another prison or be put into protective custody after she reported the alleged assaults. In emails to the special investigative supervisor at Carswell, she said other women at the prison and staff started to harass her and she was constantly afraid for her safety.

McFarlane said Bureau of Prisons policies should be survivor-centered, meaning one-size-fits-all approaches should instead focus on what would be best in individual cases.

However, she said, policies and procedures are only the first steps. A culture shift within correctional facilities and strong leadership are also needed to help survivors of sexual abuse.

On March 13, 2020, Cortez emailed the associate warden at FPC Alderson and said she spoke with the Family Refuge Center, which coordinates with FPC Alderson to provide counseling for some incarcerated people. She asked if she could visit the center in-person rather than speak on the phone with a counselor.

“I relive this every day and I will have to live with what happened to me every day of my life,” she wrote in the email, a copy of which she sent to the Star-Telegram. “I’m on edge, I am constantly living in fear of being hurt, raped again… Please be understanding with me and the situation I am in.”

In response, the associate warden wrote in an email that Cortez could not visit the center because it was against Bureau of Prisons policy.