On Monday, a U.S. District Court began hearing arguments in a lawsuit over the allegedly inadequate mental health care provided to inmates of the Alabama Department of Corrections.

The case is part of a larger suit, Braggs, et al. v. Jefferson Dunn, et al. , which also contends that ADOC has failed to provide “constitutionally adequate medical care and failed to comply with the Americans with Disabilities Act. The suit was filed in 2014 by the Southern Poverty Law Center, the Alabama Disabilities Advocacy Program, the national law firm Baker Donelson, and the Birmingham law firm Zarzaur, Mujumdar, and Deborsse on behalf of over 40 inmates in the Alabama prison system.

In March 2016, the plaintiffs reached a settlement with ADOC in the matter of how state prisons comply with the Americans with Disabilities Act. ADOC agreed to take steps to provide ADA-compliant cells, ensure that individuals with disabilities could access programs, implement a better system to identify and track prisoners with disabilities, and create a grievance and appeals process for future ADA claims.

The suit’s other claim, regarding the medical care in Alabama prisons, is expected to be addressed in a separate trial in 2017.

The Alabama Department of Corrections will not be commenting on the lawsuit, the department’s Public Information Manager Bob Horton said in an email.

Central to the plaintiffs’ argument is the allegation that the mental health care staff does not devote enough time to individual prisoners to give effective treatment.

“While the state argues that it’s constantly giving treatment, what it really talks about is just brief contact with people who are going to provide mental health [services] that are really meaningless,”said Lisa Borden, an attorney in Baker Donelson’s Birmingham office. “It’s just like box-checking. Instead of really providing meaningful psychotherapy to people, they’re just driving by their cell and saying, ‘How you doing?’ and giving a lot of medication.”

The reason the department’s mental health care professionals spend so few time with each patient, Borden said, is that “they don’t have enough qualified mental health staff to properly do the job.”

The plaintiff’s proposed findings of fact for trial, filed with the court on November 16, notes that the Alabama Department of Corrections employs just three full-time psychologists, though a previous settlement requires the department to employ 10 psychologists. “With fifteen major prisons in Alabama, a single psychologist is expected to provide ongoing and meaningful treatment to a caseload of prisoners and/or provide meaningful consultation and assistance with diagnostic formulations in nearly five prisons. This is not possible,” the document states.

The Alabama prison system also lacks a sufficient system to diagnose prisoners who have mental illnesses, said James Tucker, director of the Alabama Disabilities Advocacy Program. “Part of our allegation is . . . there is a gross failure to identify individuals who may have a mental health diagnosis and need related medical care, because logically if they’re not identified, they’re not going to get the staff or care that they need,” Tucker said.

The plaintiff’s amended complaint, filed in July 2016, notes that the Alabama Department of Corrections identifies 12.3 percent of the state’s prison population­ — slightly over 3,000 people — as having a “mild impairment” or worse mental illness. However, the complaint notes that in a 2006 study, the U.S. Department of Justice found that, nationally, about half of inmates in state prisons were mentally ill. “This almost certainly indicates that Alabama is not identifying prisoners with mental health disorders,” the complaint argues.

“If you look statistically across the country, other departments of correction have much higher proportions of people who have been identified as mentally ill than Alabama has,” Borden said. “And we’re pretty sure that the reason for that is not that Alabama has fewer mentally ill people in its prisons than any other state. It’s a failure at the very outset of the process to even identify serious mental illnesses and direct those people to treatment.”

Another issue that could feature prominently in the trial is the allegation that inmates have been forcibly medicated against their wills, said Maria Morris, managing attorney of the Southern Poverty Law Center’s Alabama office. Though individuals can, in some cases, be legally medicated against their will, the United States Supreme Court has laid down strict guidelines for when this is and is not permissible. Morris argues that ADOC has not been following those guidelines.

“People aren’t supposed to be forcibly medicated unless they meet certain criteria. They need to be either gravely disabled or a danger to themselves or others. And we’ve found there’s a lot of people who don’t meet either of those criteria,” Morris said. “One of the other things that we’ve seen that we find particularly troubling is that a lot of the time when the Involuntary Medication Committee is looking at whether or not to require someone to be involuntarily medicated, they look at really old information. There’s a lot of reference back to a person’s crime that got them into prison in the first place, even if that was years or decades ago. There’s not a lot of keeping it up-to-date so you’re actually assessing whether this person needs it right now.”

U.S. District Judge Myron Thompson is hearing the case for the Middle District of Alabama. In late November, Thompson ruled that the case could be heard as a class action lawsuit on behalf of all Alabama prisoners, based on the fact that there was evidence of “deliberate indifference” by the department to the mental health care of inmates.

Thompson’s decision to allow the case to be tried as a class action lawsuit is significant, according to Morris, because it ensures that, should the judge find in favor of the plaintiffs, his rulings on mental health care in Alabama prisons will apply not only to the plaintiffs but to all inmates in the state prison system. Since the case is now a class action lawsuit, “it is clear that this is about the care that’s being provided throughout the entire system,” not just the alleged mistreatment of the individual plaintiffs, Morris said.