MONTGOMERY, Ala. (AP) — A federal judge on Monday said Alabama has been “deliberately indifferent” about monitoring the mental health of state inmates placed in the isolation of segregation cells.

U.S. District Judge Myron Thompson issued the ruling days after attorneys for inmates said the suicide rate in state prisons has reached a crisis level.

“The court finds that the (Alabama prison system’s) failure to provide adequate periodic mental-health assessments of prisoners in segregation creates a substantial risk of serious harm for those prisoners,” Thompson wrote in the 66-page order.

Thompson wrote that prison officials have been “deliberately indifferent with regard to their failure to provide adequate periodic evaluations of mental health to prisoners in segregation.”

Alabama Department of Corrections spokesman Bob Horton said the department is reviewing the decision.

Thompson did not issue an immediate remedy.

Thompson in 2017 wrote that mental health care in state prisons was “horrendously inadequate.”

The Southern Poverty Law Center, which is representing inmates in the ongoing class-action lawsuit over prison mental health care, said Friday that there have been 13 suicides in 14 months. The organization said most of the men who killed themselves in state custody had known mental health conditions.

“People are killing themselves in our prisons because conditions are horrendous,” Southern Poverty Law Center President Richard Cohen said at a news conference with the families of inmates.

The prison system said in a response Friday that it was working to address the issue, and said the suicide spike “calls into question the long-term effectiveness of the suicide prevention measures proposed by the SPLC” during the litigation.