A psychiatrist told a judge Thursday that mental health treatment at the New Orleans jail remains lacking in many respects and is “abysmal with regard to crisis management,” bolstering the federal government’s claim that conditions at the lockup are so bad they violate inmates’ constitutional rights.

Dr. Raymond F. Patterson, a well-known mental health expert, testified in U.S. District Court that mentally ill inmates are in grave danger because Orleans Parish Sheriff Marlin Gusman has not implemented a series of court-ordered reforms.

Those reforms were outlined in a federal consent decree the sheriff signed more than three years ago with the U.S. Justice Department, the result of a class-action lawsuit filed by inmates.

“They house acutely mentally ill inmates but ... they certainly don’t treat them,” Patterson told U.S. District Judge Lance Africk, citing a recent suicide in which an inmate hanged himself inside a shower facility.

Patterson testified on the second day of a hearing that will determine whether Gusman will remain in control of the jail, known now as the Orleans Justice Center. The Justice Department asked Africk last month to appoint an outside administrator to manage the facility, arguing that “urgent” measures are needed to protect inmates.

The Justice Department, joined by the MacArthur Justice Center, a civil rights law firm that represents the inmates, has called a number of experts to the witness stand this week to describe the disarray inside the new jail, which remains severely understaffed.

Due to a lack of trained deputies, hundreds of New Orleans inmates are being housed in jails in other parishes, some of them several hours away from the city.

Patterson acknowledged that the Sheriff’s Office has made some progress in mental health treatment. The most severely ill inmates are being housed now at a renovated state prison facility in St. Gabriel.

But he pointed out a number of shortcomings. For instance, the newly opened facility has no suicide-resistant cells, even though more than a dozen inmates are on suicide watch. The facility has two cells dedicated to the observation of suicidal inmates, but they are not yet properly furnished.

Patterson also reiterated his frustrations, first voiced earlier this year, about the death of Cleveland Tumblin, a 63-year-old bipolar man who took his life in March after locking himself inside a shower facility. Patterson expressed outrage that the new jail had been constructed with locks on the inside of the shower doors — something he said he has never encountered in any other correctional setting.

He said Tumblin might have lived had it not taken so long to get to him. A nurse had to crawl under the door and cut him down using scissors; he was later pronounced dead at a hospital. “The man is dead,” Patterson said. “It’s too late for him.”

James Williams, a Sheriff’s Office attorney, asked Patterson if he could point to any correctional literature that advise jails against installing locks inside the showers. Williams suggested the locks could protect inmates against sexual assaults while showering.

“It is such a common sense issue I don’t know if anyone has written about it,” Patterson said. “It is such a fundamental practice.”

Gusman has proposed constructing another jail building to house so-called special-needs inmates, including those who are mentally ill. Mayor Mitch Landrieu’s administration has opposed the project, insisting it is not needed.

The city and the Sheriff’s Office also have clashed on the price tag of the reforms. Gusman says his progress in implementing the consent decree has been stymied by inadequate funding from city leaders.

“The reality that the (Sheriff’s Office) faces every day is that individuals are placed in our custody who have violent histories and mental and physical health issues,” the sheriff said in a statement. “We have to care for them in the safest way possible but without the funds to do so. That is the reality.”

The Justice Department continued its argument Thursday that Gusman has not been in control of the new jail since it opened in September.

One government witnesses, Darnley R. Hodge, a retired jail administrator, described chaotic conditions that he observed inside the lockup the day after it opened.

He recalled seeing a cell of naked inmates, some of whom were sleeping on the floor and none of whom had access to toilet paper. “I saw one inmate use his bare hand as toilet paper,” Hodge said.

The elevators and computers in the facility also were not working at the time, Hodge said, adding it appeared the Sheriff’s Office had opened the jail too soon.

“It seems that staff did not have psychological control of the facility,” Hodge said, “and as a result, they did not have physical control of the facility.”

Africk also heard testimony about inmates’ medical care, one of the many areas for which the Sheriff’s Office has been criticized.

Bob Greifinger, a New York doctor who has monitored medical care at the jail under the consent decree, credited the Sheriff’s Office for making strides, particularly in its hiring of a third-party provider, Correct Care Solutions. Still, Greifinger said, the jail has a “fairly substantial way to go,” adding that far too many inmates still are missing medical appointments.

He likened the Sheriff’s Office to a child learning to ride a bike with training wheels.

Follow Jim Mustian on Twitter, @JimMustian.