Bedlam: Mentally Ill Trapped In Bulging County Jail

New program seeks to help disturbed inmates after release

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In Gila County jails, a prisoner goes on suicide watch nearly every day.

“Weekends are the worst,” said Sheriff’s Lt. Swede Carlson, with people banging their heads against walls or biting themselves. One inmate has bitten chunks of his skin off.

In a crisis, jail officials call one of the behavioral health agencies they work with and — as Carlson said — “get ’er done.”

“We’re not trained for mental health,” he said.

These prisoners eventually exit jail and often commit new crimes, sometimes in the midst of mania, and land back behind bars.

“Some people get out of jail and they have no supports. They may be homeless or have substance abuse issues — so what is likely to happen without help? They end up back in jail,” said Andrea Hartwig, emergency services liaison for Cenpatico.

Cenpatico contracts with the state to serve the Medicaid population, and works with local organizations like Rim Guidance and Community Bridges. It also coordinates with the Sheriff’s office to provide services for people with mental illness or substance abuse issues.

“Addiction is not automatically a mental health issue,” said Carlson.

Hartwig brought to Gila County the prisoner review team. The concept, used in Yuma County, involves a team of mental health professionals and sheriff’s officials identifying a care plan for mentally ill prisoners that will ultimately — they hope — reduce recidivism rates.

“It’s a very new concept,” Hartwig said.

One recent study from the Virginia-based Treatment Advocacy Center found that a severely mentally ill person is three times more likely to spend time in jail than in a psychiatric hospital. In Arizona, jails hold 10 times more mentally ill people than hospitals.

Carlson estimated Gila County’s rate lower — with roughly 5 percent of the 160 inmates mentally ill.

The prisoner review team meets monthly, and discusses anywhere from two to four prisoners. The team organizes substance abuse or mental health counseling for inmates upon release, and also “natural supports” — a homeless inmate might receive advice to think about family members he could potentially live with, for instance.

Although Cenpatico doesn’t provide mental health services in jails, the agency does have a mobile crisis team that provides short-term intervention for prisoners.

Funding also allows the agency to work with inmates up to 30 days before release. This eases the path to treatment upon release — because upon release, no jail official is standing ready with a phone to call the mobile crisis team.

The prisoner review team formed last September, and numbers of those helped aren’t yet available. It’s progressing slowly. Much of the beginning stages involved outlining everybody’s roles and responsibilities. The county attorney also had to review everything to ensure legality.

The program costs nothing except for the time and travel people spend on it. Hartwig said Cenpatico organizes the prisoner review team as a community service.

Ultimately, the goal is to reduce recidivism rates. Among those incarcerated across the country, 16 percent of inmates are thought to have serious mental illness, according to a press release by the Treatment Advocacy Center.

However since 1955, the number of people in state psychiatric hospitals has dropped nearly 93 percent to 40,000, according to the Yuma County Sheriff’s Office. Yet, the number of mentally ill prisoners has grown by more than 400 percent.

“Jails have effectively become America’s new mental institutions,” wrote Yuma Sheriff’s Lt. J.D. Lackie in a department bulletin article.

Statistically, a person with a mental illness spends three times longer wading through the legal process, which triples the cost of housing and medical services, Lackie wrote.

These people are often jobless and homeless, but the prisoner review team seeks to end the cycle.

Those interviewed for this article remained optimistic about the effort’s future, and Hartwig is even working to start a mental health court in Gila County.

Several models exist, but the idea resembles drug court where a person can get treatment in exchange for having charges removed pending a successful outcome.

“People can get better and people do get better,” said Hartwig. “Recovery is possible for everyone.”

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