Experts: Remedies costly for mental health crisis

JONESBORO - Each year, 2 million people with serious mental illnesses are admitted to jails across the nation - a rate that's three to six times higher than that of the general public. Once incarcerated, individuals with mental illnesses stay longer in jail and are at a higher risk of returning to incarceration than those without mental illness.

That's according to Richard Cho, director of behavioral health for the Council of State Governments Justice Center, who said the mental health crisis in our prisons and jails comes down to several societal failures.

"Law enforcement can't treat a mental health issue," Cho said. "The courts aren't able to recognize mental illness. The mentally ill can't represent their cases, and they end up sitting in jail two times longer than the normal person awaiting trial. The jails can't provide treatment, and they get into behavioral issues. When they get out of jail, they are most likely to end up back there without any support."

Rick Thomas, Craighead County Sheriff's Office chief deputy, said law enforcement interacts almost daily with someone who is suffering from mental illness.

"We just picked up someone from St. Bernards not too long ago," Thomas said. "We just transported another patient to St. Vincent, and I think we had someone do screening today as well. We are intertwined into the process."

In February 2016, County Judge Ed Hill and Craighead County Sheriff Marty Boyd decided it was time for a change.

Craighead County is one of 320 counties that have joined the Stepping Up Initiative to reduce the number of people with mental illness in jail. It is led by the National Association of Counties, The Council of State Governments Justice Center and the American Psychiatric Association Foundation.

Allen Houston, a spokesman for the Council of State Governments Justice Center, said those counties are united under one central truth: "Jails should no longer be de facto psychiatric facilities."

To help achieve this, The Council of State Governments Justice Center will release a product Wednesday that provides counties with a map to reducing the number of people with mental illnesses in jails.

Cho said the basis of his plan will require help from not only law enforcement but also the community.

"The elephant in the room is the lack of community mental health systems all across the country," Cho said. "We need people with adequate training in the justice system to recognize those behavioral patterns and get them out of the system. Frankly, some people might need supervision. The starting point could be a good case manager."

First and foremost, Cho said, is identifying mental illness at the county level.

"We need to have data," Cho said. "We need to be able to see how many mentally ill people there are, where they are at, are they receiving their treatment? Then we need to put a lot of focus on mental health courts. We need more diversion options on the front end. We need to be able to have law enforcement officers divert these patients to a facility instead of a jail. We need pretrial diversion options. They should be diverted without going to trial."

Craighead County is ahead of most counties when it comes to mental health awareness. The county already developed a mental health court in coordination with the 2nd Judicial District and Mid-South Health Systems, which helps individuals stay out of jail by offering mental health and substance abuse treatment.

Thomas said the jail does its best to address the needs of mental health patients.

"We do have hospital cells where they can be monitored 24/7, and they have a special suicide gown that prevents them from harming themselves," Thomas said. "We hold them here until the prosecutor's office makes a decision to where they should go. We have 24-hour medical staff here that can be called."

The hospital cell room is one large open area that has two guards on duty and a clear line of sight at a series of cells where inmates are held. There are eight hospital cells and two tanks where jailers can put people who are suffering from a mental illness.

"We don't have any padded cells, but we are doing the best we can," Thomas said. "We built onto the jail for the exact purpose of addressing the issue of mental health in the jails."

Cho said what Craighead County is doing is admirable, but it will be up to the community to make real change.

"To have more capacity in jails is great," Cho said. "What is needed now is services in the community. Part of that will be the jail having a partner in the community to help avoid them going back to the jails. Other community-based services would be needed to help find a way to fund treatment for these people. Criminal justice can't solve this on their own. Also having a crisis center would be promising."

Matt Knight, director of education and marketing for Mid-South, agrees that crisis centers are a great solution.

"There is a push to have crisis units across the state," Knight said. "It would offer a place for immediate observation. It would also allow them to be stabilized, evaluated and then decide what the next step is. It would provide another level of care."

Knight said adding multiple crisis centers across the state could be a huge step toward addressing the mental health issue, but he said it takes money to build them.