Jail called no place for the mentally ill

Humboldt County Correctional Facility. Photo from WikiCommons

Humboldt County Correctional Facility. Photo from WikiCommons


Paul Mann
Mad River Union

EUREKA – County law enforcement and mental health officials say multi-pronged action is needed to keep the mentally ill out of jail in favor of medical treatment and stable living conditions.

By default, they underscore, society has allowed jails to become unsuitable mental health service providers.

What sufferers desperately need are urgent care centers, intensive case management services and crisis sanctuaries for those with mental illness who need a brief respite.

Ideally, too, Humboldt County should have a mental health court, a veterans court and adequate mental health community housing, which “plays a huge role in [crime] prevention.”

Properly trained police can provide the first step in recovery, county authorities add. Law enforcement should be bolstered with the “dual deployment” of a safety officer and a mental health professional when an incident occurs. Together, they can defuse potentially violent behavior while at the same time conducting an immediate medical evaluation.

Then, they can decide on the spot whether to channel a troubled person into medical treatment or into jail.

These and other reform alternatives were aired last week at a two-hour forum on the “Intersection of Criminal Justice and Mental Illness” at the United Congregational Christian Church in Eureka, organized by the League of Women Voters and the Humboldt chapter of the National Alliance on Mental Illness.

An audience of some 120 people heard from a panel of experts: veteran Public Defender Kevin Robinson, County Mental Health Clinical Psychologist Mark Lamers, long-time Chief Probation Officer Bill Damiano, Eureka City Police Chief Andy Mills and District Attorney Maggie Fleming.

“The criminal justice system is a very blunt instrument for providing treatment for the mentally ill,” Public Defender Robinson began by saying. Neither the court system nor the jail system is equipped for such treatment, he said, which rightfully belongs in medical institutions, not in the criminal justice system.

Yet mental health cases are common in the local court system. District Attorney Fleming said chronic mental health sufferers turn up all the time on city streets and in the criminal justice system. Diverting the mentally ill out of corrections can be problematic because the illness of a given defendant may not emerge until after a case goes to court, she added.

“Our system is not well set up” to deal with the mentally infirm who commit only minor misdemeanor offenses, Fleming said. Accordingly, her office attempts to coordinate with defense attorneys, judges and probation officers to arrange a misdemeanor term of supervised probation, case by case. Supervision helps ensure that treatment is maintained and the case doesn’t return to the jail and the courts.

Mental health demands are heavy on both the Department of Health and Human Services and law enforcement. Lamers, the department’s supervising clinician, estimates that Humboldt County – population 134,623 – is home to 1,500 to 2,000 people with schizophrenia and 6,000 to 8,000 persons with bipolar disorder.

The county suicide rate is more than four times the state average, owing to what the coroner’s office calls Humboldt’s “horrible drug and alcohol problem” (Union, May 6, p. A1). Consequently “dual diagnosis” – dealing with a person suffering from both mental illness and substance abuse – is a frequent and intractable problem, complicating both law enforcement and medical treatment.

The numbers are staggering. The U.S. Justice Department estimates that more than 64 percent of local jail inmates have symptoms of serious mental illnesses.

Both Lamers and Robinson highlighted the fact that when it comes to mental health care, history has been the enemy despite society’s good intentions.

“One of the things we’re seeing here is the consequence of social decisions that were made decades ago, when it was recognized that the state mental hospital system wasn’t working,” Lamers explained. “There were upwards of 30,000 people in California state hospitals; it was very easy to get in and very difficult to get out.

“Treatment was very unsophisticated by our standards, to put it mildly. It wasn’t just a cost-cutting measure from government that led to the change, but an upwelling of concern about the violation of civil rights of people with mental illness. A social movement developed to ensure that sufferers are accorded the same rights and privileges everyone has. We moved away from the long-term, ‘lock-’em-up-throw-away-the-key’ kind of solution, to try to find community-based solutions that really do work.”

But the reform boomeranged. Now, people with mental illnesses must obtain treatment services of their own volition, consonant with their civil rights. They cannot be ordered by a paternalistic state government to seek treatment.

“This sets up a tremendous conflict,” Lamers stated. “People with only limited insight into the nature of their illness” must act on their own to get medical help, while mental health professionals are forbidden from pressing unduly for treatment.

Said Robinson, “Basically what’s happening today is that the mentally ill are locked up in jail and the jails can’t help them. The jails have really become the mental health providers. It’s our police agencies and our probation officers who are our mental health providers.”

This is reminiscent of the cri de coeur uttered in July by Dallas Police Chief David Brown (who retired last month), after the ambush slaying of five of his officers.

“We’re asking cops to do too much in this country,” he warned. “Every societal failure, we put it off on the cops to solve. Not enough mental health funding, let the cops handle it. Schools fail, let’s give it to the cops ... That’s too much to ask. Policing was never meant to solve all those problems.”

As a model for reform, Robinson held out the example of a diversion framework set forth in August 2015 by Los Angeles County District Attorney Jackie Lacey to channel mentally ill offenders safely away from county jail. In a statement to the board of supervisors, she declared, “A jail environment simply is not conducive to the treatment of a mental illness.”

Lacey proposed a constellation of mental health services, substance abuse treatment, job training and permanent supportive housing. She called for expanded police officer training aimed at “more compassionate and effective interaction with the mentally ill.” She endorsed co-deployment teams of police officers and mental health providers.

The L.A. district attorney conceded it would take a decade to reverse the neglect of mentally ill offenders in her county.

Humboldt Chief Probation Officer Damiano noted that the county has garnered state funding to add a dedicated unit of mental health beds to the county jail, although there is no timetable for its construction. “It’s a big step forward for us,” he said.

Although the county no longer has a mental health court – the grant funding lapsed – “we do have a drug court program that’s been in operation since 1997, which is an excellent program,” Damiano said. “Hundreds and hundreds of people have graduated from it who are still clean, sober and functional today.”

He also pointed out, “We have some new Department of Finance programs for transitional housing for the mentally ill.”   

Lamers added, “Here in our community we are very fortunate that we have a county-run psychiatric hospital, one of only a couple counties in California which have such facilities. Sempervirens hospital has a capacity of 16 patients and we have a crisis unit that serves four people at a time.”

Robinson said resources are needed to deal with mental health crises that break out in jail. He suggested a “Jail Mental Health Team” comprising not only probation staff and correctional officers, but also public defenders like himself.

Public defenders need to adopt “a holistic approach and think more broadly about ways in which a mentally ill suspect can be treated to avert a return to the criminal justice system,” he said. “And that’s not a role that we’re trained [for] or comfortable in. It’s a different way of thinking about criminal defense and I would suggest it’s part of the discussion that needs to begin.”          

Despite the headway officials say the county is making in collaborative law enforcement, mental health care and volunteer community support, they are worried about the multi-generational nature of mental illness, which is exacerbated by Humboldt’s multi-generational and near catastrophic history of drug abuse, manifold addictions and broken families.

Fleming told the audience she had read a long-term study indicating that adverse childhood experiences can affect individuals their entire lives. According to the study, she said, “As many as 80 percent of young adults who have been abused and have reached age 21 meet the diagnosis criteria for at least one psychiatric disorder. We see those children frequently in our child abuse services office.”

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