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Archive for Monday, April 10, 2006

Mentally ill strain resources at jail

Long-term assistance seen as gap in support for people in need

April 10, 2006

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Editor's note: This is the second in a two-part series about the mentally ill in the Douglas County Jail.

Douglas County Jail isn't just a jail.

"We've become the mental health unit of Douglas County," said Undersheriff Kenny Massey. "We deal with a lot of people here who really ought to be dealt with somewhere else. We're not set up for this."

Last year, Massey said, the jail logged 40 suicide watches at Level 3, which is considered "very serious."

"It means they're in a special cell," he said. "It means you have to check on them every few minutes.

"That's not easy when you've got a lot going on, like last weekend. We booked 61 people into jail," said Massey, who oversees the jail. "That's a lot."

Massey and his boss, Douglas County Sheriff Ken McGovern, said using the jail to house mentally ill offenders was shortsighted and ineffective. But at any given time, they said, about 15 percent of the jail's 192 beds are filled by people who are mentally ill. The national average is close to 30 percent, but the local numbers are still a lot to handle.

"There needs to be a better way to help the mentally ill than jail," McGovern said. "There needs to be something that's long-term."

It's expensive: 40 percent of a recent $18,000 pharmaceutical bill at the jail was for psychotropic drugs.

It can be violent, and it can be messy. Some mentally ill inmates trash their cells, smear feces or throw food.

"Bathing is a huge issue," Massey said. "If they refuse to bathe, the staff assists them. It's a health issue."

Revolving door

Massey and McGovern said it was especially frustrating that many of the mentally ill inmates - they don't have an exact count - don't fare well in the community and end up back in jail.

"We don't have any programs that help them long-term because they're not here long enough," McGovern said, noting the average stay is about nine days.

It's not unusual, he said, for mentally ill inmates to leave the jail - they're driven into town and dropped off at 11th and Massachusetts streets - without medications, a job or a place to live.

They are, however, strongly encouraged to call or visit Bert Nash Community Mental Health Center. Some do, but many don't.

"The biggest gap in the system is what happens after they leave the front door of the jail," said Christy Blanchard, coordinator of forensic services at Bert Nash.

Blanchard is on a newly formed committee that hopes to hasten inmates' access to Bert Nash and to housing and employment opportunities. The committee next meets April 17.

"The connection (with Bert Nash) needs to be made, and the resources for housing, employment and supervision need to be there," Blanchard said.

But Bert Nash employees can't do much more than plug former inmates into existing services, most of which already are stretched thin.

"We don't have the money" for new programs, said Bert Nash executive Dave Johnson.

"So much of what we're talking about is tied to Medicaid - it's what we've built our health care system on," he said, referring to the federal- and state-funded program that underwrites health care for the poor. "But Congress is doing everything it can to reduce Medicaid spending, to rein in the budget."

In between

The jail's troubles come nine years after lawmakers voted to close Topeka State Hospital, which offered care and treatment for mentally ill patients.

"A lot of people we're seeing now would have been sent to Topeka State Hospital back when it was still open," McGovern said.

The state hospital in Osawatomie continues to treat Douglas County residents whose illness is so severe they cannot safely remain in the community.

But their stays are short-term, usually two or three weeks. After their conditions stabilize, they are returned to Douglas County where they may or may not take advantage of the services at Bert Nash.

Some end up at the Salvation Army shelter for the homeless, 946 N.H.

"It's not a good thing," said Mathew Faulk, a Salvation Army case manager. "It's a situation that's exacerbated by the fact that we live in a society that thinks nothing about paying ballplayers millions of dollars a year but gets up in arms over spending a few thousand dollars helping people in their own community."

Faulk opposes adding beds to - or lengthening stays in - the state hospital system.

"We need something in between the big hospitals that are run like prisons and a society that's dog-eat-dog," he said.

No alternative

Several attempts at interviews with mentally ill adults who had spent time in the Douglas County Jail were unsuccessful.

Robert Shipp's son, Ed, has been in and out of jail several times.

"It's a sad, sad situation," said Robert Shipp, of Lawrence. "It's like a revolving door - they go in, they come out, they go back in."

Shipp said his son, who's paranoid schizophrenic, was in Osawatomie State Hospital last fall.

"They did a good job with him," he said. "But when he got out, the first thing he did was go off his meds. He's back in Lawrence now. He's living in our basement, but there's no communication. He doesn't talk to us.

"We don't want him there; we don't think it's good for him," Shipp said. "But there's no place else for him to go. We're afraid that if he was out on his own, he'd end up back in jail, and we don't want that either."

In Lawrence, the jail situation isn't expected to show much improvement anytime soon.

"Over the years, there have been so many cuts in funding and resources at both the local and state hospital level that, in a lot of circumstances, jail is just about the only place left to go," said Douglas County Dist. Atty. Charles Branson. "The alternatives just aren't there."

But Gary Daniels, secretary at the Kansas Department of Social and Rehabilitation Services, said change was on the horizon.

"This isn't just an issue in Douglas County or in Kansas; it's nationwide," Daniels said, noting Gov. Kathleen Sebelius has convened a planning council on mental health policy, and a legislative committee is reviewing possible changes in state laws affecting the mentally ill in jail.

"Just about everybody agrees the burden doesn't belong on the jails," he said.

Comments

pelliott 8 years ago

medicades cut, lost of a lot of Bert Nash, losing visiting nurses, losing home health aid, they have even reduced community correction programs, all money savers, all people savers. Lower taxes, corporations gained. We voted for the corruption to flow. Now taxes will rise again and the same people who are contributing to the Salvation Army to feed people will be taxed to the point they might have to join the lines for sandwiches. Not that I am not optimistic.

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moderator 8 years ago

What about half way houses? I thought that once a person was released from a state facility they were transitioned back into society.
The problem with mentally ill homeless is their refusal to take medication after they are released from an institution. I don't know why on earth they would not want to take their medication, I would think that lucidity would be high on my scale of stuff thats important to me. Perhaps talking purple elephants have their own draw? As far as I know you can not force a person to take medication, even when they are in state custody. How about setting up a water cooler for the mentally ill homeless spiked with anti-psychotics? It is a very complicated problem with no easy answers. Cutting funding to programs that help these people are clearly not in the best interest of society.

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Bill Smith 8 years ago

Menninger's was a private mental health facility that would turn patients out once there insurance ran out.

I think we are finally seeing the consequences of de-institutionalization. It is a failed attempt at trying to keep individuals with mental illness in the community. For some, community and familial support is much better than a State Hospital. However, for those with severe and persistent mental illness it is much more difficult to maintain community living. These individuals generally have little to no family support and the community mental health centers are strained(personnel and fund wise) to provide adequate services to those who need it most. I firmly believe that it was a mistake to shut down the State Hospitals and I predict that as the correction systems become more and more strained by providing a place to house the mentally ill, we will see the State Hospital system reborn.

I have an educational background in social work and previously worked as a case manager working with those with severe and persistent mental illness in Topeka for about 5 years. I do believe that working with peoples strengths to keep them in the community is the best thing to do as long as there is a community mental health system that is properly funded and staffed. But I also believe that this system does not work for all and there are some individuals that need more intense and supervise care.

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Gootsie 8 years ago

MD - I get it!

Inmate, what is your take on this?

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Multidisciplinary 8 years ago

Apparently some can't identify posts that are just dripping with sarcasm.

Here's a clue..if it has the word roundabout in it...it's probably not meant to be taken seriously on here!

I WORK with brain damaged individuals people! Of course I'm joking! And they make jokes like this too, so if they can have a sense of humor, maybe you can too!

(FYI.This is where many would through in the standard Prozac joke.)

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Ragingbear 8 years ago

Hey, while your at it, don't forget about special camps for the Jews and Gays....

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bangaranggerg 8 years ago

Really progressive guys, just round up the mentally ill and herd them into a gated fairgrounds. This plan is flawless. oh, and ya it would be a great idea to take the criminally insane out of jail and put them into another institution, maybe tourture the illness out of them so they haunt the building and we can option the movie rights to be the 1,000th movie hollywood has done about that.

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Multidisciplinary 8 years ago

Marion, You may have hit on something there, use of public land. Since they are taking up so much land for roundabouts, just make them little roadside temporary containment rehabiltation centers. (Was that PC enough, may need to work on it). The officers could check in on them as they drive by, the land is already purchased, it wouldn't look like one "BIG HOUSE" institution, heck, they could be kept in their home neighborhoods so relatives could drop by, how convenient. NO one could say, don't put that on MY side of town, they could be put everywhere! LOL.

Okay, enough, I know. hehehe it's early, it's my shift to sleep.Nite all.

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Marion Lynn 8 years ago

For all he good that we do the homeless mentally ill now, we should just round them up and keep them in the buildings at the Fairgrounds or one of the stadiums around town on which so much money has been spent.

We could surround the place with traffic calming devices and roundabouts so if any escaped they would never find their way out.

Thanks.

Marion.

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Richard Heckler 8 years ago

If tax dollars are being spent to assist the mentally ill in jails why not recreate a different institution in which to treat. Put the tax dollars into this project and leave jail space for rapists etc etc. Republican State legislators cutting off funding for the Menninger Clinic has proved to be not too smart( must be getting their orders from Washington D.C.). We're still spending the money without providing the necessary and proper long term treatment.

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