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Posted on Wed. Mar. 04, 2015 - 12:01 am EDT

Allen County Jail inmates with mental illness have few options

The Allen County Jail provides medication for inmates with mental illness but has little else in the way of services for them. (Photo by Ellie Bogue of The News-Sentinel)
Click on image to view.
Minneapolis is overhauling its system for the treatment of mentally ill adults who are arrested, detained and put through the criminal justice system.
Instead of landing in the county jail, offenders who are arrested and identified as having a mental health disorder will be re-routed to a one-stop recovery center. There they will be stabilized and given therapeutic services while under detention.
So why couldn't Allen County try a similar system? While Allen County's current intervention system means few people who need mental health services land in jail, those who do can spend twice as long behind bars as those without a mental illness who commit the same crime. The Kelley House, one of the few alternative programs for inmates suffering from mental illness, recently closed due to a lack of funding. Thousands of dollars are spent every year on medication for county jail inmates with mental illnesses, but they are provided with little else.
Currently, Fort Wayne uses a Crisis Intervention Team (CIT), a collaboration among law enforcement and the local community health system. When someone with a serious mental health problem is "acting out" and may be destructive to himself or others, the CIT can be called in to intervene. CIT police officers, who are often the first on the scene, have been specifically trained to deal with people with mental health issues. They are able to divert a majority of the calls, such as a suicide or someone acting out and take the suspect to a mental health care provider before the suspect ends up in jail. This system, launched in Fort Wayne in August 2001, has been able to dramatically reduce the number of adults with mental health issues who are arrested and land in the Allen County Jail. In a given year, said Paul Wilson, CEO of Park Center, which works with people experiencing mental illness, there are generally 1,500 calls to CIT, and of those fewer than 10 result in arrest. The remainder of those suspects go to some kind of a treatment facility.
"We have a pretty active working partnership between law enforcement and the mental health community," Wilson said.
Despite the low arrest numbers Wilson said there are still those who are sitting in jail with a mental illness, and they are more likely to serve longer periods of time for a crime than those who are not mentally ill. The problem is once they enter the system they frequently have fewer resources to get out. Hiring a lawyer and posting bond could be beyond their means, and they have a harder time understanding and navigating the judicial system.
Even with a court-appointed attorney, but no bail, they can end up sitting in jail waiting for their post-initial hearings for a long time. Suspects who are psychotic could do something to make their situation worse, such as spitting on an officer, which is a felony charge. These are the people Wilson said he worries about.
"Jail is not a good place for somebody who is mentally ill," Wilson said.
Allen County Sheriff David Gladieux said he would like to see a system here like Minneapolis' but is not sure funding for it would be possible. In a given year the jail has 15,000-17,000 people go through the county's lock-up. They're booked on initial charges and by law can be detained for 72 hours before their initial hearing. If in their initial hearing the charges are not dismissed they will go back to jail until their next hearing.
In 2013, 3,789 Allen County Jail inmates went to sick call, which Gladieux said is where the process of mental evaluation starts. That year the jail conducted 2,607 mental health assessments.
In 2013, the county spent $490,645.76 on medications for the jail inmates. Gladieux said about 60 percent of that cost was for the treatment of mental health issues. It could be anything from depression to anti-psychotics and mood stabilizers. The cost for those drugs is high.
In 2013, the jail spent the following for the noted medications:
• $5,811.69 anti-anxiety
• $31,716.27 atypical antidepressants
• $253,268.82 atypical anti-psychotics
• $11,442.61 mood stabilizers
• $4,359.60 typical anti-psychotics
• $17,194.96 SSRI's (selective serotonin re-uptake inhibitors, or serotonin-specific reuptake inhibitor, which are used to treat depression and anxiety).
• $1,498.05 sedatives/hypnotics
Last year the county switched to Diamond Drugs, a national wholesale pharmacy for corrections facilities. Because it is a national company that buys pharmaceuticals in bulk, it can sell them for less to jails. Because of this switch Allen County was able to pay 50 percent less for pharmaceuticals in 2013 than it did in 2012. But medication is about all the jail does.
"We really do very little for the mentally ill," Gladieux said.
A mental health assessment is done when an inmate is incarcerated, and inmates can see a nurse if they ask. A psychiatrist comes in once a week from Park Center. The doctor is given assessments from an assistant who conducts interviews daily with inmates who have requested them or been assessed as having a mental health issue that needs medical intervention. They are kept in a separate cell block from other inmates.
"They closed the (Fort Wayne) Developmental Center, so now we end up with people who may have caused a problem at a group home," Gladieux said. If those people have committed a crime, there is nowhere else for them to go. They must go through the legal system, and that can take time.
Some people they bring in could have been on a medication at one time but are currently off it, said Steve Stone, Allen County Sheriff's Department spokesman, adding, "Once they get in jail they're put back on medication, but once they get out there is no guarantee they will continue taking it."
It can be very difficult, Gladieux said, to know exactly how many people in the jail are mentally ill because many of those who suffer from depression may go unnoticed if they don't speak up.
"The medication and the cost of medication is a significant issue," Wilson said.
What could be improved in this community, Wilson said, is the treatment of those in jail who have a mental health issue. There has not been a good way found to get these suspects out of jail quickly. It's a complex issue. You have the community who wants safety, and there are times when people with a mental illness are left languishing in jail.
The inmates of whom Park Center is made aware are medicated and treated. But there are no significant services in the jail at this time. If there are people who should be out of jail, making that happen is not easy. Many different people are involved in the process, including the prosecutor's office, judges and jail staff, Wilson said.
"If you look at all those people in the complex system, the jail would love to have those people with a mental illness out of there, because they can be the most confusing and difficult people to work with," Wilson said.
The jail has made a real effort to work with these individuals; several officers have been trained in the CIT program, Wilson said. A lot of the people in the system have addiction issues. They could be self-medicating for a mental health problem or they could have alcoholism or a drug addiction. You have to filter through this, Wilson said.
Kelley House, a halfway house and treatment center that was recently closed by Community Corrections, was an alternative. It worked with people who had significant mental health issues, drug addictions or alcoholism, and who had a significant criminal problem. Wilson said it was a great facility to address both.
"It was very successful, and it is really unfortunate that the funds could not be found to continue it," Wilson said.
Until about a year ago the Psychiatric Assertive Identification and Referral Project in Indianapolis allowed people who were in the system on a misdemeanor charge, were deemed to have a mental illness and believed not to be a high risk of danger to the community to be discharged from jail with the caveat that they follow up with the mental health treatment. This is something Wilson would like to see in Allen County.
Wilson said it is unfortunate that people only remember the few extreme cases of people with a mental illness who have committed terrible crimes. The vast majority of the mentally ill do not.

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