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Jails grapple with mental health needs
Appeal-Democrat - 2/9/2018
Feb. 09--In many instances, county jails have become the new form of a mental institution.
In every U.S. county with both a county jail and a county psychiatric facility, more seriously mentally ill individuals are incarcerated rather than hospitalized, according to the nonprofit Treatment Advocacy Center.
It's a lose-lose situation both for jails and inmates with mental health issues, officials said.
"Jails have now become de facto mental health facilities," Sutter County Sheriff J. Paul Parker said prior to a Thursday tour of the county's jail. "We are not set up to be that."
The local conversation of jail treatment of inmates with mental health issues isn't new: in 2010, Rodney Bock, a local fruit farmer, hanged himself in Sutter County Jail while awaiting transfer to Napa State Hospital. His family sued the county, alleging poor care from Yuba-Sutter psychiatrists and the jail before he hanged himself in his cell. Bock's survivors and the county reached a $800,000 settlement in 2014.
Just after last Christmas, a lawsuit was filed against Yuba County Jail in the January 2017 death of Bertram Hiscock, 34. Hiscock died of self-consumption of his own urine and feces to induce choking due to acute psychosis, according to the lawsuit.
Hiscock had been incarcerated for more than two months despite the court determining he was mentally incompetent to stand trial and needed to be sent to a state mental institution.
"The county jail is not an appropriate place for mental health concerns," said Michele Deitch, a criminal justice policy expert and senior lecturer at the LBJ School of Public Affairs at the University of Texas. "There are people who are going to be suicidal. The question is what kinds of preventative measures the jail has in place to identify and treat these individuals at the jail."
Deitch said the 2015 jail suicide of Sandra Bland in Texas led to more attention focused on the issue, and that Texas jails have worked to better screen inmates with mental health issues. She said jails have improved a screening form to make it clearer for staff who are not mental health professionals, which has helped bring down the numbers of suicide.
But it's not enough, she said. State prisons simply are better equipped to handle medical and mental health needs, she said, because inmates serving time in prison have already been through a diagnostic process with more personal information readily available.
"One problem is the issue of people with mental illnesses just cycling through jails," Deitch said in a phone interview. "Another problem is you're getting people right off the street... Staff have no idea who these people are, (and) not knowing who they are means you don't necessarily know how to respond to them."
Sutter County has worked to make significant strides, Parker said. Mental health professionals are not full-time, but they are at the jail every day. A screening process takes place as soon as an inmate is being booked, and again by nurses. And while there are isolated safety cells and padded rooms for suicidal people, Parker said inmates aren't isolated for long.
For those posing a risk of self-harm, officers conduct strict 15-minute rounds, held accountable by electronic checks. And unless suicidal inmates pose a danger to others, they are housed with other inmates, a new way of thinking and practice that has proved beneficial, Parker said.
But Parker acknowledged that this may not be enough for those in dire need of mental health help. He pointed to the shortage of state hospital beds forcing longer county jail stays. And realignment has also passed the burden on housing inmates with certain felony offenses to county jails to free up prison space, he said. In the past, county jails would house inmates for up to a year. Now, inmates can stay for as long as 10 years.
"County jails were never built to house long-term inmates," Parker said. "It's created great stresses on local counties."
Parker said a mass shutdown of state hospitals back in the 1960s -- a Reagan move ending the practice of institutionalizing patients against their will -- may lead to county jails having to step up and care for these patients on their own, with reimbursement from the state.
"They basically closed their hospitals, hoped for the best, and the best didn't happen," he said. "There's literally no place else for them to go."
Brother speaks out on death
For the two months Hiscock was incarcerated in Yuba County Jail, his rapid mental health deterioration was largely ignored and staff failed to take the steps to get him adequate help, according to the lawsuit. For his younger brother, Vincent Hiscock, the lawsuit is not only for personal closure but an effort to affect the system that failed Bertram. Yuba County cannot comment on pending litigation.
"Bert was an extraordinarily intelligent, empathetic, and courageous individual whom I miss more than words can express. All available information shows that the jail incarcerated him under conditions of almost unutterable dehumanization which ultimately resulted in his death," Vincent Hiscock said in an email Thursday. "Unfortunately, Bert's death is exemplary of a state of affairs in which mental disability remains among the highest indicators that predict whether or not you will have to try to live unhoused or lacking other basic necessities, whether or not you will be subject to police abuse or police killing, whether or not you will be jailed or imprisoned, and whether or not, during your incarceration, you will face abuse or even be able to stay alive ... Only significant institutional transformations will save other individuals from the kind of horror and suffering faced by my brother Bert."
Parker acknowledged that lack of resources and state support is "unfair to everybody involved."
"We don't have the illusion that we will cure someone," Parker said. "But at the very least we want to keep people from hurting themselves."
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