Culpeper seeks help for mentally-ill inmates
Culpeper County Sheriff Scott Jenkins tells the story of a mentally disturbed woman whose family called 911 to say that she had a cocked pistol in her mouth.
After lengthy negotiations, the woman finally dropped the gun and came outside, but not before she had fired a shot out a window.
Understanding the situation, Jenkins said his officers did not want to arrest the woman, but rather sought to get her psychiatric help.
His office, however, could not get a custody order issued, which is required to hold a person for a mental evaluation. So, for her safety and the safety of her family, investigators were forced to file criminal charges.
“That’s the game we have to play because the system is broken,” Jenkins said.
Culpeper Criminal Justice Director Andrew Lawson has a story of his own, about a woman who was arrested for heroin and cocaine use, then ultimately released on bond. Understanding that she could not control her addiction on her own, the woman committed another crime just to get back in jail, where she knew she would not have access to drugs.
“She violated her bond and went back to jail and the taxpayers are paying for her incarceration,” Lawson said. “Sometimes it is just a revolving door with these people.”
As was pointed out in the case involving state Sen. Creigh Deeds, there are serious flaws in Virginia’s mental health system. A lack of bed space prevented Deeds’ son from getting emergency mental health treatment. The son later attacked Deeds with a knife, seriously injuring his father, then took his own life.
In Culpeper, it is a shortage of licensed clinicians and psychologists that too often prevents those with mental issues—and those with no insurance—from getting help.
In an attempt to rectify one aspect of the situation, both Lawson and Jenkins are asking the Board of Supervisors to provide about $65,000 in the next fiscal year’s budget to hire a licensed clinician to expedite the evaluation of those who come into the jail with obvious mental problems.
According to Lawson, this clinician would also see that those with mental issues have a fixed treatment plan in place when they are released. The fact that many are now let go without plans only leads to re-incarceration, both Lawson and Jenkins said.
“Some mentally ill inmates may receive psychotropic drugs while in custody and they begin to function normally again,” Jenkins said. “They may get a two-week supply of those drugs when they hit the street, but when they run out, they quickly become psychotic again.”
When these mentally ill people go into jail, they also fall out of the social services system.
“It may take them four or five months to get back into the system and see a psychiatrist,” who can write a prescription for more drugs, Lawson said.
Although a licensed clinician couldn’t write prescriptions, he or she could “do the intake and have those people on a plan when they are released,” Lawson said.
‘WHAT CAN WE DO?’
Lt. Vern Fox, who is in charge of the jail, said an obviously disturbed inmate may now get a five-minute session with a mental health expert.
“Usually they just tell us that these people have a behavioral problem,” Fox said. “Often it is obvious that this is not the case.”
Moving mentally disturbed patients along in the system would also help with Culpeper’s jail overcrowding problem.
As in the case of the woman with the gun in her mouth, a person who should be treated for mental health problems but cannot be properly evaluated within the state-mandated length of time is often just placed in jail.
Culpeper’s jail, built to hold fewer than 60 inmates, now routinely has a population of 80 or more—with an average of 25 per day farmed out to other regional facilities. Renting beds from other jails costs the county about $500,000 each year.
Those who have mental health problems but can’t get evaluated only add to the overcrowding.
But, Jenkins stressed, the problem goes much deeper than overcrowding. In more than a few cases, it becomes a matter of human rights.
Those who are declared mentally disturbed and a threat to themselves cannot be housed in normal jail cells. Instead, they require special rooms called “observation tanks” that have no toilet and no bunk. Culpeper’s jail has only two such cells.
“They only have a grate in the floor [for bodily wastes] and a rubber mattress,” Jenkins says. “And because there is a backlog in the courts, sometimes they must remain in those conditions for extended periods of time. We’ve seen people stay in these cells for a week or even weeks.”
Both Jenkins and Fox said those inmates sometimes smear feces on the walls and eat and drink their own waste.
“I would hate to think that some member of my family is housed in there because of the lack of mental health facilities,” Jenkins said. “But what can we do? We can’t put them in a jail cell and we have no other facility.”
A COMPLEX SYSTEM
The mental health system and the laws governing it, especially for those with no insurance, are so complex that it is difficult for the layman—and even law enforcement officials—to fully understand.
Those who are reported as mentally ill and possibly a threat to themselves and others can be held only for a certain number of hours without a court order. Some who shouldn’t be released must be released.
Culpeper courts are so backed up that they have been forced to hold Saturday sessions this winter. So inmates often must wait until a judge has time to order more in-depth mental evaluations.
Inmates suspected of being mentally ill must be evaluated, but the system is short on licensed psychologists, psychiatrists and clinicians, and the evaluation process often takes days or weeks instead of hours. And then, there may not be beds available for those who need hospitalization.
According to Lawson, having a licensed clinician at the jail should help to provide inmates a proper initial evaluation and get them out of the observation cells.
A funding request from the Culpeper Community Services Board to add a psychologist would help cut the wait to get clients back in the social services system from four or five months to maybe two months, CSB Director Brian Duncan told the Board of Supervisors in February.
The General Assembly is also attempting to speed up the process of finding an emergency bed for the mentally disturbed, but little headway is being made with regard to court backlogs.
Board of Supervisors Chairman Steve Walker said he thinks the $65,000 request for the licensed clinician will be funded in the county budget that takes effect July 1. Funding the CSB’s request appears less likely.
Walker said the board will probably approve a one-year pilot program for the clinician to see if it saves money.
Lawson thinks it will.
“If it reduces the jail population by four inmates per day, that position will pay for itself,” he said.
Jenkins said he is just as concerned with the human aspect of the problem.
“It is just inhumane to keep these people in conditions like that,” the sheriff said.