Cutting the number of mentally ill inmates in Los Angeles County's jail system would require spending tens of millions of dollars on new treatment facilities and housing for offenders who would otherwise be released into homelessness, a long-awaited report concludes.
A task force of public officials and mental health advocates convened by Los Angeles County Dist. Atty. Jackie Lacey issued the report after spending more than a year studying how to divert mentally ill people from the criminal justice system.
"Our approach to this problem [to date] has been really ill-conceived," Lacey said in an interview. "You don't imprison someone and say, 'Don't be sick anymore.' People get well when you give them incentives to get help and to be employable.... You give them a life and a place of their own, where they have the freedom to thrive."
The report comes as county supervisors are under pressure from federal authorities to improve conditions for mentally ill jail inmates and are wrestling with plans for a new Men's Central Jail that would be largely focused on psychiatric treatment. Some supervisors want to downsize the planned facility and had hoped that Lacey's task force would help chart a path to dramatically reducing the number of mentally ill jail inmates.
But Lacey's task force cautioned that a new approach to mental health issues would not necessarily eliminate or significantly scale down the need for a costly facility to replace the aging downtown jail.
"Mental health diversion is not a jail reduction plan," the report said.
It added that the jails are overcrowded now — which has caused some inmates to gain early release — and that a reduction in the population of mentally ill inmates "would enable serious and violent felony offenders who are not mentally ill to serve a longer percentage of their sentences. Such a result would enhance public safety, but would not reduce the need for jail beds."
And some serious and violent mentally ill offenders would continue to be housed in county lockups, the task force said.
As a first step, the task force recommended putting all 5,355 Sheriff's Department patrol deputies through a week of training on how to deal with people who suffer mental health crises. That would take six years and cost an estimated $15 million in deputy overtime — but probably save money by reducing excessive-force lawsuits, officials said.
Lacey said her office's Criminal Justice Institute will help host 16-hour training programs twice a month for other law enforcement agencies, where officers can learn how to de-escalate encounters with the mentally ill.
The Sheriff's Department already has eight special teams of deputies and mental health workers who respond to emergencies, but the task force recommended those units be nearly tripled to 23, at a cost of more than $5 million a year.
County officials were also urged to prioritize building three crisis urgent care centers, where officers could take people who are acting out because of mental health issues rather than book them into jail or spend hours waiting outside crowded hospital emergency departments. County officials have plans to do just that, using state money. The task force also recommended that the county build "sobering centers" for people in withdrawal from alcohol or opiates.
The task force further recommended adding hundreds of subsidized homes for mentally ill homeless people, particularly those with criminal records, and creating a management position to oversee the housing programs. The cost to subsidize housing for 400 mentally ill offenders who have been released from custody would be nearly $30 million over the next five years.
But officials and advocates warned that without creating more long-term treatment programs, diverting people from jail could lead to worse bottlenecks in the already-strained county psychiatric system.
"If you develop a front door, we also have to make sure we have the back door," said Robin Kay, chief deputy director of the county Mental Health Department. That could include more long-term locked psychiatric beds for the most severe cases, as well as expanding programs that treat people in the community.
Brittney Weissman, executive director of the Los Angeles County chapter of the National Alliance on Mental Illness, agreed. Weissman praised Lacey's vision, saying it has the potential to "dramatically improve" the way law enforcement interacts with those with mental illness and their families.
"Training law enforcement is the very first place to start," she said. "Second place is to build treatment resources because you can't divert individuals if there's nowhere to divert to."
County supervisors will take up the report's recommendations next month, along with a discussion of the Men's Central Jail plan.