Citing a dramatic increase in jail suicides, the U.S. Department of Justice announced Friday that it was seeking court oversight of how the Los Angeles County Sheriff's Department treats mentally ill inmates.
The move marks a significant expansion of the federal government's efforts to improve the "deplorable" living conditions and care of the mentally ill in the nation's largest jail system.
Jail cells are "dimly lit, vermin-infested, noisy, unsanitary, cramped and crowded," exacerbating prisoners' mental distress, the Justice Department said in a report to county officials.
"Prisoners with mental illness do not receive adequate supervision and are housed in conditions that present, rather than prevent, a risk of suicide," the report stated.
Federal officials said there had been 15 suicides in under 30 months. Some of the deaths might have been prevented with better monitoring by jailers, according to federal officials, who also accused jailers of verbally abusing mentally ill inmates. Objects to potentially assist in suicide, such as plastic bags and spoons, were readily accessible in the jails, and suicidal inmates were given sheets with which some later hanged themselves.
Jail officials did little to address the situation even after suicides more than doubled, from four in 2012 to 10 the following year, the report said.
Federal officials said they planned to seek a court-enforceable consent decree to ensure that the county enacts the needed reforms. But county officials disputed the federal government's findings and defended their treatment of mentally ill inmates.
"We are disappointed that today's report fails to fully recognize the additional progress made over the last year and a half to improve mental health services," the Sheriff's Department and Department of Mental Health said in a jointly prepared statement. "The report also mischaracterizes and significantly understates the incredible efforts made to improve our suicide prevention practices."
The strongly worded report is yet another blow to the Sheriff's Department, which has battled allegations of corruption and excessive force in its jails. An ongoing federal investigation into the jails has led to criminal charges against 21 sheriff's officials.
The Sheriff's Department is also negotiating with federal authorities to reform its policing methods in the Antelope Valley, after the Justice Department found that deputies violated the civil rights of black and Latino residents.
In January, longtime Sheriff Lee Baca retired amid the various scandals. Long Beach Police Chief Jim McDonnell and retired Undersheriff Paul Tanaka are competing in a runoff election to replace him.
Federal involvement in the L.A. County jails dates back to 1997, when the Justice Department issued a set of recommendations for improving mental health care. Since 2002, the jails have operated under a memorandum of agreement after federal authorities determined that inmates' constitutional rights were being violated.
Peter Eliasberg, legal director of the ACLU of Southern California, said the continued problems after nearly 20 years were "really depressing and sad."
"The human cost is not just in terms of terrible mental health outcomes, but the human cost really in deaths," Eliasberg said. "There are people who are not alive today because these two departments could not do what the Department of Justice and others have recommended in terms of suicide prevention."
The problems begin at intake, when some inmates are not properly labeled as suicidal, federal officials said.
In one case, an inmate who'd had seven psychiatric hospitalizations and a history of suicidal behavior was not put in mental health housing, and later hanged himself in his cell, according to the report.
In some areas of the jails, security checks are conducted every 60 minutes instead of every 30 minutes, the report said. One inmate who hanged himself last year had not been checked on for over two hours.
The lack of supervision is "especially troubling" because cells are not suicide resistant and contain hazards like metal bars and wide mesh vent covers, the report said.
In addition to vermin and dim lighting, mentally ill inmates deal with extremely dirty cells, where feces smeared on walls is not removed with steam cleaners. Some mentally ill inmates are not given enough recreation time, spending 22 hours at a time in their cells, and they are commonly denied basic comforts like mattresses, the report said.
"When suicide precautions are unnecessarily harsh, it raises the risk that some prisoners who are actually suicidal will be hesitant to admit their suicidality," the report said.
Mentally ill inmates are also victims of "inappropriate and unprofessional behavior by deputies," who use "obscene and derogatory language" toward them, the report stated.
One inmate was suffering hallucinations and a worsening of her psychotic depression as the anniversary of a family member's death approached, the report said. Her county psychologist knew of her condition, but no extra precautions were taken and a deputy did not act immediately after noticing that she was not moving. She died soon after she was found with a plastic bag over her head.
Her death, the report concluded, was preventable.
The Sheriff's Department has made improvements in some areas, including mental health screening, electronic medical records, staffing levels and staff training, the report said.
The report also applauded efforts to increase diversion programs to treat mentally ill offenders outside the jails, noting that a large increase in mentally ill inmates had made running the jails more difficult.
A divided county Board of Supervisors voted last month to move forward with a $2-billion replacement of the aging Men's Central Jail downtown, while also undertaking a study of how to divert more mentally ill offenders from the jail system.
On Friday, some supervisors cast the Justice Department report in that context.
Supervisor Michael D. Antonovich said Friday that the new jail would improve care by delivering "integrated health, mental health and substance abuse treatment services."
Two of his colleagues who did not support the jail construction plan said the report should be viewed as a call to divert the mentally ill from jails. "The place to deal with mental illness is not jail," said Supervisor Mark Ridley-Thomas.
Supervisor Zev Yaroslavsky said the board should revisit its jail construction plan and "treat mentally ill inmates in an environment far more conducive to success than the ailing county lockup."
"I feel certain the DOJ will not wait 10 years for us to erect a new $2-billion jail, despite its promise of more humane and intensive treatment for the county's thousands of mentally ill inmates," he said.
Sheriff's and county mental health officials contended that the report failed to give credit for many improvements in the system.
Stephen Shea, the county's medical director for jail mental health, said that in the last two years, the county had implemented a new suicide risk assessment and had stepped up suicide prevention procedures for inmates going through drug withdrawal or with a history of substance abuse.
Marvin Southard, head of the county's mental health department, said the rate of suicides was "lower or comparable to similar jail systems" elsewhere.
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