Steps Urged to Keep Mentally Ill Out of Jail

In an attempt to reduce the growing number of mentally ill people filling Los Angeles County’s jails, a task force recommended a series of reforms Tuesday that would help divert thousands of psychologically troubled offenders into treatment programs.

A key element of the plan by the Task Force on the Incarcerated Mentally Ill calls for the creation of a countywide program to place teams of mental health professionals in patrol cars. Jail workers would receive additional training in mental health issues and more funding would be provided for existing court diversion programs.

If adopted by the county, the plan would cross jurisdictional lines: Los Angeles police officers, sheriff’s deputies, Superior Court and municipal court officials and mental health workers would join forces.

“Many of these recommendations will make a substantial difference and will help provide appropriate and compassionate care,” said Cynthia Telles, who chaired the task force.

Although Telles did not estimate the cost of the task force’s recommendations, she and other panel members said many elements of the plan could be implemented with existing resources.

“The problem wouldn’t exist in the first place if there were sufficient community-based resources,” Assistant Public Defender Dave Meyer said. “But there are things that can be done. And we’re going to do them.”

However, members of the Board of Supervisors, wary of any additional drain on the county’s shaky budget, ordered a cost analysis of the plan Tuesday.

The supervisors commissioned the report in September, 1991, after a series of articles in The Times detailed how the jail system had become a “hospital of last resort” for the chronically mentally ill. Thousands of acutely ill patients have been cast adrift by the slow and steady decline of California’s mental health system.

The county estimates that one in six of its jail inmates suffers from a mental disorder. With more than 3,300 mentally ill inmates incarcerated on any given day, Los Angeles County jails have become, in effect, that nation’s largest mental institution.

Supervisors accepted the report but stopped short of immediately adopting its recommendations. They postponed action until the board’s budget deliberations begin in July and ordered the Department of Mental Health to calculate the cost of the programs.

Board Chairman Ed Edelman said the county’s lingering budget crisis may make it difficult for the board to implement all of the reforms. The county is facing a budget shortfall of up to $1.4 billion in the coming fiscal year.

“We’ll try to say what can be implemented without additional cost,” Edelman said. He added that a key selling point of the plan may be the savings accrued by reducing the inmate population. A county report estimates that it costs about $15,000 annually to maintain each jail bed.

“It’s the humane thing to do,” Edelman said of the task force plan. “It’s the dollars-and-cents thing to do.”

The task force was made up of mental health advocates and representatives of the Sheriff’s Department, the Los Angeles Police Department, the Department of Mental Health, the district attorney and other officials.

In its 18-month investigation, the task force found that about 40% of county jail inmates with mental illness reported that they were homeless at the time of their arrest.

“A lot of the people are homeless, they’re substance abusers, they have very low incomes and they’re unemployed,” Telles said of the county’s mentally ill inmate population. “That’s why they end up in jail.”

The number of inmates referred to the jail’s mental observation units has increased 90% over the past five years. Of those identified as mentally ill, 32% were diagnosed as suffering from schizophrenia and 22% from other psychotic disorders.

Telles said the task force found that the most effective way to combat the problem is for mental health professionals to intervene when law enforcement officers first come in contact with people who are exhibiting symptoms of mental illness.

Such people may simply be acting in an irrational and antisocial manner without committing any serious crime. Often, officers will arrest such people for trespassing or other misdemeanors simply get them off the streets.

To prevent such arrests, the task force recommended expansion of the county’s Systematic Mental Assessment Response Teams. The teams are made up of deputies and mental health professionals.

Two such teams were created as part of a pilot program in January, after the task force issued preliminary recommendations. Telles said the teams could be expanded into a countywide, round-the-clock mobile response program.

Telles said the teams have intervened in 380 cases in which suspects faced arrest for various crimes. Of those, only 11 were arrested and incarcerated; the rest were diverted to county emergency rooms, private facilities and community mental health programs.

For public defender Meyer, such results are proof that even small reforms can make a important difference.

“If we have a beneficial impact on just 100 people, it will be worth all the effort,” he said.