Sheriff Reports on Improvement in Inmate Mental Care

Los Angeles County appears to have made significant progress in recent weeks in improving care for mentally ill inmates in its overcrowded jail system, a panel of experts from the U.S. Justice Department has told sheriff’s officials.

However, Sheriff Sherman Block, who is trying to avoid a federal lawsuit over the issue, said Thursday the experts warned that the department must improve its antiquated system of tracking medical records to eliminate dangerous lapses in the dispensing of medication.

“They made it clear that we still have work to be done,” Block said. “But they are very optimistic that all that needs to be done will be done, because of the effort they have already seen us put forth.”

In September, the Justice Department issued a scathing report ordering the Sheriff’s Department to take drastic action to improve care for more than 1,000 mentally ill inmates in the county jails. Experts found that conditions in the jails’ dark, cramped mental wards were so bad that they exacerbated the inmates’ illnesses.

Sheriff’s officials responded last month by moving the inmates out of the rundown psychiatric wards at the Men’s Central Jail and into the new, state-of-the-art Twin Towers jail. The size of the mental health staff was more than doubled, and deputies stepped up efforts to identify mentally ill inmates during the booking process.

Justice Department officials--who returned Monday to reassess the situation--declined to be interviewed. Their formal report on the visit is expected to be issued next month. “I don’t think there is any question we have turned a corner” on the problems, Block said. “We still have a long way to go, but we are on the upward slope.”

Faced with chronic overcrowding and a lack of funding, the Sheriff’s Department has been struggling for years to provide adequate medical and psychiatric care to hundreds of inmates who arrive at the jails each week. Some prisoners report waiting days and even weeks to see a doctor. Doctors’ orders are often lost or misplaced in the jail’s paper-based system of tracking medical records.

Justice Department officials--in preparing their September report--found that mentally ill inmates were allowed to languish without the medication they needed to keep their illnesses under control. The federal experts also found that the mentally ill inmates were locked up almost continuously in their tiny cells, having little access to exercise or day rooms. Even showers were infrequent.

In Twin Towers, where they are allowed to shower when they like, the inmates watch television and play basketball in recreation areas.

Inmates’ medical charts are kept on the floor where they are housed.

Guards and doctors from the county Department of Mental Health have also stepped up their efforts to screen all inmates for mental illness when they are first brought into jail.

Finally, sheriff’s officials say, they hope to have the medical records computerized within the next two years to solve many of the paperwork woes.

Paul Hoffman of the American Civil Liberties Union said he is encouraged by what he has seen. Like the federal experts, however, Hoffman also believes more must be done to fix the long-standing problems.

He said the ACLU has retained its own expert to audit medical services in the jails. That probe, he said, is set to begin in April.

“The Sheriff’s Department is certainly paying a tremendous amount of attention to this problem,” Hoffman said. “They have had a very high level of involvement in responding to the concerns. I’m hopeful over the next few months, we are going to get [medical and psychiatric care] back to where it should be.”