Mentally Ill Inmates to Get Ongoing Help After Leaving Jail

In an effort to keep mentally ill people out of jail, the Sheriff’s Department has created a new position dedicated to helping sick offenders find help.

Social worker Kate Robinson is the department’s new discharge coordinator, working one-on-one with petty offenders in the days before they are released from jail to make sure they have a place to stay and will receive treatment.

“This is about helping a segment of the population that’s about as close to the bottom as you can get,” Robinson said. “They are in jail and dealing with a mental illness. And they have unique needs that haven’t been addressed before.”

Authorities are hoping Robinson, who started in February, can interrupt a dizzying cycle that shuffles the mentally ill between the streets and jail. It is a problem mental health advocates say has gotten worse as the state’s limited number of treatment facilities falls further behind the swelling demand.

What began with the closure of many state hospitals in the 1980s, when federal lawmakers believed care for the mentally ill could be better handled on the local level, has resulted in more wandering mentally ill who continually cross paths with authorities.

Officials are not sure how many homeless mentally ill people are in Ventura County. But the county’s Behavioral Health Department provides some form of assistance to 2,500 people each year.

With few alternatives available, they end up in jail for petty offenses such as theft, trespassing and disturbing the peace. Deputies have become so familiar with some of them that they know them by name, said Cmdr. Mark Ball, who oversees the county’s main jail in Ventura. Ball said he continues to meet people he first met as a deputy in the jail 17 years ago.

“And each time you see them, they’re a little worse off than they were before,” Ball said. “And those people you will see until they die.”

As much as 15% of the jail’s inmate population, roughly 230 men and women, are under psychiatric care while behind bars, sheriff’s officials estimate, with illnesses ranging from clinical depression to schizophrenia. That number prompted Sheriff Bob Brooks to more than double the number of hours psychiatrists from the county’s mental health agency visit the jail.

But the crucial missing link, Ball said, was someone to help inmates continue with treatment and ensure they stay on medication after incarceration. Officials applied for a grant to pay for a discharge coordinator in 1998, but were turned down. Agreeing to the need, Brooks approved money from the department’s general fund to pay for a 20-hour-a-week position.

Robinson screens about three inmates a day. Her job is to help them overcome the mistrust they often hold toward law enforcement and get them to talk about their problems. Sometimes they know they have an illness, even naming the diagnosis and their medication. Sometimes they have no idea what’s wrong and it’s up to the jail’s mental health team to figure it out.

That’s become easier with the creation of Robinson’s position. Because health records are confidential, in the past the jail could not find out if an inmate was under a psychiatrist’s care. But since Robinson is also an employee of the county’s Behavioral Health Department, all that information is at her fingertips.

Still, finding out what’s wrong is only half the battle. Then she has to find them help. That can mean treatment, usually through the county’s outpatient program, shelter or even by reuniting an estranged family.

The county’s limited resources for the homeless and the mentally ill make the job a challenge, said Robinson, 51, who didn’t know if she was up to it at first.

“I wasn’t sure I wanted to be here,” she said.

It’s clear, however, that the job has grown on her in the almost two months since she began. She enjoys helping people like the 30-year-old man who seemed disoriented as he was being booked into the jail for a parole violation. When he began to cry, deputies signaled mental health workers.

The man said he heard voices, ones that were always putting him down, and he had become afraid. Doctors diagnosed him with a major depressive disorder with psychotic tendencies. Robinson got to work, contacting estranged siblings and convincing them their brother needed their help.

“Families rarely give up on their loved one,” Robinson said. “But they do give up on their disease. But usually if we can get the family, someone to work with so they know they aren’t out there like the Lone Ranger, then they can usually hang in a little longer.”

Nicoleta Weeks, the Medical Program Manager for the county’s jails, said Robinson’s job is so crucial that it may eventually become full time. That’s already been done in Los Angeles County, where the Twin Towers jail facility has been dubbed the largest mental health facility in the nation.

Of the jail’s more than 4,400 inmates, about 52% are receiving psychiatric treatment, said Lt. Paula Larson, mental health liaison for the Los Angeles County Sheriff’s Department. Larson said a team of mental health workers are based at Twin Towers and part of their job is finding services for inmates who are on the brink of being released. She said that’s a major change from the 1970s, when she first became a deputy.

“Back then, unless you had to put someone in full restraints, you didn’t even pay attention to them,” Larson said.

A series of grants from the state Department of Justice has helped, Larson said. Funds are being set aside routinely to help reduce the incarceration rates for the mentally ill. Ventura County is applying for one such grant. They hope to fund a $2.4-million program that will pay for 11 additional behavioral health professionals and three probation officers to oversee cases filed against the mentally ill.

A separate court calendar also would be created for those defendants who would be diverted into a treatment program instead of jail. The Sheriff’s Department also plans to track their programs to measure the impact.

Despite efforts, officials know reducing returns to jail is a tough goal to meet. The mentally ill often go off medication as soon as strict supervision ends.

Robinson, however, said it’s not impossible. A county mental health counselor recently called to report that three patients kept appointments Robinson made for them. That shows there’s hope, Robinson and Weeks said.

“Even if we have people who are here every month suddenly coming in every other month, then we’re starting to make a difference,” Weeks said.