Jails across the nation are crowded with mentally ill inmates who are there because of a broken promise. Over the course of several decades, states closed mental hospitals and vowed to replace them with community-based psychiatric treatment and housing. But the treatment and housing failed to materialize.
Now people whose mental health problems go unaddressed get arrested for conduct they often can’t control. They sit in jail, awaiting trial. They are convicted, return to jail, serve a few weeks or months, and are released with no continuing care and often no place to live but the street. With their illnesses still untreated, they offend again, and the cycle repeats. The sick remain sick, the streets and jails fill, the costs mount.
In Los Angeles County, ambitious proposals to move thousands of sick inmates out of jail and into psychiatric care have been frequently met with fear and skepticism. At one point, jail officials estimated the number of inmates who could be safely freed as being in the single digits.
Los Angeles County may have reached a turning point.
They were wrong. In 2015, District Attorney Jackie Lacey presented the Board of Supervisors with a framework for diverting mentally ill inmates from jail into treatment, and the board responded by creating an Office of Diversion and Reentry. Judge Peter Espinoza left the Superior Court to lead the office, which since 2016 has successfully diverted more than 3,200 people.
That has meant better and longer-lasting care for ex-inmates, who otherwise would have no intensive case management after jail. That, in turn, means lower recidivism and better public safety, studies have suggested. In many cases it also means savings, because it costs $600 a day to keep an inmate in jail, but only about $70 to house the same person in supportive housing.
So last August, the board wanted to know, if there are about 16,000 inmates in L.A. County jails, and an estimated one-third of them are mentally ill, just how many could be safely diverted to out-of-jail treatment and housing?
Now we have an answer. On Monday, the diversion office will present the preliminary results of a study showing that well over half of the jail’s mental health population could be safely released to community-based services. That’s nearly 2,900 people.
The study undercuts long-held assumptions about how best to deal with mentally ill people arrested on suspicion of committing petty or even serious crimes.
For years, L.A. County officials (just like their counterparts in other counties and states) responded to the growing number of inmates by planning bigger jails. As recently as February, a “Consolidated Correctional Treatment Facility” was on track to replace an existing jail and would have been devoted to custodial treatment of inmates with psychiatric and other health problems.
But experts, civil rights groups and community activists argued that jail was no place for mental health care, and that armed and uniformed sheriff’s deputies were the wrong people to respond to illness-related behavioral problems. The board was persuaded to change course. The new numbers from the diversion office back up their decision.
Now, how does the county increase the pace, and get closer to diverting everyone eligible? The process takes time. It requires a study of each defendant’s criminal and medical records, background reports from the Probation Department and negotiations among prosecutors and defense lawyers.The county diversion office has a housing program that directs former jail inmates to supportive housing and case management; but until recently, all participants went through downtown Los Angeles courtrooms. Capacity was limited.
Now, though, the Los Angeles Superior Court is opening a second hub for the program at its huge courthouse near Los Angeles International Airport. Additional hubs — at courthouses in Van Nuys and Lancaster — are due to open by the end of the year.
Los Angeles County may have reached a turning point. It is ready finally to take on, on a large scale, the kinds of reforms that have been discussed and tried in dribs and drabs over the years — improving treatment of the mentally ill, reserving jail for the most dangerous people, reducing costs while enhancing public health and public safety. The numbers released by the Office of Diversion and Reentry show the way. The missing ingredient now is the funding to expand the program. So, Board of Supervisors — get on with it.