RICHMOND—Virginia is far from the only state in the nation facing a mental health crisis in its jails, according to a national study of the issue released Thursday.
A survey by the national nonprofits Treatment Advocacy Center and Public Citizen found jails across the country are increasingly crowded with mentally ill inmates, yet very little training is available for the officers tasked with their care.
Virginia leaders have been grappling with mental health reform for well over a decade—long before Jamycheal Mitchell’s death at Hampton Roads Regional Jail; before state Sen. R. Creigh Deeds, D-Bath, was attacked by his mentally ill son; and before Seung-Hui Cho gunned down dozens of fellow classmates at Virginia Tech.
Yet little has been done to change the system, said John Snook, executive director of the Treatment Advocacy Center.
“Virginia is one of the states that needs to read the writing on the wall and take mental health seriously,” Snook said in a conference call held Thursday to release the results of the survey.
None of this is news to Tammy Farmer, whose son, Thomas Jeter, died of an overdose at their Chesterfield County home in 2011.
Jeter, who had been an active and outgoing teenager, developed severe depression and anxiety when he was 20 years old. He wound up self-medicating with drugs and alcohol and developed addictions.
He went to jail after he was caught stealing cough syrup, but he was not given his medication behind bars. He also was stripped naked to keep him from hanging himself with his clothes.
Farmer said the humiliation crushed him and the lack of medicine sent him on a downward spiral.
Throughout the years, as mental hospitals were shuttered or downsized, many severely ill patients wound up on the streets, said Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center. On the whole, state and local governments didn’t set up enough resources on the community level to keep people stabilized.
That’s resulted in about a million seriously mentally ill people living in communities who would have been hospitalized 50 years ago, Torrey said. Half of those people aren’t receiving treatment, and about 200,000 of them are homeless.
America’s mental health system largely requires people with mental illness to reach a point of crisis before they’re eligible for long-term psychiatric care, so many of them wind up in jails first.
“These are crimes of survival—not because they are a master criminal, but because they are trying to survive on the streets,” said Tom Dart, sheriff of Cook County, Ill., who participated in the conference call.
Jails are the last place a person with mental illness should go to get better, Dart said, especially when many of them wind up in solitary confinement.
“When the day comes to release them, their issues are greater than when they came in,” Dart said.
The survey included responses from 230 sheriffs departments that operated jails in 39 states. Seven Virginia jails participated in the study.
Almost half of the jails reported that 2 percent or less of the initial training provided to their staff and deputies was dedicated to dealing with seriously mentally ill inmates. About 60 percent of jails said only two hours or less of annual training is provided on the topic. Still, about a third of the jails reported that 11 percent or more of their employees’ time involved handling seriously mentally ill inmates.
“Jail personnel are challenged on a daily basis to try to provide care for these inmates that, as they put it, their training has not prepared them for,” said Dr. Azza AbuDagga, health services researcher for Public Citizen and the report’s lead author.
Whenever possible, mentally ill people who commit crimes should be kept out of jails and diverted into treatment programs, the report recommends. Outpatient treatment programs should be expanded, as well as intake screening in jails.
The report’s authors also recommend jails provide proper treatment for seriously mentally ill inmates and that states expand the number of beds available to treat patients.
Jennifer Hoff of Orange County, Calif., who participated in the conference call, said she felt her severely mentally ill son was pushed off a cliff when he turned 18 because as an adult, only he could seek out treatment for himself. But he was unaware that he was sick.
He’s been in jail for years, including two cumulative years in solitary confinement.
“I can say without a doubt that our system for caring for the mentally ill is completely and utterly broken,” Hoff said. “We want this pain to stop for everyone.”
Just over a third of the jails reported providing individual psychiatric care, and about 10 percent reported providing group psychotherapy.
About 42 percent of the jails in the survey reported offering pharmacy services, even though medications are central to stabilizing people with serious mental illnesses
Less than a quarter of the jails said they offer a support system for mentally ill inmates once they are released.