By Kayla Regan
The Hutchinson News
HUTCHINSON, Kan. — A 6-by-8, whitewashed and windowless concrete room. That’s where, if space allows, the Reno County jail holds a person with a diagnosed or perceived mental illness.
Eerily similar to the rooms of early 20th century mental institutions, the cells are far from ideal, said Reno County Sheriff Randy Henderson. He knows how that looks, but right now that’s what they’re dealing with.
Soon, though, he said, that will change.
The new jail is expected to bring more space and better services for those held locally with mental health issues. Forging better relationships between service providers and law enforcement through efforts like the Crime Reduction Task Force is also promising. The governor’s plan to shift tens of millions of dollars in state funds toward mental health centers and behavioral health treatment certainly won’t hurt.
And while no one is certain what new policies or efforts will help correctional facilities house and care for the mentally ill, everyone seems sure the issue isn’t going away soon.
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It’s well-documented that for a number of decades, after the closure of state mental institutions, local jails and prisons have become the primary providers of mental health services. According to Kansas Department of Corrections data, more than one out of every three inmates in Kansas had a diagnosed mental illness in 2012. The department classified 14 percent of the more than 3,500 inmates with a mental illness as having a severe and persistent condition. The Larned Correctional Mental Health Facility, the state-designated mental health facility for inmates, has a capacity of 553 beds in its mental health and psychiatric units, 546 of which were full on Oct. 17, the KDOC online population report indicated.
“You only send people to Larned that really need to be sent to Larned,” said Reno County District Court Judge Joseph McCarville.
Henderson noticed mental health becoming an issue locally on the streets in the late 1990s, which he attributed to the closure of hospitals and budget cuts to mental health programs.
“They had no place to go, were out of meds; oftentimes they were committing small crimes to get cocaine or meth to sell, to self-medicate,” Henderson said.
“Jump to 2013 and we’re not seeing a whole lot of change. We’re seeing the same thing.”
For a long time, said Henderson, the jail had a hard time handling the population. To this day, he said, it’s a learning process. By nature, he said, criminals try to trick or deceive law enforcement. Then staff has difficulties confirming and obtaining prescription medications. Sometimes, said Henderson, you have to track down an out-of-state doctor or the brand of the medication isn’t what the jail prisoner is used to.
The Crime Reduction Task Force is helping change that, Henderson said, largely because it’s facilitating a relationship between law enforcement and mental health providers. And Henderson said he’d be the first to admit the relationship wasn’t always great.
“Part of that’s my fault because I don’t understand everything they do. They don’t understand everything we do and we got off on the wrong foot.”
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The first thing Henderson and Horizons Mental Health Center CEO Mike Garrett did together was go through the jail log and count names.
“About 20 to 25 percent of inmates, at any given time, are individuals with open charts or ones we’ve seen in the last year,” Garrett said. “And so immediately we recognized that there was this great need.”
Garrett said the need is likely greater than what he counted on the jail log. He estimated that about 50 percent of those in the Reno County jail probably suffer from a mental illness - everything from depression to schizophrenia.
Henderson called the realization “eye-opening.”
Because of a better relationship, he said it’s a smooth process whenever a Horizons client comes through the jail.
“If an inmate came and said, ‘I was taking such-and-such medication with a mental illness,’ we have to find the doctor, we have to find the pharmacy, so we can prove that we can get their meds,” said Henderson. “Oftentimes it’s a mess, especially if it’s out of town. But if it’s Horizons, it’s fast.”
The relationship is providing a model for what should happen between law enforcement and care providers. Ease of access, both agreed, is essential.
“You really want to close that time frame that they’re off their medication. A lot of time, that’s the reason they’re here, is if they’re off their medications and don’t have the coping methods they need,” Henderson said.
Having a good relationship is mutually beneficial, said Garrett. His goals are to reduce the rate at which people are sent to hospitals like Larned and to help ensure a greater quality of life both in jail and out of it.
“My initiative starting out ... was to try to make sure we can provide continuity of care, so we can work towards a smooth transition back when they’re released,” Garrett said.
Three months ago, Horizons also began sending a staff member to the jail one night a week to help make sure mental health needs were being met. When the staffer first started, she had four appointments. Now, her caseload has doubled.
Garrett said they might expand the program further in the new jail. The current jail offers no private, secure space for an inmate to meet with a therapist - something that will be rectified in the new jail. The new jail will offer 20 single-bed rooms, compared to the six in the current location.
“As the program grows, it will be normalized. Inmates won’t see it as a negative to go talk to a therapist, but they’ll see it as a benefit,” Garrett said.
On Monday, Henderson met with the Governor’s Mental Health Task Force in Wichita, along with other mental health service providers and area law enforcement officers, to discuss how to better identify, treat and support individuals with a mental illness. Earlier this year, Gov. Sam Brownback announced he planned to shift $10 million in state funds to mental health centers and provide an additional $2 million for behavioral health treatment for probationers under the supervision of Community Corrections departments across the state. He said the meeting was a great experience, and he learned that other Kansas communities are dealing with the same things as in Reno County.
“We’re all talking about the same issues,” Henderson said. “The issue is how to solve it.”
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Regardless of whether they have a mental illness, most in the jail are there because they committed a crime. In the eyes of the law, said Judge McCarville, the bar is high to prove a person’s mental state excuses the crime.
“There are a lot of people who have difficulty controlling their behavior. Sometimes it’s their attitudes and sometimes it’s their ability to control their impulses,” he said. “The law does not excuse behavior because of their mental being.”
Those patrolling the streets are a little more lenient. Hutchinson Police Department Capt. Troy Hoover said officers, who have responded to 25 concern-for-welfare calls in the last month, only make an arrest if the person presents a clear danger to himself, herself or others. Officers are especially less likely to take action given the fact that taking a person to the hospital for an evaluation means at least two officers will be off the streets for hours at a time, likely to just have that person return home.
“There aren’t too many days when I sit down listening to the radar that we’re not dealing with a mental illness case,” Hoover said. “It’s a frustrating cycle sometimes, and it requires a tremendous amount of our time.”
While the mentally ill are in jail, at least, said Henderson, it’s in the county’s best interest to make sure that population is cared for.
“You’re not allowing them to live the quality of life that they deserve to live. And because they don’t get to live the quality of life they deserve to live, they have issues with others ... which leads to crime, which leads to our intervention,” Henderson said. “It’s a vicious cycle.”
If the juvenile population is any indication of who Reno County’s adult offenders will be, don’t expect the cycle to disappear. Reno County Youth Services Director Bill Hermes said the majority of minors coming through both the shelter and as offenders come in with psychotropic medications and a diagnosis.
“Twenty-four years I’ve been doing this. At first we had a few kids on psychotropics. Now we’re having a majority coming in with several psychotropics that are very expensive,” Hermes said.
“We’re going to see more and more inmates in our jails and prisons that are on medication,” he said.