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Mentally ill patients becoming a burden for Ala. county jails

The only state-run mental hospital in north Alabama, the North Alabama Regional Hospital, closed in June

By Briana Harris and Leah Cayson
The Decatur Daily

DECATUR, Ala. — Limestone County Sheriff Mike Blakely said there have been three instances within the past two months where there wasn’t a bed available at Decatur West’s psychiatric facility.

Two of those times, the individuals were charged with a crime — usually disorderly conduct, domestic violence harassment or domestic violence assault — and held in Limestone County Jail. In the other instance, the person hadn’t crossed the threshold of committing a crime, so there was nothing that could be done.

Blakely said the number of people with mental illnesses who end up in jail has increased over the years. He said the Sheriff’s Office is experiencing an increase in the number of times deputies have to respond to calls to the same residence.

Morgan County Sheriff Ana Franklin said the Morgan County Sheriff’s Office also is experiencing an increase in call volume dealing with mentally ill individuals.

The only state-run mental hospital in north Alabama, the North Alabama Regional Hospital, closed in June. It had the capacity to care for 74 patients, and was serving 41 patients at the time of its closure.

Patients were transitioned into community-based programs near their homes instead of state institutions.

Greil Memorial Psychiatric Hospital in Montgomery and Searcy Hospital in Mount Vernon closed in 2012.

Most of the time, it’s the families who call the police because they can’t control their loved one and are afraid for the safety of themselves and their loved one, Blakely said.

He said the Sheriff’s Office has been dealing with a man diagnosed with paranoid schizophrenia for weeks. He said this man hasn’t committed a crime but has a history of becoming violent as his condition deteriorates.

“Sometimes we have to leave them there because they may not have reached the point of committing a crime, so we can’t legally arrest them,” Blakely said. “It’s frightening because you know that when you leave there you may be getting another call a hour later and you just hope that nobody’s been killed.”

Living facility

The Mental Health Center of North Central Alabama is using its own resources to build a nine-bedroom independent living facility in Athens for indigent individuals — those living on less than $7,000 a year — with a serious mental illness.

Bill Giguere, development director of the mental health center, said the center’s medical staff will decide who lives in the facility based on the severity of their mental illnesses. The patients will pay, which will be calculated based on their income.

Giguere said the facility will be located near the Athens-Limestone Counseling Center on East Elm Street. The facility’s proximity to the counseling center is so the patients can be monitored frequently. They also will be participating in programs at the counseling center.

The mental health center has been saving money from fundraisers and donations the past seven years to fund the project, which has an estimated market value of $450,000.

Giguere said the mental health center has about $280,000 saved.

“We’re hoping to spend much less than $450,000 by having materials donated and with the help of volunteer skilled laborers,” Giguere said. “We’ve done this before, and we know we can get it done.”

He said he has not found a state or federal grant the project would qualify for. If weather permits, Giguere said, the project could be completed by summer 2016.

The mental health center has six housing programs located in Morgan, Lawrence and Limestone counties.

Blakely said a problem he’s noticed is mental health patients at some point stop taking their medication, and their families have a hard time getting them to take their medication.

“It’s just been a constant progression over the years,” Blakely said. “It’s a tough situation.”

Those who are arrested are segregated from the jail population for their safety and for the safety of the other inmates. On a given day, Blakely said the county jail has two to three mentally ill inmates.

Quest Recovery Center, the Mental Health Center of North Alabama’s outpatient alcohol and drug treatment program, closed in August because it was unable to break even financially for three consecutive years.

Franklin said there is most definitely a correlation in substance abuse, crime and mental health.

“Well over half of the people in our facility now have substance abuse problems,” Franklin said. “They might have committed burglary, but because it was because they were strung out on meth or crack, they were trying to get money for their addiction.”

Once they are in jail, Franklin said they can be ordered to in-house drug treatment and sometimes drug treatment facilities.

“We are very lucky in our jail, we have a clinic inside our jail with 24/7 mental personnel that’s there,” Franklin said.

One issue with mental illness in jail is patients can refuse their medication in jail, she said.

“In a mental health hospital, they cannot refuse medication,” Franklin said. “They refuse treatment inside the jail.”

When inmates refuse treatment and medication, Franklin said, the next step is to go through the court system to have an assessment done to see if commitment to a state hospital is necessary.

Wait of 4-6 months

Franklin said the facilities are generally full and the wait is about four to six months. Until a hospital bed is available, inmates are put under direct supervision or placed in the medical wing in the clinic of the jail.

While incarcerated, Blakely said the goal of the jail medical staff is to get them back on medication to help improve their condition.

“Jail isn’t built to care for people with mental illnesses,” Blakely said. “Anytime we’re dealing with people who should be in a mental institution, it’s really a burden because we don’t have the same capabilities and resources as a mental health facility.”

The Limestone County Jail recently underwent a 10,850-square-foot expansion to add 24 single-bed cells. The project cost about $3.7 million. Blakely said the single bunk cells will be used to isolate any inmate who, for whatever reason, cannot be a part of the general population.

“Jails are now the inpatient mental health facilities in America,” Franklin said. “That is what the trend is becoming. That’s the reality ... we are housing the mentally ill because they’re not enough beds in a hospital.”

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