By Dave Ress
Richmond Times-Dispatch, Va.
VIRGINIA BEACH, Va. — After an arrest, an individual with a serious mental illness can wait long weeks in jail, falling deeper into the depths until a bed opens at an already overcrowded state hospital.
They’re stuck, because they aren’t competent to stand trial — they don’t understand they’ve been charged with an offense and are unable to help a lawyer defend them in court — and the only place their competency can be restored is a state hospital.
And once that’s done, and they’re back in jail, they can wait weeks to go back to court — falling back into the depths of their illness and needing another trip to the hospital.
But Virginia Beach Sheriff Rocky Holcomb says he thinks there’s a better way.
He’s teamed up with the city’s human services department to provide restoration services in the jail, in a pod on the third floor of one of the state’s largest jails. A two-year, $1.8 million state grant is launching the program this month.
The new jail restoration unit means Holcomb’s deputies won’t have to watch someone getting worse while behind bars and waiting for a bed at Eastern State Hospital .
It means when a bed opens up, they won’t have to securely transport a troubled individual the 62 traffic-choked miles from the jail to the hospital, as they’ve done 43 times already this year.
It means that when the hospital’s clinicians feel the individual is ready to stand trial, the deputies won’t have to transport them back and watch, as they sometimes must, defendants waiting in jail for their trial and losing what they gained in their hospital stay.
“This program helps eligible individuals get the services they need sooner,” Holcomb said.
For Commissioner Daryl Washington of the state Department of Behavioral Health and Developmental Services , it’s one more tool to tackle the years-long overcrowding at state hospitals, which routinely operate at or above their formal capacity.
Eastern State and Central State hospitals are also mostly filled with patients courts send them for competency restoration or because a defendant was found not guilty by reason of insanity.
The 300-bed Eastern State Hospital in Williamsburg often houses more than 100 competency restoration patients at any one time. Courts sent most of the other patients at Eastern there, as well, generally after finding them not guilty by reason of insanity.
On just one day last week, Eastern admitted 12 patients for restoration and Central admitted 11.
“Far too many Virginians with serious mental illness have sat in jail, scared and confused, while waiting for care they desperately need,” said Virginia Secretary of Health and Human Resources Marvin Figueroa .
With jail units like Holcomb’s, and like similar efforts at the Riverside Regional Jail in Prince George County and the Arlington Detention Center , “We can help people move through the competency process more quickly, reduce unnecessary delays, and ease pressure on our state hospitals,” Figueroa said.
The Virginia Beach unit will be in a 26-cell pod that had been used for lower-security inmates. It has a large common area outside the cells, where inmates spend much of their time.
Deputies staff the pod 24 hours a day and will spend time walking through the common area and interacting with inmates.
The deputies have had mental health training. It’s vital in a jail where, Holcomb said, 63% of inmates have some sort of mental health issue.
“We’re not therapists, we’re just there to talk and be helpful,” said Sgt. Brandon Mullen , who has a “CIT” pin on his uniform, to show he’s completed the intensive, 40-hour “crisis intervention team” training that teaches police and other first responders ways to help individuals in a mental health crisis.
Virginia Beach’s human services department will assign a psychiatric nurse practitioner to the restoration unit to manage the medication that inmates may need to deal with their mental illnesses.
The department also is assigning a licensed clinician for individual and group therapy and a specialist clinician to handle the education that defendants may need to understand their charges and what they face in court.
The restoration education clinician will also handle discharge planning, because an element of the restoration unit program will be connecting defendants to community services once they’ve been restored to competency and had their case tried and resolved.
The program will typically run about 45 days, said Brad Jones , the jail’s forensics supervisor. That’s the usual amount of time between arrest and trial for district court cases, and includes efforts to maintain competency once it is restored.
Often, across the state, when defendants return to jail after a state hospital has restored their competency, they slip back because the medication and therapy they need aren’t always there.
The Virginia Beach jail already has three units for inmates with serious mental illnesses.
There’s a severe mental health pod, which houses about 22 individuals.
“Those are guys that we work directly with to try to get them out to shower, do the basic stuff,” Mullen said.
“Then we have a step-down mental health block with people who have SMIs (serious mental illnesses) who, you know, may be talking to themselves, they may be presenting behaviors we’re not used to seeing,” he said.
From there, defendants who are doing better can go to another step-down block “so that way we’re not just grabbing guys, we want to transition them to GP (general population) … we just don’t want to grab people and just throw them into situations,” Mullen said.
Defendants’ mental health is a daily challenge, Holcomb said — and not just for the smooth functioning of a jail.
“You don’t know how bad it is until you’ve been touched by this problem. ... We’ve got to make a difference each and every day,” he said. “Again, I tell you, until you’re touched by it, when a mother calls me and is in tears: ‘Sheriff, help me! Help me! Help me!’ It’s heartbreaking.”
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