More than half of the nation’s inmates report symptoms of mental illness, but in South Dakota, fewer than 4 percent of state prison inmates get regular attention from mental health staff.
By Josh Verges
The Sioux Falls Argus Leader
SIOUX FALLS, S.D. — More than half of the nation’s inmates report symptoms of mental illness, but in South Dakota, far fewer are being treated.
Advocates say those inmates deserve better care. Without treatment, they are vulnerable to abuse behind bars and struggle in the community after release, often leading to return trips to jail.
Department of Justice surveys have found 58 percent of the nation’s jail and prison inmates have mental health problems and 16 percent have a serious mental illness.
Yet, fewer than 4 percent of state prison inmates get regular attention from mental health staff, and the Minnehaha County Jail has no treatment programs specifically targeted to those inmates.
“The jail and the prison is an area that I think we need to look into. I think things aren’t as well as they would like us to believe,” said Phyllis Arends, executive director of South Dakota’s National Alliance on Mental Illness.
For the past 50 years or so, states have been closing mental health hospitals with the aim of integrating would-be patients into society with the help of psychotropic drugs.
But with insufficient help from social workers and family, many people can’t afford or choose not to take medications, which at times leads to criminal behavior.
A 2006 study by the Department of Justice found 56 percent of state prisoners and 64 percent of jail inmates reported symptoms of mental disorders in the previous 12 months.
“De facto, jails are becoming mental health facilities,” Arends said.
Sheriff Mike Milstead said the trend has put “an additional obligation” on jail and prison staff, but he argues the significant changes should be made outside those walls. Society must do more to make sure mentally ill people are getting the care and medication they need to keep their conditions under control, he said.
“A community program ... can do an even better job of making sure (they) are getting the right medication and are following up on aftercare,” Milstead said. “Many of these people do not need to be behind bars.”
Minnehaha County Jail
The jail will buy about 28 hours of contracted counseling and psychiatric work each week this year at a facility that averages 320 total inmates.
The jail doesn’t keep statistics on its number of seriously mentally ill inmates, but Milstead said it probably matches the national average. That would give them about 50 inmates at any given time.
Certified nurse practitioner John Erpenbach evaluates jail inmates and manages their medication. He said the 10 hours per month he shares with another practitioner are “very busy (and) sometimes people fall through the cracks.”
Tom Walsh, a counselor who did suicide assessments at the jail until last year, said staff there often dismissed inmates’ mental health complaints, leaving them without medication for days. Many inmates look to use medication as currency, so staff often are skeptical to legitimate concerns, he said.
“The guards have been burned so many times. Everybody has a story and try to get whatever they can out of you,” he said. "(Most) are pretty callous to the needs of the inmates.”
Erpenbach and Walsh agreed treatment programs and more psychiatric time with inmates would help.
Milstead said deputies frequently transport mentally ill inmates to Yankton’s Human Services Center, and others can access programs within the jail, such as drug and alcohol treatment. But nothing is made specifically for the mentally ill.
“The jail is not a treatment facility,” Milstead said. “The average stay is 11 days. Not a lot of diagnosis and treatment can be done in 11 days.”
Arends said that’s not good enough.
“People can be held there up to a year. They need to have things in place,” Arends said. “People’s lives are at stake.”
100 with serious illness
Of the 3,000 inmates in South Dakota’s three prisons, about 100 are classified as having a “severe and persistent mental illness (SPMI),” according to Amy Iversen-Pollreisz, director of the Department of Human Services Division of Mental Health.
The state employs the equivalent of 12 full-time counseling and psychiatric employees, who establish treatment plans and work regularly with the SPMI inmates. They see other inmates only when requested.
“I think we do a good job of providing mental health services to the folks in the prisons,” Iversen-Pollreisz said.
But the services pale when compared to Minnesota, which employs twice the number of mental health staff per prison inmate, and 25 percent of those inmates are actively receiving mental health treatment, drugs or both.
Arends said mentally ill inmates who are not classified SPMI still need help.
“People who have a mental illness, even if it’s not that severe, still require seeing a therapist and a psychiatrist,” she said.
Copyright 2008 The Argus Leader