Spike in mentally ill inmates putting strain on COs

Mercer County Jail Warden Erna Craig says inmates need medication and treatment typically offered in an in-patient mental health setting

By Sandy Scarmack
The Herald

MERCER, Pa.  A spike in the number of inmates who are mentally ill is putting a strain on prison guards trying to handle situations they aren't fully trained for, according to Mercer County Jail Warden Erna Craig.

Craig said she's meeting this week with county commissioners, prison board members and counselors from the Behavioral Health Commission to search for solutions to take some of the burden off of her staff, who find themselves dealing with suicidal and violent inmates who would be better served at a mental health facility.

Regardless of the crimes committed, Craig said a significant number of the inmates are not mentally able to go through the court process. Some of the worst cases involve inmates who need medication and treatment typically offered in an in-patient mental health setting, but it's incredibly difficult to get them transferred, she added.

Most of the inmates with problems such as depression and personality disorders like schizophrenia and paranoia are treated by a psychiatrist via a video screen from Prime Care, the prison's medical coverage provider. That typically just means long-distance managing of medications, Craig said.

The county pays about $75,000 a month for that medical care, which also includes a registered nurse supervisor and several licensed practical nurses.

She blames the closing of state mental hospitals and the lack of funding for local treatment programs for the increase in the number of mentally ill inmates. "You can't cut funding for treatment and just pretend mental illness doesn't happen. The treatment centers shut their doors and we end up being the caregivers."

Ideally, Craig would like to have an in-house licensed social worker who could help in finding the appropriate treatment and facilities for those too incapacitated to face the court system. She estimates about 30 percent of the county's 280 inmates are dealing with mental illness and many have drug or alcohol addictions as well.

"We are all about security. We are not educated in nor do we have experience in dealing with the mentally ill," she said.

The only option now is to have the most seriously mentally ill inmates transferred to Torrance State Hospital in Derry, Pa., but that process takes months. Craig said in one case it took more than six months to transfer an inmate who was both a danger to himself and others.

In-patient mental health facilities are full and rarely have room, she said. Dealing with this particular inmate was "a daily battle to subdue him," she said. He refused to take prescribed medication, would not care for himself and routinely attacked staff.

She was assaulted in February by an inmate, she said. Her injuries were not serious, she added, but she knows the situation could have been handled better.

"It's very frustrating not to be able to get them help. If you have cancer or a brain tumor you're immediately admitted to the hospital. If you have mental illness, you're on the back burner," she said. The inmate who attacked her was number 28 on a waiting list to be admitted to a mental hospital.

It's not only a safety concern, but a financial one as well. Craig said there are times when it's necessary to assign a guard one-on-one coverage because an inmate is suicidal. That costs overtime, she said. For those who try to kill themselves there is the cost of an ambulance and treatment at a local hospital. And some have succeeded in taking their own life, she said.

She also said she thinks mental health issues are exacerbated in the jail. "They are likely in here because they weren't taking their medications, they acted out in society and ended up involved in a crime. They sit here in jail where things seem to fester and they can't even go through the judicial process because they aren't competent. Those with mental illness seem to be here longer," she said.

There are programs in place to help inmates getting released from prison avoid problems that will lead to another jail term. The programs keep the inmates connected to sources of help and tried to avoid a scenario where an inmate is released and "just dumped onto the street."

Those programs do not address the problems of mentally ill inmates still in jail, she said.

County Commissioner Chairman Matt McConnell agrees with Craig's opinion that closing state mental facilities has led to this problem in Mercer County.  He doesn't think there's been an increase in the amount of mental illness, but that the closed facility doors have brought more people into the local jail system, he said.

"It's a political blunder on the part of the state," he said. He said Mercer County struggles as fifth-class county in competing with wealthier and larger cities in the eastern part of the state for money. Because those areas have more population and more people needing mental health help there are more treatment centers available.

He called it an "economy of scale" situation where mental health care is less expensive where more of it is needed. 

"There's no easy solution. It's a shame the costs have been pushed back to the county because to try and develop what a mental hospital could do would bankrupt Mercer County in the process," he said.

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