We are seeing crisis levels of mental illness among Hennepin County jail inmates. While we are working to fast-track long-term solutions — like arrest alternatives, community treatment options and conditional release programs — in the meantime, we can’t wait.
The fact is, our nation’s county jails have become the largest mental health facilities in the nation. On any given day in our jail, we have a caseload of approximately 200-300 inmates with mental illness — far more than the 115 beds in operation at the Anoka Metro Regional Treatment Center (the largest psychiatric facility in Minnesota).
During a recent “One-Day Snapshot” study of the jail’s inmate population, 52 percent had confirmed indicators or met other criteria associated with mental illness. That is a much larger proportion than previous estimates, and confirms what we in the Sheriff’s Office have been seeing as we work with jail inmates day in and day out. And for us, that should change the way we operate the jail — and in fact it has.
As sheriff, I am mandated to maintain the safety of approximately 33,000 jail inmates every year — from the moment they are brought to intake by an arresting agency to the point where a judge releases them. I do not have discretion as to who comes to the jail or when they leave. I do, however, have every intention of providing each and every inmate the very best care we can provide while they are in custody.
The issue of mental illness among offenders in the criminal justice system and, in particular, among jail inmates is not new. What is new today is that we now have much better information about the scope of the issue. Approximately half of jail inmates would benefit from or are in need of mental health services. Jail inmates need to be assessed by trained medical professionals to properly and in a timely way identify their individual needs. In this study, we asked registered nurses to perform a full health assessment for all 680 inmates in the jail on July 27, 2016. We learned that only 67 percent of inmates with mental illness were acknowledging the issues during screenings conducted by deputies at the point of intake.
We want to identify inmates with mental illness as early as possible so they can be connected to the services they deserve. Early identification also will allow us to house inmates according to their acuity levels so our jail security staff can better monitor, recognize, and manage needs and behaviors. This is an important distinction. We monitor and manage inmates in the jail; we do not provide treatment, and we are not licensed as a treatment facility.
To better meet the needs of inmates, beginning this month the Hennepin County Medical Center, our medical services provider for the jail, has assigned two RNs round-the-clock to conduct all inmate assessments, continue medications, arrange for services, assist with discharge planning and provide 24 hours’ worth of medications for inmates at the time of their release. We will add a mental health caseload advocate to our staff, and we will expand the Integrated Access Team (designed to help inmates transition to resources in the community upon release).
We are also working to expand our Crisis Intervention Training (CIT) program for deputies and jail security staff.
All of our deputies and security staff have completed eight hours of CIT, and all new deputies and detention deputies are now going through 32 hours of intensive CIT conducted by the Barbara Schneider Foundation. CIT is a vital tool for teaching our deputies and jail security staff about the different diagnoses, behaviors and symptoms associated with mental illness. The training is necessary so they can better understand what they are seeing when they deal with someone with mental illness, especially someone in crisis. They train in scenarios that are often very intense, to help them learn to calmly talk through issues, and they practice strategies for de-escalation.
To ensure that this 32-hour training is available for all Hennepin County deputies and jail security staff, and throughout all Minnesota counties, I call upon our Minnesota congressional delegation to address this immediate need at the federal level: Provide reimbursement funding for CIT for local law enforcement officers beginning in 2017. The urgent need for this training is a direct consequence of federal action requiring states to close our state psychiatric hospitals with no immediately viable community alternative. Our county jails should never have become the largest mental health facilities in the country.
I also call on Gov. Mark Dayton and state legislators: We need your help in managing the crisis of mental illness in county jails across Minnesota. The current system criminalizes mental illness, because we have no viable placement options. We need your assistance in funding long-term solutions and piloting innovative best practices for arrest alternatives, community treatment options and conditional release programs. I ask you to also make funding for CIT your top legislative priority for 2017.
Rich Stanek is Hennepin County sheriff.