In a new tactic to reduce the number of people with mental illnesses languishing in jail cells, Hennepin County will bring psychologists into its downtown Minneapolis jail complex to assess nonviolent offenders who screen positive for psychiatric problems.
County officials said the plan will allow them to release dozens of jail inmates with serious mental illnesses into court-monitored treatment programs in the community, rather than confine them to jail cells without adequate mental health care.
Inmates who choose to undergo the evaluations can be released into treatment programs instead of being detained while awaiting trial. In the first year, the program is expected to result in conditional release for up to 100 inmates charged with low-level crimes, officials said.
County health, human services and law enforcement officials said they hope the project, and other recent initiatives, will help break the revolving door of arrest, incarceration and release that has trapped many people with psychiatric disorders in the county criminal justice system for relatively minor offenses.
There is a widening recognition, in Minnesota and nationally, that jails are not the proper place for offenders who need intensive mental health treatment. A growing number of large cities, including Houston, Los Angeles, Miami and New York, are experimenting with programs that divert offenders with psychiatric disorders out of the criminal justice system and into community treatment.
"This is not about overcrowding in the jail, or saving money. This is about fairness," said Hennepin County Sheriff Richard Stanek, an outspoken proponent of efforts to prevent incarceration of people with mental illness.
"We have far too many people sitting in jail with underlying mental health issues, and they will keep coming back again and again until they get those issues resolved," Stanek said.
Some 20 to 25 percent of the roughly 100 people booked each day into the downtown Minneapolis jail complex screen positive for a serious mental illness. However, the Hennepin County Sheriff's Office this month will complete a more in-depth analysis of the jail population on a single day in July; preliminary results suggest that a far higher percentage — closer to 50 percent — have a mental health disorder, officials said.
"Many of these people quite honestly don't need to be there," Stanek said.
Though the new program will be voluntary, inmates will have an incentive to participate because it could result in an early release from the 839-bed jail complex, county officials said.
Under the program, psychologists will clinically assess certain inmates identified as having a mental illness. If an inmate is found to require therapy, the assessments will include specific treatment recommendations, which could lead to the inmate's conditional release from jail to community treatment, such as an intensive residential treatment center or a court-monitored outpatient program.
Some get worse in jail
To ensure public safety, only people charged with nonviolent misdemeanors and low-level felonies will be considered, officials said. Offenders released from jail will be monitored by probation officers and social workers and will be expected to make scheduled court appearances and attend treatment.
The process is similar to one that already exists for people with chemical abuse problems, in which inmates can receive a chemical dependency evaluation while in jail and be released to treatment.
A similar diversion program in Miami-Dade County in Florida has proved remarkably effective, reducing recidivism by more than two-thirds among offenders with mental disorders who participate in treatment. "This is such a big problem, and this population is so underserved, that doing almost anything can have a profound impact," said Ira Burnim, legal director of the Bazelon Center for Mental Health Law, a Washington-based legal advocacy group.
Many inmates get worse while in custody because jails are usually not equipped to provide mental health care as people await their court hearings. In a report issued early this year, state Legislative Auditor James Nobles found that jails across Minnesota often failed to perform mandatory checks of inmates' well-being, putting them at risk of self harm or suicide. Since 2000, there have been more than 50 suicides and 770 suicide attempts in Minnesota jails — some preventable, the auditor found.
In 2013, Hennepin County paid $1 million to settle a lawsuit by an inmate with mental illness who stabbed himself with a pencil in both eyes after being held in the county jail for 40 days without proper psychiatric care.
Barbara Rea of St. Louis Park, who is 70 and has a mental disorder, spent four days in the Hennepin County jail in July after being accused of stalking a Minneapolis police officer. Rea said her mental state worsened during her stay because an inmate in a nearby cell kept screaming and banging on his door, keeping her awake most of the night.
"You can't imagine the hell of being in a solitary cell during a mental health crisis," Rea said.
Among the recommendations in his report, Nobles said legislators should amend state law to require that all inmates in county jails at least 14 days receive a mental health assessment by a medical professional, in keeping with national correctional standards. Minnesota state rules currently do not require jails to conduct mental health assessments of inmates.
"If you want to reduce the jail population, you have to look at mental health," Stanek said. "The problem is, it's such a monolithic … monster that no one knows how to grab onto it."
County officials said they hope to build on the success of another initiative, launched early last year, that brings teams of social workers into the downtown jail to help inmates who suffer from untreated mental illnesses and substance abuse disorders get access to treatment and other services upon release. In the first quarter of this year, the outreach effort decreased jail readmissions by 48 percent among the inmates who participated, the county found.
"Our main goal is to get the criminal justice system working with the social services sector — so that people get the services that they need, in the hope that it will prevent criminal justice involvement," said Judge Kerry Meyer, who presides over Hennepin County's mental health court.