Troubled by years of horrific and costly incidents at the Hennepin County jail, officials are proposing a sweeping overhaul of the way mentally ill adults are treated after being arrested, detained and funneled into the criminal justice system.
Offenders with psychiatric disorders — many of whom are arrested repeatedly for minor nuisance offenses — would be diverted to a one-stop “recovery center” in south Minneapolis instead of winding up in jail. Once there, they would be stabilized and provided with therapeutic services while under detention.
A 2013 Star Tribune investigation found that as many as a third of the county’s inmates on any given day have a history of serious mental illness. Officials say the county spends millions of dollars annually as these people cycle through courts, cellblocks and hospital emergency rooms. In addition, the county has paid large legal settlements over incidents of maltreatment at the jail.
“The system is broken. … We have high costs and poor outcomes,” said Jennifer DeCubellis, the county’s assistant administrator for health, who designed a plan now being floated by senior county officials.
The new center would be located in a county building at 1800 Chicago Av. S., now used mainly for mental health court services and detox treatment.
Similar recovery centers now operate in Orlando and Houston, and have attracted the attention of Minnesota legislators and county judges. Hennepin County District Judge Jay Quam and State Sen. Barb Goodwin, DFL-Columbia Heights, recently toured the Orlando operation, and came away convinced that Minnesota could benefit from a similar system.
“Most mentally ill people in jail are in a hell they don’t deserve,” said Quam, who recently presided in the county’s mental health court. “Communities like Orlando are proving there is a more effective, economical and humane way to treat mental illness and improve lives.”
DeCubellis reviews daily reports on psychiatric patients at the Hennepin County Medical Center, and often finds herself acting like a traffic cop trying to unclog a jammed intersection.
One recent day, the hospital had 18 mentally ill patients who needed long-term stabilization but had nowhere to go. She noted another 18 county patients receiving care at a state facility, the Anoka Metro Regional Treament Center, who are stabilized but can’t be discharged because there aren’t appropriate community facilities.
In addition, the jail held many inmates who needed to be admitted to Anoka within 48 hours because they’ve been found mentally incompetent to face court proceedings.
“This is a crisis-driven system. … We have to get people out of [one] place in order to get [other] people in,” she lamented.
“Right now the front door to most [care] is going to jail or the emergency department,” she said.
“Health and welfare programs are not connecting — instead, the onus is on the individual who is in crisis.”
Languishing in jail
A Star Tribune investigation last year detailed maltreatment of mentally ill inmates in county jails across the state. The newspaper found that inmates are sometimes held for months with little psychiatric care while they wait for competency evaluations and sentencing.
Even though many were arrested on minor misdemeanor charges, such as public nuisance, they stayed in custody for weeks because they were not allowed to post bail until they received a psychiatric evaluation, the newspaper found.
The series documented several jail suicides and beatings that resulted from negligence in various counties.
Under the best-case scenario outlined in her proposal, DeCubellis says that mentally ill and chemically dependent adults arrested for low-level crimes would bypass the jail and instead be dropped off at the recovery center by police. There, they would be medically examined, assessed for services and then discharged with a care plan within a day of their arrest.
In the current system, she said, many of these people continue to commit mostly low-level crimes due to the lack of community supports. As a result, they end up returning to a jail system that costs about $145 a day to hold them. And when they don’t receive proper care, the cost to taxpayers can skyrocket, as evidenced by the case of Michael Schuler.
Last year, the county paid $1 million to settle a maltreatment lawsuit brought on behalf of Schuler, a mentally ill inmate who blinded himself in one eye after receiving inadequate psychiatric care during his 40 days of confinement.
DeCubellis said the cost of renovating the building on Chicago Avenue could go as high as $30 million. An overall cost-benefit analysis would likely be completed early next year, and county commissioners could consider the project by the end of 2015, she said.
DeCubellis estimates the county could recoup as much as 70 percent of any building costs by streamlining programming at one site. “There would not be any need to create new funding streams,” she said. “We’d simply redirect the money appropriately.”
Last week, New York Mayor Bill De Blasio announced plans to spend $130 million over four years to transform health care delivery throughout the city’s criminal justice system, especially focusing on vulnerable people who commit low-level crimes without getting proper treatment.
Physicians and staff at Hennepin County Medical Center are expected to get their first briefing on the project this week. “I want to build a system … that finds a path regardless of the barriers we have now,” DeCubellis said.