County Jails Struggling With More Mentally Ill Inmates

The Denver Post

As county jails across the state face a quickly growing population of mentally ill inmates, the Adams County Sheriff's Office is looking for money to create a specialized unit to house those prisoners.
The Sheriff's Office has asked for funding either to renovate an unused portion of the jail for about $1.5 million or to build a new wing at a cost of about $3 million to house the most uncontrolled mentally ill inmates.
"It would give us an opportunity to have a unit where they can be efficiently seen by, treated by, our mental-health staff," said Adams County Sheriff Doug Darr. "When we have this many people coming in with these issues, it tells us something's wrong and we need to be on top of it."
The Adams County commissioners have asked for more information from the Sheriff's Office but aren't scheduled to take up the discussion any time soon.
Although the Adams County jail may be the only large county jail on the Front Range without a unit for the mentally ill inmates, Darr isn't the only one who wishes he had more space.
"There's an increase in people coming to jail with mental-health issues, and the mental-health issues we're having to manage are more severe," said Bruce Haas, administrative commander for the Boulder County Jail. "We have people in disciplinary housing units that belong in special housing units. There's more demand than we have space."
Haas said officials at the Boulder jail are also starting to explore options to find more room.
The two options Darr's staff has proposed would allow deputies to move mentally ill inmates from the shared infirmary unit of 15 double-bunked cells to a separate unit with 16 double-bunked cells.
Abigail Tucker, a psychologist who runs one of the support programs at the Adams County jail, said a bipolar inmate who was in detox once spent 12 hours screaming right next to irritated inmates who were physically sick and trying to rest.
"It's about making sure both are getting well," Tucker said. "Some people just have different needs."
Crowding the unstable inmates also creates a safety issue.
"Often we have inmates with severe mental illness coming in with minor charges, but while here they end up assaulting our officers and staff and rack up charges more serious than what they came in for," said Capt. Kurt Ester, commander of the Adams County jail.
But mentally ill inmates can also be the targets of violence.
"People that are mentally ill are sometimes vulnerable or potential victims. We don't want to put them in a position where they're going to be teased or abused," said Boulder County Sheriff Joe Pelle.
Though the state doesn't regulate many county jail operations, most large jails follow similar processes based on published national best practices.
Screening can start with the officers or deputies on the street, or when suspects are booked in the jail.
Staff members who range from certified nurses in Adams County to counseling staff in Jefferson County undertake the first evaluations on every inmate entering the jail.
Any warning sign of a mental condition or a previous diagnosis will earn inmates a referral, but screening staff prioritize the needs so that inmates who may have more severe problems are seen first — often within 24 hours.
That appointment is meant to be a more thorough screening, but at some jails, such as in Jefferson County, getting another referral to a psychologist who can make an official diagnosis and prescribe any needed medication can take up to two more weeks.
Haas, the administrative commander in the Boulder jail, points out that prescriptions aren't a solution if inmates refuse to take them.
"Jails do not have the legal ability — even if a psychologist has prescribed medication — to force inmates to take that medication," Haas said. "Often that's when we see the greatest volatility."
If a judge orders an inmate to a state hospital for an evaluation before trial, staff there can involuntarily medicate inmates to stabilize them, Haas said.
Inmates who aren't flagged in those initial steps also have the opportunity to send private messages to mental-health staff at any point during their stay.
Deputies, family members or other staff who notice irregular behavior also can flag an inmate for an evaluation.
Inmates who are transferred to the special housing units — or in Adams County's case, the infirmary — might then be evaluated daily to determine if they have become stable enough to transfer to the general population to make room for other incoming inmates who may have higher needs that day.
"Ultimately, the state and the counties have to do something different," Boulder Sheriff Pelle said. "When there's no more state hospital beds or there's a severe shortage, it takes a long time to get someone in for treatment. In the meantime, jail is an expensive alternative."
Yesenia Robles: 303-954-1372, yrobles@denverpost.com or twitter.com/yeseniarobles

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Inmates seek counseling

Metro-area jails keep track of inmates with mental-health issues. In this list, the first number represents the percentage of all inmates with clinical diagnoses, such as bipolar disorder and schizophrenia. The second number, which was not reported by all jails, is the percentage of inmates seeking mental-health counseling for any reason.
Adams: 22 percent
Arapahoe: 7 percent; 22 percent
Boulder: 35 percent
Denver: 3 percent; 60 percent
Jefferson: 16 percent
Douglas: 37 percent

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