Never Meant: Jails Become Last Resort for Mentally Ill

August 29, 2016

The Courier

By Christinia Crippes

Eight years ago, when he was first running for office, now-Black Hawk County Sheriff Tony Thompson would have laughed at the idea he would spend much of his time and energy as sheriff focused on mental illness.

It didn’t even take three months after he got the job, however, for Thompson to see the troubling convergence of criminal justice and mental illness. Since then, he says the problem has steadily gotten worse.

“Never, not since there was nothing in place other than family and neighbors taking care of the mentally ill, never was that structure supposed to fall on the backs of the courts, and the police and the jails; just from a mental health perspective, that should never be the case, but right now it is,” Thompson said. “We do it every day, every single day.”

National estimates suggest as many as two-thirds of local jail inmates have some sort of mental health disorder, though that data dates back nearly a decade. Thompson estimates it’s somewhere between one-third and two-thirds of inmates at the Black Hawk County Jail.

But it’s only a small percentage of those — about three to 10 people at any given time in the Black Hawk County Jail — that take up the time, energy and effort that put Thompson and Black Hawk County at the forefront of efforts to reform the criminal justice and mental health systems.

A study from Miami found 97 people who were those most seriously mentally ill accounted for $13.7 million in services over four years. Thompson estimates there are between 30 to 50 of those most seriously mentally ill and most difficult to place people living in the county.

Though Thompson has been outspoken about jails being the placement of last resort for several years, it’s only been in the last six months Black Hawk County has joined a national initiative called Stepping Up that is aimed at reducing the number of people with mental illness in jails.

“For these chronically mentally ill folks, they have a reputation: Covenant doesn’t want them; Allen doesn’t want them, and other places around the state do not want to take them because of the problems that they’ve had in the past. There’s just no place for them to go, so that’s our frustration,” said John Miller, who is spearheading the county’s Stepping Up effort.

Miller, a Black Hawk County supervisor, meets monthly with a group of 15 to 25 people in the region. The makeup of the Stepping Up committee, however, is more important than its numbers.

“That’s part of the beauty of the Stepping Up initiative is that we’re putting the people at the table that can make the decisions, the sheriff, the judges, the county attorney, the public defender, the county supervisors,” Miller said.

Because they have budgets and can make decisions on behalf of their various entities, the group offers promise of making real changes.

Study in success

At their most recent meeting, part of the focus was on an upcoming trip to Bexar County, Texas, that will look at a program that is reducing recidivism rates of people with mental illness by having a focus on supports after the person leaves incarceration.

They hope the trip will offer some concrete tips Black Hawk County can enact, or at the very least have some ideas for solutions and seek funding for those remedies.

Thompson praised the Stepping Up efforts, but he worries the impact may be limited until the state takes on a larger role — both in recognizing the extent of the problem and offering resources to address it.

“As we step off the plane from Bexar County, we know that that same elephant is going to be standing in the corner of the room stymying our effort,” Thompson said, but added, “Maybe there’s something else out there, so it’s worth the travel; it’s worth the education; it’s worth the investment that we’re putting into it right now to keep looking, to keep finding answers.”

He said the effort is about more than “rattling cages.” It’s also promoting forward progress, partnerships and collaboration.

Positive signs

“As tired as we get about meeting and meeting and meeting and talking and talking and talking, and never coming up with solutions or funding or ways to fund solutions that we do have, that collaborative effort continues to exist, and I do believe that’s somewhat unique to Black Hawk County too,” Thompson said.

So, that means the work will continue.

He points to successes like the crisis stabilization center that has 15 beds, and the efforts of County Social Services Chief Executive Bob Lincoln, who oversees the center, to try to expand it to become a sub-acute center that can take on intermediate needs of people.

The county also has received attention and praise for its years-long efforts at jail diversion, to try to find alternative placement immediately.

Along with jail diversion, Stepping Up continues to look into crisis intervention training for some of the city and county officers that will start that diversion process before arrest for those who are not truly criminal but acting out due to their mental illness.

The concept is a welcome one in the county, but the training is a week-long commitment for staff, which could take time away from their other duties.

June Klein-Bacon, a member of Stepping Up, notes the efforts are not about giving out “get out of jail free” cards, but instead creating a system that can help reduce recidivism, support re-entry and create a path for people to re-enter society in the most healthy fashion to be productive in their communities.

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