Long jail stays, but no help

Lack of room in state hos­pi­tals for those de­clared in­com­pe­tent for trial has be­come a per­sis­tent prob­lem.

Los Angeles Times - - CALIFORNIA - By Abby Sewell

In Jan­uary 2014, Ed­ward La­mont Ma­son al­legedly at­tacked and in­jured a woman with a base­ball bat.

He was ar­rested and has been in jail ever since, even though a judge ruled he was un­fit to stand trial.

Ma­son, it turns out, is de­vel­op­men­tally dis­abled. The vic­tim of the al­leged as­sault was his care­taker. And while the judge or­dered him sent to Porter­ville De­vel­op­men­tal Cen­ter — the only state hos­pi­tal set up to house and treat de­vel­op­men­tally dis­abled crim­i­nal de­fen­dants — there is no room.

So while the case against the Hay­ward, Calif., res­i­dent has been tem­po­rar­ily suspended, he re­mains an in­mate in Alameda County’s Santa Rita jail, not re­ceiv­ing the treat­ment that would al­low his case to move for­ward.

Ma­son’s lawyer, as­sis­tant public de­fender Brian Bloom, said if his 37-year-old client had been con­victed and sen­tenced, he prob­a­bly would have served less time than he has now spent wait­ing for a hos­pi­tal bed.

“He’s con­fined in jail for no other rea­son than he’s de­vel­op­men­tally dis­abled, which is re­ally quite hor­rific when you think about it,” Bloom said.

State of­fi­cials say there is noth­ing they can do about it. A back­log of men­tally ill or de­vel­op­men­tally dis­abled de­fen­dants who have been ruled in­com­pe­tent to stand trial has be­come a per­sis­tent prob­lem that judges, lawyers, doc­tors and jail­ers are scram­bling to re­solve.

There are about 50 in­mates like Ma­son in jails around Cal­i­for­nia, wait­ing for beds to open up at Porter­ville, which they rarely do. As of early March, Ma­son was num­ber 13 on the list.

More than 300 other in­mates with di­ag­noses such as schizophre­nia and bipo­lar dis­or­der are also wait­ing for beds in the five other state hos­pi­tals that treat men­tally ill de­fen­dants.

Of­fi­cials and ad­vo­cates across the board agree that

the back­log is cost­ing tax­pay­ers money and de­lay­ing treat­ment for the ac­cused as well as jus­tice for them and their al­leged vic­tims.

In some coun­ties, in­clud­ing Los An­ge­les, lock­ups are al­ready un­der scru­tiny over their treat­ment of men­tally ill in­mates. More state money could build and staff ad­di­tional hos­pi­tal beds, but some of­fi­cials want to first see whether the prob­lem will be eased by Propo­si­tion 47 — which has al­ready re­duced over­crowd­ing in county jails by slash­ing penal­ties for many prop­erty and drug crimes.

State an­a­lysts also be­lieve the Depart­ment of State Hos­pi­tals needs to bet­ter man­age the re­sources it has now. In some cases, hos­pi­tal beds re­main empty de­spite the wait­ing list.

In the mean­time, the state wants coun­ties to treat more men­tally in­com­pe­tent in­mates in the jails, a po­ten­tially cheaper so­lu­tion that has won some sup­port but also raised the hack­les of de­fense at­tor­neys and ad­vo­cates who say jail is not the right set­ting for such pa­tients.

Once a judge finds a felony de­fen­dant is in­com­pe­tent to stand trial, the per­son is sup­posed to go to a state hos­pi­tal for treat­ment and train­ing un­til he or she is able to un­der­stand the crim­i­nal charges and help an at­tor­ney pre­pare a de­fense. In cases where the ill­ness is too se­vere for a trial to go for­ward, a pa­tient can re­main hos­pi­tal­ized for as long as three years.

The num­ber of men­tally ill and de­vel­op­men­tally dis­abled de­fen­dants await­ing trans­fer to state hos­pi­tals at any given time rose to 376 last year from a monthly av­er­age of 162 in 2012. State and county of­fi­cials of­fer a va­ri­ety of ex­pla­na­tions, in­clud­ing cut­backs in county men­tal health ser­vices dur­ing the re­ces­sion that may have led to more men­tally ill peo­ple com­mit­ting crimes, and dif­fi­cul­ties at­tract­ing enough psy­chi­a­trists to work in the hos­pi­tals, which would en­able them to take in more pa­tients.

“It’s a huge prob­lem, for a num­ber of rea­sons,” said Judge James Bianco, who rules on cases in the men­tal health court in Los An­ge­les. Bianco keeps a run­ning stack of cases in which de­fen­dants have been wait­ing more than a month for trans­fer to state hos­pi­tals, and he calls in state of­fi­cials weekly to ex­plain the de­lays. “Th­ese are peo­ple who are se­verely men­tally ill, who need to be in treat­ment at a state hos­pi­tal rather than in jail.”

In Los An­ge­les County, more than 100 yet-to-be-tried jail in­mates are wait­ing for state hos­pi­tal beds. On av­er­age, sher­iff ’s of­fi­cials said, they wait in jail for 2 1⁄2 months af­ter be­ing de­clared in­com­pe­tent be­fore they are trans­ferred to state hos­pi­tals.

The waits are of­ten longer for de­vel­op­men­tally dis­abled in­mates.

Gary Don­nell Wil­liams, a de­vel­op­men­tally dis­abled L.A. County jail in­mate, waited for three years. Dur­ing much of that time, state and county agen­cies were wran­gling in court over who should be re­quired to take him. Wil­liams was ac­cused of sex­u­ally as­sault­ing a woman with Down syn­drome who he had met on a bus. A judge found Wil­liams in­com­pe­tent and or­dered him sent to Porter­ville, but the hos­pi­tal re­fused to take Wil­liams — who also had med­i­cal is­sues and was wheel­chair bound, ac­cord­ing to court doc­u­ments — say­ing he would en­dan­ger other clients.

Fi­nally, af­ter an ap­peals court ruled that Wil­liams was be­ing il­le­gally held, he was re­leased to a South Los An­ge­les group home in Oc­to­ber.

A re­cent re­port by the state leg­isla­tive an­a­lyst’s of­fice noted that Propo­si­tion 47 could re­duce the de­mand for state hos­pi­tal beds. A sep­a­rate re­port by Los An­ge­les County said some 400 in­mates in state hos­pi­tals who have been found in­com­pe­tent to stand trial might be el­i­gi­ble for re­lease if their crimes are re­duced to mis­de­meanors. That has raised con­cerns among county men­tal health work­ers, who say an ex­o­dus of pa­tients from state hos­pi­tals could strain lo­cal re­sources.

But as of Fe­bru­ary, the Depart­ment of State Hos­pi­tals had only been or­dered to re­lease 17 men­tally ill peo­ple whose charges were re­duced un­der Propo­si­tion 47, a spokesman said. Four­teen oth­ers were re­moved from the wait­ing list. No pa­tients have been re­leased from Porter­ville un­der the new law.

In the mean­time, at the urg­ing of the state, San Bernardino and River­side coun­ties have launched in-jail treat­ment pro­grams for a small num­ber of men­tally ill felony de­fen­dants, although not those who are de­vel­op­men­tally dis­abled. Los An­ge­les County is con­sid­er­ing fol­low­ing suit.

The pro­gram would have some fi­nan­cial ad­van­tages, as the state would pay to house and treat the in­mates in the county jail. Cur­rently, the L.A. County Sher­iff ’s Depart­ment re­ceives no re­im­burse­ment for hous­ing in­mates await­ing trans­fer to state hos­pi­tals.

Some ad­vo­cates, at­tor­neys and treat­ment providers are adamantly op­posed to the pro­posal.

“I think it’s a fool­hardy idea,” said Terry Ku­pers, a psy­chi­a­trist who spe­cial­izes in jails. Men­tally ill jail in­mates spend most of their time in a cell and, in some cases, in iso­la­tion, which can ex­ac­er­bate their symptoms, he said.

“Of course it’s pos­si­ble to do qual­ity treat­ment in the jails,” Ku­pers said. “I’ve just never seen it hap­pen.”

As­sis­tant Sher­iff Terri McDon­ald, who over­sees the jails, ar­gued that the pro­gram could, in the short term, help the county, the state and the in­mates.

“State hos­pi­tal beds don’t get built overnight,” McDon­ald said. “I’m not con­vinced this is a long-term so­lu­tion, but as a tem­po­rary so­lu­tion our goal is to get th­ese in­mates the treat­ment they need and get them back into the crim­i­nal jus­tice sys­tem.”

‘Th­ese are peo­ple who are se­verely men­tally ill, who need to be in treat­ment at a state hos­pi­tal rather than in jail.’

— Judge James Bianco,

who rules on cases in the men­tal health court in Los An­ge­les

Robert Gau­thier Los An­ge­les Times

HUN­DREDS OF in­mates de­clared in­com­pe­tent are wait­ing for beds in state hos­pi­tals set up to house and treat the men­tally ill and de­vel­op­men­tally dis­abled. Above, an in­mate sleeps in the med­i­cal unit of the Twin Tow­ers Cor­rec­tional Fa­cil­ity in Los An­ge­les.

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