SPIKE IN MENTALLY ILL PRISONERS
Surge blamed on methamphetamine use but doctors are not so sure
PERHAPS the largest group of mentally ill inmates in the United States resides in Los Angeles in one of the world’s largest jail complexes.
Over the past seven years, the jail’s population has spiked almost 50 per cent — with nearly every inmate having both mental illness and substance abuse problems — and officials suspect the rise is due to methamphetamine use.
The Twin Towers Correctional Facility is home to about 4,000 mentally ill inmates. The increase in the number of mentally ill prisoners — about 30 per cent of the county’s total jail population — has led the sheriff’s department to adapt its policies as deputies and clinicians work to treat people dealing with both psychiatric disorders and substance abuse.
County Sheriff Jim McDonnell blames the surge on meth use, but doctors say it’s often difficult to distinguish whether the patients had underlying conditions and then started using drugs, or if their chronic drug use led to psychiatric disorders.
Chronic use of meth, a highly addictive stimulant, can cause paranoia, visual and auditory hallucinations and delusions.
“It’s causing people to become mentally ill, and we’re going to be dealing with those individuals in one way or another for the rest of their lives,” says McDonnell.
Sheriff’s officials say they are training deputies to deal with mental illness and focus on treatment instead of punishment.
“No one ever expected jails and prisons to be mental health institutions,” says Kelly Harrington, the assistant sheriff who oversees the county jail system.
“The deputies, although they don’t have specific psychiatricor psychology-type degrees, we give them as much training as we can in the short period of time we have them.”
The American Civil Liberties Union (ACLU) routinely receives complaints from Twin Towers inmates who say they haven’t been able to see doctors or psychiatrists, haven’t received their medication and that their medical needs are being ignored, says Esther Lim, jails project director at the ACLU of Southern California.
“The jail has a history of not providing adequate medical care or mental healthcare,” she says.
Harrington says he has heard similar complaints but noted the jail system has made significant progress in recent years to ensure that inmates receive proper care. Still, he concedes, more work needs to be done.
Over the past year, the sheriff ’s department has rolled out training programmes that focus on de-escalating potentially violent situations and teach deputies to handle mentally ill inmates, says Harrington.
They have also adopted techniques and programmes that take the inmates out of their cells for recreational programmes and therapy.
In addition, county officials have launched a programme to transition mentally ill inmates with substance abuse problems to continue treatment in community programmes so that they don’t return to a life of crime to get quick cash to buy drugs.
Recently at Twin Towers, inmates took part in life skills lessons, substance abuse counseling and classes to earn a General Educational Development diploma.
Some inmates met one-on-one with clinicians to discuss their progress, while others chatted with peer mentors and passed the time playing cards and checkers.
The inmates spend nearly all of their days in contained jail blocks. Some are segregated into pods because of their crimes, sexual orientation or gender.
On the jail’s fourth floor, inmates sat at small tables around their cells and had a group discussion about the harms of substance abuse. They seemed to cling to every word from teacher Edward Monteilh.
“I really want them to understand how their brain works,” says Monteilh, who has led classes at the jail for about five years.
“I try to explain to them how mental illness affects them, how substances affect their brains and the compound effects of the two.”
Even as sheriff’s officials work to implement new programmes and treatment initiatives, experts say the restrictive settings can often lead mentally ill prisoners, who are already more likely to break jail rules, to become more symptomatic and violent.
“That kind of isolation is not going to help your psychosis in any way, shape or form,” says Dr Jeffrey Reynolds, a social worker who specialises in substance abuse and addiction disorders.
“They are probably walking out in a lot worse shape than they were when they went in.”
And access to drugs inside the jails only makes the problem more complex. Between 2011 and last year, the amount of meth recovered during searches inside Los Angeles county jails increased by nearly 750 per cent.
Jail officials across the nation are struggling with how to deal with mentally ill inmates, including those who are also addicted to drugs.
A 2014 report by the Treatment Advocacy Centre and the National Sheriffs’ Association found 10 times more mentally ill inmates in America’s jails and prisons than in its state hospitals. The report also showed the number of mentally ill prisoners and the severity of their conditions continues to climb.
“That cycle is feeding off itself, and we end up with what was initially a health problem as a very expensive criminal justice problem for years to come,” says McDonnell. AP