Mentally ill offenders need services, not jail

Jail is not the best place for people who have a serious mental illness and have committed nonviolent crimes, according to a Ventura County grand jury report released June 15.

Instead of jailing nonviolent offenders who have been diagnosed with mental illnesses such as paranoid schizophrenia or bipolar disorder, the report recommends the county establish a permanent mental health court and provide the offenders with adequate housing.

The report, "Mentally Ill Housed in Ventura County Jails," states that prisons and jails are the nation's largest psychiatric hospitals and that in Ventura County up to 14 percent of the jail population has been diagnosed with a mental illness. That means 235 of the 1,680 incarcerated inmates in the county's three jails last October were mentally ill.

Grand jury foreman Ron Zenone said the jury realizes a lack of money and personnel can be obstacles, but county leaders and judicial and law enforcement officials should "put their heads together" and implement the jury's recommendations.

"It has to be a buy-in with all the different organizations," Zenone said.

Mental health court

versus recovery team

A mental health court is a collaborative approach among mental health providers, representatives from the justice system and others. Its aim is to encourage offenders who have a serious mental illness to enter treatment. The court focuses on supporting the offender, reducing his or her criminal activity and closely supervising his or her progress. The judge interacts directly with the offender.

Ventura County has a similar program, the MultiAgency Referral and Recovery Team, with many of the same officials. But in September, after only 18 months, federal funding for the recovery team stopped. The team deemed the program so successful that the participating agencies began funding it themselves.

Of the 59 offenders with a serious mental illness who were suitable for the program and agreed to receive mental health treatment, 14 completed all that the court asked of them and "graduated."

The grand jury said the recovery team "should be applauded" for their efforts but more "could and should be done."

The recovery team should be set up as a mental health court and take on more cases, Zenone said. Also, nonviolent offenders who have a serious mental illness need housing, something that's in short supply, while undergoing treatment and supervision by the mental health court. Only those who are not harmful to themselves or others would be allowed into the program.

Zenone said providing the offender with housing and proper treatment can benefit society. It can result in the offender becoming a productive member of society and create more room in the jails for real criminals, he said.

In preparing the report, some of the grand jury members visited the San Bernardino mental health court and learned of success stories there. For example, one former offender is now in college and another is working full time, Zenone said.

Until the county implements these changes, the mentally ill will continue to "cycle through" the county jails, the report said.

Supervisor Linda Parks said she supports changing the recovery team into a mental health court.

"Instead of . . . confining them in a jail," Parks said, "you're helping them deal with society, monitoring their progress and giving them resources,"

In December, Parks wrote a letter about the problems that come with jailing lowlevel criminals who have a mental illness. The letter, which appears on her page on the county board of supervisors' website, was included in the grand jury's report.

In the letter Parks states that common offenses for people with a mental illness are public intoxication, theft, trespassing and substance abuse, and that incarceration can add to the person's mental illness. There may be confusion over the proper medication to give the offender. Also, the convicted person will lose their government benefits and possibly their health insurance policy, Parks states. A lack of insurance for medication can contribute to the person returning to jail.

Also, jail is expensive; it costs the county as much as $154 a day to house an inmate at one of its three facilities—more than it costs to attend Harvard University, said Parks, a member of the county's mental health committee.

Parks admitted that adequate housing for mentally ill offenders is a problem.

"This is one thing we are missing and one thing we should have in place," she said.

What's already in place?

The county does have programs in place for the mentally ill, such as wellness treatment centers throughout the county, outreach programs and peer counseling. In a year or so the county plans to open a residential crisis center for the mentally ill that might be the answer to the housing suggested by the grand jury, Parks said.

But Meloney Roy, director of the county's Behavioral Health Department, said the proposed facility will be a shortterm rehabilitation residential treatment facility for mentally ill people who are in a crisis. Stays at the facility, an alternative to a psychiatric hospital, would be no longer than 30 days.

Treatment for the mentally ill participating in a mental health court, on the other hand, usually requires "wraparound" services—intensive case management, medication monitoring and other supportive services a multidisciplinary team can provide, Roy said. The residential crisis facility could be used to help stabilize them but would be inappropriate as their primary source of treatment called for by a mental health court, she said. The courts usually require treatment that's longer in duration.

Another reason it would be difficult to implement the grand jury's recommendations is that it would require the county to modify some programs but expand others. They would be forced to hire more professionals, not just in Behavioral Health but also in other participating agencies, during a difficult economic time, she said.

Roy said she thinks the county is doing a lot for the mentally ill already. Through the Mental Health Services Act of 2004, Ventura County has received about $36 million in funding to help people with a serious mental illness. The act has funded a number of county programs that provide "wraparound" support services for those at risk of hospitalization or jail, making available whatever services and programs are necessary to stabilize their mental state and avoid more restrictive levels of care, Roy said.

An example is having a discharge planner from Behavioral Health at the jail to help connect offenders who have a mental illness with programs and services that can help keep them from returning to jail, Roy said.