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Officials: Jail Is No Place For Mental Health Patients
The Greeneville Sun - 11/18/2017
- Part 1 of 2 -
In January of 2015, Kim Russell faced one of the most painful experiences a parent can endure - the loss of a child.
Russell's 27-year-old son, Matthew Wills, died of natural causes while in the custody of the Greene County Sheriff's Department. Wills, who had gone from a happy, loving child to a young adult diagnosed with paranoid schizophrenia, was awaiting transport from the jail to a state mental health facility in Chattanooga to receive care for his condition.
The tragedy underscored a mental health care system that uses the state's network of jails as a catchall for those that fall through its gaps.
According to a Tennessee Department of Corrections report, 28 percent of state inmates are dealing with mental health issues.
TDOC and the Tennessee Department of Mental Health and Substance Abuse Services recently received a grant from the U.S. Department of Justice that will be administered through the National Alliance on Mental Illness to study, develop strategy and expand the network of crisis intervention teams, which provide training and resources to law enforcement.
That's good news to Russell, who works to raise awareness about mental illness through Matthew's Way, an organization she founded after her son's death and which she says she is thankful has received much support from the community.
"I'm glad there's money coming down," Russell said. "It should have been coming down a long time ago. It needs to be spent correctly and wisely."
Wisely, Russell said, includes more and better training for officers that emphasizes respect and compassion.
She noted that when the mentally ill are arrested, they stay in jail longer, even for misdemeanors.
Greene County Sheriff Pat Hankins said that's because of the gaps in the mental health system, which frustrate him. They also strain the department.
"We truly have a problem in Greene County," Hankins said. "Right now, we are having to transport people from the hospitals to Woodridge in Johnson City, Moccasin Bend in Chattanooga, and it is running us ragged right now. It places a huge burden on the sheriff's department. We're making as many as seven transports a day. It's killing my budget."
Greene County Jail Administrator Roger Willett agrees.
"It puts a tremendous strain on our staff," Willett said. "When you have an individual that's incarcerated with mental health issues, they need more supervision. You need to look at special housing for that individual.
"On one hand, you take this individual that's in a mental health crisis and one option is you detain him in a cell by himself. Is that the best thing for him? Or maybe you detain him with a group of people that he can be around and talk to. You've got to look at each case individually. Some are in a state that there's no way we can house them with other inmates. That puts a bigger strain on my staff as far as supervision."
Willett said the jail often sees residents from group homes, usually after getting into an altercation with a house manager or other staff.
"They get arrested," he said. "They come to jail. Some of these people don't even know why they're in jail. They've got to go before the judge and he's got to try to sort it out and come up with some kind of plan so that these people can get help. You take someone that doesn't realize he's or she's in jail and all of a sudden he's locked up in cell by himself. I'm sure it's traumatic."
Whatever the reason they find themselves in a cell, Willett doesn't feel that jail is the right place for someone in a mental health crisis mode.
"It's not a hospital," he explained. "It's a jail. We're not designed to hold mental health folks."
He added: "It's frustrating. I just wish there were more services available to get these folks help."
State law also mandates that all transfers of mentally ill patients in crisis at hospitals be transported by that county's sheriff department.
Willett said that can also take an emotional toll on the inmate and the officers.
"You take and inmate that's elderly or they're a veteran and they've never broken a law in their life, and all of a sudden they're being put in the back of a police car and transported to a mental health facility," Willett said. "That's the requirement put on us by the state."
Although officers are offered crisis intervention training through the department and Willett aims to have one certified officer on each shift, the number of inmates with mental health issues and the number of transfers - as many as four to six transfers a day - is outpacing them.
The problem also affects the hospital emergency departments, according to Willett. When a patient requires a transfer to a mental health facility, the hospital has to wait for a bed to open up and then wait for an officer to be available.
"Sometimes that will take two or three, maybe four days or even longer, before they can get transportation to either Woodridge, Peninsula or Moccasin Bend, which is in Chattanooga," Willett explained. "So I've got to take and officer or two out of my facility - where I'm housing over 400 inmates - to take this one individual to transport them from the hospital to a facility that can house them safely."
According to Takoma Regional Hospital Emergency Department Director Christy Lane, the wait and the manner of transport can complicate things for patients already in crisis.
"The faster they can get to somebody that's on their way to crisis, the better off their treatment is," Lane said.
She added: "Sometimes they feel like they're being punished for having a mental health issue. They may view it that way. That's not what we're doing. We're doing that to keep them safe in order to get to the next facility. But the patient may look at it as I've done something wrong."
Lane said if family members are with the patient in the hospital at the time they are being transported, it can also be hard for them to see their loved one handcuffed and placed in a police cruiser.
"If I could ask for any one thing, it would definitely be placing those individuals with mental health facilities quicker," Lane said. "Right now there's a waiting list to place individuals within a facilily because the facilities are so full. Either expanding facilities or finding better ways to get people to their treatment quicker."
Willett would like to see a plan in place to provide transportation to facilities more quickly. His suggestion is to train regional teams specifically trained and dedicated to transport the mentally ill.
State Rep. David Hawk thinks that's an idea worth looking into.
"I think Mr. Willett's idea is a very good idea," Hawk said. "It's certainly worth looking into to use some of the potential grant money for a system like that."
Hawk sees an equally pressing problem facing the state, though.
"At this point, what we're finding is we just don't have enough people in the field," he explained. "We just don't have enough people in the profession of treating mental health issues to take care of everybody that's got a need across the state of Tennessee."
He said he hopes that as the state moves forward with providing higher education degrees, more people will go into mental health care work.
General Sessions Court Judge Kenneth Bailey thinks more short and long-term facilities are needed to work in concert with other efforts and help close the system's gaps and said having people with mental health issues in jail only exacerbates their condition.
"We have closed down all of our long-term mental health facilities," Bailey said. "We have folks that are living on our streets in Greene County that have mental health issues. I can think of five to 10 that I see on a regular basis that need to be in a facility and we don't have those long-term facilities anymore."
Bailey said at best, those individuals may go to Johnson City to a crisis stabilization unit for anywhere from three to five days but then are released back onto the street and told to follow up at the local mental health center. Bailey said it's a system that keeps them in a cycle that never allows them to get the long-term help they need to improve their quality of life.
"I think we need to have money invested in six- to eight-month programs to try to get folks reconditioned and to help them with their mental health needs," Bailey said. "I think crisis is a major need and I think short-term or long term facilities."
Whatever the solutions may be to the growing number of people needing mental health care, all parties seems to agree on one thing - jail is not the answer.
Editor's Note: Another story will appear in an upcoming edition of The Greeneville Sun and will detail inmates' experiences, as explained by local nurses.