Only four other California counties had higher percentages of jail inmates receiving psychotropic medication than San Luis Obispo last year, according to state data compiled by The Tribune and Sacramento Bee.
Data for California’s county jails in 2018 show that San Luis Obispo County Jail continues to rank high among the state’s detention facilities in terms of inmates suffering from mental illness, open mental health cases, and inmates awaiting or receiving treatment.
But last year’s figures come in lower than years past due to errors in the county’s reporting a mental health officials said had gone on for decades when asked about the high numbers by The Tribune last year.
County officials had no comment on the new statistics for this article, and the county Behavioral Health Department is no longer involved in the treatment of inmates since WellPath, a private medical and mental health services company for correctional institutions, took over care at the jail in February.
Last year, Behavioral Health Director Anne Robin said the county had over-reported its numbers for the number of people awaiting beds in a mental health facility, and likely over-reported types of psychotropic medications and open mental health cases that other counties don’t count.
It appears San Luis Obispo County corrected its reporting in 2018, but it is unclear how it did so. Robin referred questions for this article to the county’s chief medical officer, Dr. Christy Mulkerin, who referred questions to the Sheriff’s Office.
The Sheriff’s Office declined to elaborate on the figures compiled by The Tribune, and spokesman Tony Cipolla did not immediately respond Thursday afternoon to followup questions about who now reports jail data to the Board of State and Community Corrections (BSCC).
According to the county’s latest data, the number of SLO County Jail inmates receiving psychotropic medication fell from 2017 to 2018.
About 39 of every 100 jail inmates received psychotropic medications in 2018, down from 45 per 100 in 2017, according to survey data from the BSCC.
Among California counties, that was the fifth-highest rate of inmates receiving such medication during 2018.
Robin said last year that a lack of a standardized definition of “psychotropic” medication previously led the county to report even over-the-counter medications such as sleep aids in that category.
Before the fix, state data showed that no county in California had a higher percentage of jail inmates receiving such medication from 2010 through 2017.
Asked about how the agency ensures it is receiving accurate data, BSCC spokesman Adam Lwin said via email that it stresses the importance of doing so, but data collection practices across agencies can vary due to local agency-specific data systems, data collection limitations, and definitions.
“BSCC screens the data and communicates with reporting agencies to attempt to ensure accuracy and completeness,” Lwin wrote. “The screening process is done on an agency-by-agency basis and does not compare counties.”
He wrote that the agency does not conduct investigations or audits of the data, and that its records are a “live database” that represents point-in-time data.
“Previously reported data are regularly updated to reflect any revisions received from local agencies,” Lwin wrote.
Open mental health cases
Among all California counties, San Luis Obispo had the fourth-highest rate of inmates with open mental health cases during 2018, according to the latest data.
There were about 60 open mental health cases per 100 San Luis Obispo County Jail inmates in 2018, down from 65 per 100 inmates in 2017.
The county had showed the second-highest rate of open mental health cases in California jails from 2010 through 2017 last year. Robin said at the time that, similar to the medication issue, differences between counties’ interpretations of “mental health” likely led to San Luis Obispo County reporting a higher rate than others.
She also said the local jail’s new electronic records system and an aggressive screening protocol for all inmates during booking has led to more “open” mental health cases, though an inmate may not be actively receiving mental health treatment.
Mental health beds
One category the county said it had definitely been misreporting was the number of inmates “needing, or actually assigned to, mental health beds” in the jail.
Last year, there were about seven San Luis Obispo County Jail inmates assigned to mental health beds per 100 inmates, which is up just slightly from 2017.
Among California counties, that was the ninth-highest per-capita rate of inmates assigned to mental health beds during 2018.
Previously, data showed that San Luis Obispo County had the highest rate in California for that category, from 2010 through 2017.
Robin told The Tribune last year that it had been reporting the classification of inmates, and not the number of occupied specialized or protective beds, which the BSCC survey actually asks for.
County officials appear to have submitted new data for mental health beds going back several years, which reduced their numbers significantly.
Treatment of people incarcerated at the County Jail has been under intense scrutiny since a series of inmate deaths over the last few years, many of whom suffered some form of mental illness.
In addition to an ongoing investigation by the FBI related to the January 2017 death of Atascadero resident Andrew Holland, the jail is also under review by the U.S. Department of Justice’s Civil Rights Division.