Warehousing mentally ill defendants in county jails must stop

Henry Herrera is the family services forensic liaison for Transitions Mental Health Association, which works to find options for those with mental illness in and out of jail.
Henry Herrera is the family services forensic liaison for Transitions Mental Health Association, which works to find options for those with mental illness in and out of jail. dmiddlecamp@thetribunenews.com

Mentally ill people in the criminal justice system are often invisible to the general public — locked up, out of sight and out of mind, until something goes wrong.

As Tribune writer Patrick Pemberton reported, something is going wrong — very wrong — in that mentally ill people are being warehoused in county jails because there aren’t enough beds in state hospitals.

Here in San Luis Obispo County, mentally ill defendants who have been found incompetent to stand trial and require treatment to restore them to competency are spending months “languishing” in county jails, as one local defense attorney described it. His client, a woman arrested for a probation violation, waited in jail so long that a judge had no choice but to release her. Within days, she was arrested again for allegedly assaulting a friend with a porcelain bowl, causing lacerations to the woman’s face.

As Pemberton noted, mental health therapy and medication are offered at the SLO County Jail, but such treatment is voluntary and often refused by mentally ill inmates. Instead of receiving the treatment they need, they often are confined in isolation because of their behavior — a situation that can aggravate their illnesses.

That’s an awful situation for the defendants and their families, and while we don’t want to demonize mentally ill defendants, it can also be a public safety issue when they are released untreated. And we aren’t talking about isolated situations.

Just last week, San Luis Obispo County had 12 inmates awaiting transfer to state hospitals. If a small county like ours has a backlog of 12, imagine what the backlog must be for large counties.

What can be done?

Simply throwing money at the problem isn’t the answer. According to a report by the state’s nonpartisan Legislative Analyst’s Office, state hospitals don’t have the capacity or the staff to handle all patients who have been found mentally incompetent to stand trial. Those patients have a lower priority for admission; sexually violent predators and mentally disordered offenders, among others, are given higher priority.

To deal with the backlog of patients awaiting competency treatment, the Legislative Analyst’s Office recommended expanding a pilot program that proved successful in San Bernardino County. That county contracted with a private provider to treat mentally ill inmates who require treatment before they’re ready to stand trial. The treatment was provided at the county jail, more quickly and at less expense than at state hospitals. It had the added advantage of allowing the defendants to stay close to their support networks of family and friends.

The Legislative Analyst’s Office recommended expanding the program first in counties that are the biggest “feeders” to Atascadero and Patton state hospitals, including Los Angeles, Kern and San Diego.

That makes sense, since it would free up beds in state hospitals for defendants from smaller counties, such as San Luis Obispo.

Since the report was released, Riverside County has created a program similar to San Bernardino’s, and other counties are interested.

That’s encouraging, but we suspect it’s going to require public outrage and political will — particularly on the part of state legislators — to ensure that the problem is remedied to the extent that mentally ill inmates are no longer “languishing” in county jails for months.

In other words, it’s time for us all to pay attention to a population that’s been too often overlooked.