As rural jails bear an increasing burden of individuals with mental health problems, jail authorities in Quincy, Il., have deployed innovative measures such as video counseling, special training for corrections officers, and partnerships with police and health providers.
Every Monday, a representative from Clarity Healthcare, based in Hannibal, Mo., visits the small Adams County jail in Quincy, Ill., to help authorities treat inmates who need mental health counseling.
The “visit” is often connected through video, allowing authorities to speak with a psychiatrist who can prescribe medications and assist with any issues they have with the medications.
“If we feel that Clarity needs to (help) somebody, we will definitely get them hooked up with it,” said Adams County Sheriff Brian VonderHaar. “From there’s up to the individual.”
Diagnosis by video is just one of the options jails in smaller jurisdictions are using to help them deal with a growing population of mentally ill inmates.
Bipolar disorder, schizophrenia and depression are just a few of the diagnoses some inmates at the Adams County Jail in Quincy have received.
With no elevator up to the booking area on the fourth floor, inmates must walk—or at times be carried—up the stairs to get booked, putting staff and the inmate at risk, especially if a mental health illness makes them uncooperative.
It’s a nationwide problem.
According to the Vera Institute of Justice, about 14.5 percent of men and 31 percent of women in jails have a serious mental illness, compared to 3.2 percent of men and 4.9 percent of women in the general population.
Going by that estimate, it means with a capacity of 118, 21 inmates—15 men and six woman—in the Adams County Jail could be expected to have a serious mental health illness.
However, the jail has exceeded its capacity in recent years. Recent populations have soared to more than 140.
Although construction continues next to the Adams County Courthouse on a new, larger facility, local authorities are deploying in the interim a number of innovative options such as video counseling to address mental health.
Another option is focused staff training. New hires for the jail automatically go through crisis intervention courses after they complete their Basic Correctional Officer Training.
The crisis intervention team training is specifically designed to help jail officers deal with individuals who suffer from mental health illness.
Jail Administrator Chad Downs said four or five corrections officers recently completed the crisis intervention team training.
With the new jail set to open before the end of the year, VonderHaar said it is possible that more services could be offered, including in-jail counseling, but more discussions are needed for that.
Downs said after an inmate leaves, he or she might stop taking medication and then end up getting sent back to the jail after getting arrested. After they get back on their medications, he says they’re fine.
“It’s when they leave here that they might get off track,” he said, adding aftercare is another area that needs to be addressed.
Partnerships with Police
The Quincy Police Department has also changed how it interacts with those with mental health illness.
Sgt. Erica Scott, a 15-year veteran of the Quincy Police Department, has seen the change in approach when police officers are given crisis intervention training to deal with individuals suffering from mental health illness.
“It basically teaches officers not to diagnose, but how to recognize someone in crisis and how to recognize someone who is potentially mentally ill, and then how to handle it — ways to approach them, things to do, things not to do and a little bit of a de-escalation,” Scott said.
The Quincy Police Department also is working with Clarity to provide mental health evaluations as needed. The department contracted Clarity last year for evaluations and to provide services during crisis to crime victims or even officers.
“They are basically on call to us 24 hours a day to provide mental health services, so if we have someone in custody that is suicidal or homicidal and they need to be evaluated prior to being put in jail, they will come and do an assessment and determine whether or not that person really needs to go to the hospital or if they can go to jail,” Scott said.
*In 2018, officers with the Quincy Police Department responded to about 660 calls for service involving an individual with mental illness.
Scott or another assigned officer along with someone from Clarity will occasionally reach out to individuals with mental illness to make sure they are keeping up with medications and follow-up appointments they may have with an area provider.
*”I think law enforcement as a whole has taken a new perspective that jail is not a solution for a lot of these people,” she said. “It’s getting them follow-up services. A lot of people don’t need to be hospitalized. There can be out-patient services that can treat them.”
Aftercare for jail inmates is cited by both law enforcement and justice officials as an area that particularly needs attention. Last year, Adams County launched a Mental Health Court in 2018 to help divert former inmates with mental health issues to treatment.
State’s Attorney Gary Farha said the goal of Mental Health Court is to stop a pattern of behavior of repeat offending by inmates suffering from mental health illness. Cases can range from multiple counts of retail theft to violation of an order of protection.
The Mental Health Court team includes representatives from Transitions of Western Illinois, Blessing Hospital, Quincy Medical Group, the state’s attorney’s office, the Adams County public defender’s office, the Adams County Probation Department, and other representatives from law enforcement.
“You’re not only getting treatment providers looking at (inmates’) cognitive thinking, but they’re also looking at their medication and what it might do to them—and what not taking their medication might do to them,” Farha said.
“That’s the wonderful thing about the team approach, because you get everything from different prospective. Ultimately, the judge is the arbitrator.”
The problem-solving court is a more intensive version of probation for those convicted of crimes who suffer from mental health illness.
However, Farha takes issue with a state requirement that sets specific standards for admission in the program. With space for just 20 to 25 people, that could limit people who staff believe would be successful from entering the program, he said.
“That’s a little bit frustrating when you’re trying to start (an inmate) out a program because we’ve already had an individual that has left the program for not being able to handle it, and there are a couple others that are having difficulty with it,” he said.
Matt Hopf, a staff writer for The Herald-Whig, is a 2018 John Jay Rural Justice Reporting Fellow. This is a condensed and slightly edited version of an article written as part of his fellowship project. The full version can be accessed here.