Fixing Our Jails

Penobscot County Sheriff Glenn Ross is right that he shouldn’t have to call the governor’s office to get help for a prisoner who has repeatedly tried to commit suicide. As mental hospitals have downsized, jails have been left to handle more people with psychiatric and substance-abuse problems. The result was last week’s cry for help from Mr. Ross and area health care providers. That cry should be heeded by lawmakers, service providers and the community.

Nationally, correctional facilities house eight times as many mentally ill people as do state psychiatric facilities. Nationally, about 16 percent of the inmate population is in treatment for mental illness, but in Maine, that figure is closer to 25 percent, according to a report released in 2002 by the Maine chapter of the National Alliance for the Mentally Ill. Compounding the problem is that well over half of the inmates have drug and alcohol abuse problems, making jails detoxification facilities too. This is not where individuals with these problems belong.

The result is a county jail unable to find treatment and a safe place for an inmate who has tried to commit suicide eight times, the last few attempts while held alone in a room clad only in his underwear.

To change this situation, there must be short- and long-term efforts. In the short term, jails need to be revamped to better provide services for those with mental illness and substance abuse problems. Clearly, being held nearly naked in a bare room will worsen the mental state of nearly anyone and more so for someone suffering from mental illness. One improvement would be to increase the number of mental health counselors who work in and with the jail. Of course, there is a cost issue and this expense should be borne by the state, not county taxpayers.

Some solutions lie outside jail. Six Maine communities have formed crisis-intervention teams. These teams include police officers trained to de-escalate psychiatric situations. Such efforts reduce arrest rates and lead to calmer patients or inmates if they must be taken to a hospital or jail. There are plans to start such a team in Bangor and a study is under way to see if it works in a jail setting.

In the longer term, community-based facilities must be created where law-breakers with diagnosed mental health issues can be treated and housed. As Carol Carothers, president of NAMI-Maine, says, community attitudes must change. Rather than seeing inmates as “bad people,” local residents need to view these men and women as members of the community who need help. Once this has occurred, new facilities are more likely to be built and welcomed in neighborhoods.

There are clearly humanitarian reasons for such changes. There are financial benefits too. Currently, county taxpayers, through their property taxes, pay nearly all the bill for the care of prisoners, including medical and psychiatric treatment because Medicaid benefits stop when someone enters the corrections system. Politically, covering prisoners under the federal health insurance program won’t happen. So, alternative means of paying for such services should be sought. Perhaps shifting money from costly hospital stays and other ineffective interventions to practices that work will cover much of the new costs.

Fixing the problem will take a lot of will and money. Doing nothing will still cost even more.