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Courts and Crime


Ohio jails: Mental health treatment of last resort
In part two of her series, WKSU’s Amanda Rabinowitz explores other options that Northeast Ohio communities are trying to keep people whose crime is often simply their illness out of jail.
by WKSU's AMANDA RABINOWITZ


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Amanda Rabinowitz
 
Canton South resident Dan McFarland meets with his case manager, Charlene Colvin, at Coleman Behavioral Health.
Courtesy of Amanda Rabinowitz
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The scaling back of  many of the state’s psychiatric hospitals means jail is often where people with mental illness end up – and often where treatment begins. In the second part of our series, WKSU’s Amanda Rabinowitz explores options that Northeast Ohio communities are trying to keep jails from being the state’s defacto mental hospitals.

Ohio jails: Mental health treatment of last resort: Part 2 audio

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Treatment often starts in jail
Often times, it takes a crisis for someone with mental illness to get the treatment they need. And even with that treatment, many still cycle in and out of jail. Take Sharon Bushner. Ten years ago, the now-42-year-old Akron woman was diagnosed with bipolar disorder and depression. "I was out on the streets, I didn’t have anyone to turn to...I was just out there on drugs and alcohol...I was going through a lot of problems with my family, it was like I just stayed violent all the time mentally-wise."Diagnosed with bipolar disorder, Sharon Bushner is now employed at Community Support Services working with clients in the lobby (photo credit: Amanda Rabinowitz)

A sheriff's new policy
That violence prompted Summit County’s sheriff to declare earlier this year that he would no longer house violent mentally ill inmates in his jail unless they get mental health treatment first. Had that policy been in place in 2004, Bushner may have been one of those the sheriff would have turned away. She was arrested for domestic violence and spent three weeks in the jail. There, she got medication and met with a counselor.

And today, Bushner is sober, happily married, has a home and takes her four medications regularly. She’s also employed – at Community Support Services, one of the organizations that provides treatment and support to mentally ill people in Summit County. That organization, she says with a bright smile, linked her with the county’s mental health court program. "You know I feel that I still be out there with a crack pipe in my hand, drinking. They never gave up on me.”

Mental health court
Mental health court is one of several approaches Northeast Ohio communities are taking to break the cycle. Summit County was the first in the state to establish such a court 11 years ago. Probation officer Tony Ingram says offenders who undergo two years of supervised treatment can have their cases dismissed and sealed. "Once they’re done with us, we want to make sure that if they ever get in crisis again in the future, turn to your case worker, turn to your psychiatrist, turn to the mental health system and try and avoid the criminal justice system to do that – that’s really our goal."

But no one is quite sure if it’s working
Of the more than 800 people who have participated in the program in Summit County, about 200 have graduated. The mental health court acknowledges, however, it has compiled no statistics on recidivism. Even Sharon Bushner admits, it took her two tries to successfully complete mental health court – she quit the program and landed back in jail briefly. The judge gave her a second chance.

Case management
By choice or circumstance – mental health court isn’t for everyone. Canton resident Dan McFarland meets regularly with his case manager at social-service agency Coleman Behavorial Health. McFarland has schizoaffective disorder with bipolar tendencies and attention deficit disorder. It’s been a context of his life for most of his 36 years.Dan McFarland of Canton South meets with his case manager, Charlene Colvin who helps him organize appointments  (photo credit: Amanda Rabinowitz)

He has a host of people who keep him on his medications, follow through on appointments and essentially help him manage his life. Unlike Sharon Bushner, McFarland has never been homeless or had a substance abuse problem.

Still, he ended up in the Stark County Jail for more than two weeks in 2009. He got into an argument with a friend and was arrested on multiple charges including destruction of property. It happened on a weekend – when no case managers were available to talk to the police or the judge. Without a lawyer, McFarland pleaded “no contest;” the judge found him guilty and sent him to jail. It took weeks for his family and counselors to get the judge to reverse himself.

McFarland swears it will never happen again. "I’m not losing everything, because if I get in trouble again which I do not want to get in trouble again, I’ll lose everything...my housing, I’ll lose my Social Security...I know it’s hard sometimes to stay OK sometimes, but I’m doing pretty good at it."

Jail-liasion program
While McFarland has plenty of people keep him on track, many of those who end up in jail are unaware that help is even available. So, Stark County has started a new jail-liaison program.

Paul Sarsany is a counselor at Coleman Behavioral Health who started the program in 2011 for low-level mentally ill offenders. Sarsany says counselors go into the jail to talk to people with problems -- when they’re medicated and more likely to listen. "We cannot just wait for people to come to us. Sometimes, we have to go to where people are. Whether that’s to the homeless shelter, whether that’s to the street, or whether that’s to jail. And to know that 90 days after they’re released from jail, we’re calling and we’re following up."

Sarsany says his program has connected with about 350 inmates in the past year and a half, and just 10 percent of them have returned to jail.

Additional Reading
Sequential Intercept Model Paper (PDF)
Stark County launches program to address mental-health needs of inmates
Kasich to merge service agencies
Depts. of Mental Health, Drug and Alcohol Services will merge
Psychiatric patients overcrowd hospitals
Many men suffer with mental illnesses, avoid seeking help because of social stigma
Prisons giving mentally ill ex-inmates double dose of medicines

New approaches in Summit County
Summit County has a similar program and it's also trying several new approaches to reduce recidivism. The Alcohol, Drug Addiction and Mental Health board developed a forum to explore options for crisis management, treatment and jail services in 2009. Director Jerry Craig says the agency has increased by 30-percent the amount of medication dispensed in the jail and got grants to help with the transition out of jail. 

Also starting this month, the county is collaborating with Cuyahoga and Lorain counties, along with Case Western Reserve University and Northeast Ohio Medical University to develop a team that includes counselors, psychiatrists and even probation officers to coordinate treatment.

Craig says, "Nationally, 19 percent of people in the prisons have a persistent mental illness. In Summit County, we’re about 10-11 percent. So, we’re doing a good job, I think we’re addressing it. Now, at the same time, we have to say there are some people who need to be in the jail, and that’s why we have such a robust service system in our jail."

And, in fact, a National Institute of Corrections study found that the Summit County jail is doing an adequate job of providing mental health services.

People have to want to get better
Penney Moore, who works with Summit County’s Mental Health Court, says above all, people have to want to get better. "Sometimes the community doesn’t understand that we can’t force the treatment on individuals, they have to be at the point that they accept that they have a mental illness and that they need that treatment and I think that gets missed sometimes and that gets overlooked. And they think that we can fix it."

The question, she says, is if Ohio’s jails should be a starting point for a fix.
(Click image for larger view.)


Related WKSU Stories

Ohio jails: Mental health treatment of last resort
Thursday, July 26, 2012

Listener Comments:

This issue defines us as a country ... as a people. We need to devise and have ready more options more safe housing, and more treatment facilities for our fellow men and women troubled with these kind of health problems. And it is true that one of the biggest hurdles is that the patients need to at least appear to want to be well. When necessary the local jail should be a VERY temporary place to start the evaluation ... in days not months/years.


Posted by: Don (Dayton) on September 26, 2012 10:09AM
It is inhumane to incarcerate mentally ill persons for behavior that is due to their illness. Imagine arresting someone who had a heart attack while driving and caused an accident! Psychiatric eval and treatment should supersede incarceration for those with mental illness.


Posted by: Ed Herzog (Akron) on July 27, 2012 3:07AM
Thanks to Amanda and WKSU for the report on NE Ohio jails and the work being done to care for persons with mental illnesss and addictions who become involved with the justice system. In Portage County, we have a diversion program funded by the Mental Health


Posted by: Amie Cajka (Kent) on July 27, 2012 1:07AM
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