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Virginia’s Treatment of Jailed Mentally Ill Persons Found Lacking

Jails have become an essential part of Virginia’s mental health system, but they lack the capacity to satisfy the current demand for mental health services. That is a finding of a report by Virginia’s Office of the State Inspector General (SIG). The biggest factors in that systematic failure are a lack of funding and the absence of strategy to deal with the mentally ill.

“Virginia’s jails have become the largest mental health providers in Virginia,” said John W. Jones, Executive Director, and Virginia Sheriff’s Association. That has forced sheriffs to “use valuable law enforcement resources routinely to serve a growing mental health population, placing significant burdens on local law enforcement agencies.”

“In July 2012, Virginia’s local and regional jail systems reported 6,322 incarcerated persons with mental illness,” states the SIG report. “Of this group, 48% (3,043 individuals) qualified for a diagnosis of serious illness.”     

The sheriffs are “particularly interested in addressing the needs” of these people. They recognize, said Jones, that these jailed individuals “are in serious need of mental health series… because they are sick, not because they have committed serious crimes.”

Each year Virginia “appropriates $762 million to support community-based mental health treatment.” Yet, there are “no comparable” state funds “appropriated to jails for the treatment of individuals with the same behavioral health treatment needs.”

This has the result of individuals who were receiving community mental health services prior to their incarceration not being tracked or monitored by their previous community providers. It also has left jails ill-equipped or unable to equip their facilities to treat the mentally ill within its confines.

All jails reviewed by the SIG “were designed in a manner that maximized safety and ensured the greatest capacity to control inmate movement. Those designs are “not always conducive to addressing the treatment needs of inmates with mental illness, especially the most sever forms of mental illness and those individuals with active psychotic symptoms.”

Many of the jails (54%) referenced segregation for those “identified as having mental illness during the screening process, or for an individual experiencing an acute episode.” When an individual has an acute episode, medical staff emphasized the focus “was primarily on ‘control and safety’ not treatment,” states the report. “Medication was cited as the primary tool for intervention in an acute episode and inability to medicate over objection was cited as a barrier to treatment.”

It was also found that “[s]ome jails established separate mental health units or pods in order to decrease the isolation of individuals with mental illness.” The staff in such units typically had additional mental health training. Transition from jail to the community lacked funding to assure case management and housing, which often lead to re-arrest.

The SIG recommended funding for mental health treatment in jails, changes in existing jail structures and future construction to treat the mentally ill, jails should use standardized processes to identify the mentally ill during screening, relationships between jails and community service boards, mental health pods or regional mental health facilities should be established, individuals with mental health issues should be tracked and treated upon release, and jail personnel should be trained to interact with the mentally ill.

The report,” A Review of Mental Health Services in Local and Regional Jails,” is available on PLN’s website.

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