Treating Inmates Central Coast officials seek to change the way they deal with mentally ill inmates

By Joe Livernois

A section of the Monterey County Jail will soon transform into a mental health facility designed especially to provide treatment to inmates from throughout the Central Coast.

In criminal justice circles, it’s long been acknowledged that county jails have become the de facto mental health care system for a growing number of incarcerated people. And those with severe mental health issues who are charged as felons have had to wait months to get the care they need to be competent enough to stand trial. 

“We’re housing these people anyway, but we’re not housing them in treatment,” said Monterey County Undersheriff John Mineau. The condition of inmates waiting in jail to get treatment in state hospitals often spirals downward, he said, posing a risk to themselves and to correctional officers. And the longer it takes them to get help, the longer it takes to recover. “They are a really vulnerable part of our population,” Mineau said.

Mineau and other representatives from law enforcement agencies in Santa Cruz and San Benito counties gained approval from the Monterey County Board of Supervisors on Tuesday to establish a program that could change all that. 

The board Tuesday endorsed the addition of a mental health treatment program at the Monterey County Jail, with the aim of speeding up the “restoration” of inmates charged with felonies but who are found to be incompetent to stand trial. The “Jail Based Competency Treatment” program in Monterey County, which will become one of a handful of other similar programs throughout the state, is an effort to provide needed services to people with mental  health issues who have run afoul of the law.

Mineau said that inmates who have been treated at other jail-based hospitals in the state are able to recover in 69 days, on average, as opposed to an average of 152 when they are forced to wait until a bed opens up for them at a state hospital like Napa or Atascadero. According to Department of State Hospital figures, an average of 819 inmates with mental illness were awaiting placement last year, compared to 343 inmates five years earlier. 

The increasing number of inmates in need of treatment has overtaxed the five state hospitals, and inmates can wait months to get the help they need. Jim Bass,  deputy chief of the Monterey County Jail, said that an inmate currently in his facility has been waiting to get treatment since April, when he was declared incompetent to stand trial, while two others have been waiting since May. “It’s the eleventh of September and they’re still waiting,” he said.

'We know that for a lot of people it is an issue of mental health and not criminality.'

Supervisor John Phillips, who helped to create the mental health court in Monterey County while he was a Superior Court judge, said that local criminal justice advocates have long recognized the need for more treatment centers. “We know that for a lot of people it is an issue of mental health and not criminality,” he said.

Critics have noted that facilities for people with acute mental health issues are dwindling generally, and that there is a long waiting list for people who have been caught up in the criminal justice system to get the help they need at state-run hospitals. Mineau said that inmates who are able to get treatment soon after their arrest are more likely to see a quicker recovery. As a result, the Department of State Hospitals is working with county jail administrators to set up regional programs to serve as “satellites” for the state hospital system.

Bass said that the local jail has the capacity to convert one of its units to a mental-health hospital that would serve up to 15 inmates. And beds would be available for inmates in need of treatment from Santa Cruz and San Benito counties, Bass said in a report to the Board of Supervisors. Administrators from jails in the adjoining counties attended the meeting Tuesday to support the program. Bass told Voices of Monterey Bay that at least 30 inmates in the three counties are currently waiting for treatment.

The agreement with the DSH will extend for two years and will cost $3.6 million, all of which is being paid for by the state. Treatment will include the standard curriculum offered in state hospitals for inmates, including “therapeutic living environment that fosters socialization with other program participants” and individual therapy when necessary, Bass said. The jail would be designated as a “mental health treatment facility” so that psychotropic medications can be administered by staff psychiatrists, and provisions will be made to allow families to participate in recovery.

Bass said he is confident a section of existing jail can be redesigned to serve as the mental-health treatment facility by the end of this year.

Amie Miller, behavioral health director for the Monterey County Health Department, said the Monterey County treatment program is a “step in the right direction. It will get people in need more timely access to care. Timely treatment is what people deserve and need to support recovery.”

Added Bass: “Jails were never designed for people with mental illness.”

The National Alliance on Mental Illness reports that up to 2 million people with mental illness are booked into jails across the country every year. “In a mental health crisis, people are more likely to encounter police than get medical help,” according to information provided by NAMI.

In a 2018 study by the Police Executive Research Forum, researchers found that the “reoffending rate for individuals with serious mental illness is higher than the rate among all individuals with criminal histories.” It also found that treatment programs for people with serious mental illness can reduce recidivism. “In this respect, effectively managing mental illness in jails is a community safety issue,” according to the study’s authors.

Bass said that experience in other California counties with the Jail Based Competency Treatment program indicates that inmates are getting treatment and “restored to competency” at an accelerated pace. 

“The introduction of these local programs has kept inmates from languishing any longer in county jails and has gotten them the treatment they need … in some cases in a time faster than they would have been transferred to the state hospital,” he said.

Editor’s note: The author is president of the Monterey County of the National Alliance on Mental Illness.

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Joe Livernois

About Joe Livernois

Joe Livernois has been a reporter, editor and columnist in Monterey County for 35 years.

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