Early last week, Mobile Metro Jail Warden Trey Oliver saw a familiar face in lockup. The young man before him had been arrested for the 14th time, this time for loitering.
“This gentleman was released from our custody just a few days ago and supposedly returned to his group home,” Oliver said. “Guess where he is again? He’s in the (jail) and I just got through talking to him. I went in there and I called him by name.”
Oliver said the young man was picked up for simply “standing in the store.” The man told Oliver he was trying to use the phone to get in contact with his father, when he was arrested.
“Here’s this man here, this is his 14th time in jail,” Oliver said. “I don’t know about you, but I’m convinced that he cannot survive out in the community. He doesn’t need to be in a group home because it’s not restrictive enough.”
This man, Oliver said, has a history of walking away from his group home and once even broke out of the back of a transport van, only to be found four hours later, either drunk or high.
“This is a clear example of a man that needs to be institutionalized,” Oliver said.
Unfortunately, this isn’t the only example of a seriously mentally ill inmate stuck in a revolving door at the jail, Oliver said, and it highlights a need for a change in the way the state handles mentally ill patients.
Alabama has been following a nationwide trend of closing big state-run hospitals and opting instead for community-based treatment through group homes and less-restrictive environments. To help plug a $40 million hole over four years, the state department of mental health decided about a year and a half ago to close two of its long-term care mental hospitals, which included Searcy hospital in Mount Vernon.
AltaPointe Health Care Systems is Mobile, Washington and Baldwin counties’ mental health provider. Their network includes two hospitals, 24 group homes and one higher security group home. Despite the number of facilities, Oliver is not satisfied.
AltaPointe CEO Tuerk Schlesinger said the jail as a whole has a tough situation with the releases.
“They see a revolving door of those with a criminal mind,” he said. “That’s just a problem.”
Oliver, who has been warden for close to four years, was never in favor of closing Searcy, the 220-bed facility in north Mobile County.
“Anyone who tells you closing Searcy was a good idea is either uninformed, uninitiated, or is misleading you,” Oliver said. “Ever since Searcy closed, it has put a burden on jails in the area that are seriously mentally ill patients.”
The warden said the number of mentally ill inmates at the jail has doubled since Searcy closed, and the bottom line is additional beds are needed in a more secure environment.
Schlesinger, though, said there are more beds available now than when Searcy closed and he doesn’t understand how the jail’s population of mentally ill inmates could have doubled.
In another example of a seriously mentally ill inmate, Oliver said, a different man has been arrested and brought to the jail 25 times in the last 11 years on relatively minor charges including: failure to obey, trespassing, harassing communications and disorderly conduct. He’s been in and out of jail for the last 16 months, Oliver said.
“He is facing a (charge of) theft of property first degree right now, but no one can tell me the only reason this man’s crimes are escalating because he’s not being given the proper mental health treatment,” Oliver said. “If he was treated, being treated in a secure facility, he wouldn’t be here and he wouldn’t be continuing to violate the law.”
Oliver said this inmate recently tried to kill himself with a pencil.
“He’s on suicide watch now, but he needs to be in a hospital,” Oliver said.
Many of the mentally ill inmates are isolated from the general population, and are put into two different sections, or wedges in the jail. One is for those inmates on medication and one is for those who aren’t, Oliver said. On average, 90 inmates take psychotropic drugs; of these about 25 are considered seriously mentally ill, Oliver said.
An inmate in one of these isolation cells was moved because of multiple suicide attempts, Oliver said. The inmate would climb up the wall, pull the sprinkler head off and try to cut his wrists with it.
Ronwick Thomas, a corrections officer with the jail who works the isolation wedges as part of a rotation, said it gets difficult at times.
“It’s challenging here because even in a normal setting we deal with different people, different backgrounds and mental positions throughout the day, but when you come into this setting, depending on their medication, or how they’re being treated by their families, or charges, they have a lot more going on in their mind and you just don’t know what you’re going to come into from day to day,” he said. “It changes throughout the day.”
Thomas said he knows at least six of the mentally ill inmates by name, and some can be released during Thomas’ shift, but will be right back in jail when he comes back to work.
Dr. C.E. Smith, the jail’s part-time psychiatrist, noted the increase of mentally ill inmates in prisons since the push for more community-based care began in the 1960s and 1970s.
“It sounds like a good idea and it started with good intentions, but unintended consequences have popped up,” Smith said. “The result has been that roughly 10 percent of seriously mentally ill patients can’t be treated in the community.”
Smith, who previously worked at Searcy and with AltaPointe and now works for NaphCare under contract at the jail, said he would like to see more beds at state-run hospitals for those patients who can’t be cared for in the community because there is currently a gap that’s not being addressed.
“I think there’s an incredible number that cannot be managed outside of captivity,” Smith said. “They used to be in asylums, now they’re in jails and prisons.”
He said many of the “gravely” mentally ill patients at the jail are veterans of Searcy and many are suffering from schizophrenia.
“There’s no doubt some people in the community are doing well enough I guess, but the sickest 25 to 30 people here are as sick as anyone on Earth,” Smith said.
The jail has one psychiatrist, three full-time therapists and two part-time therapists total, said Director of Mental Health Mark Lasko. The jail’s mental health unit has two units and 32 beds in 16 cells.
“They’re never not full,” Lasko said of the beds.
That’s more beds than AltaPointe’s adult acute care hospital in Daphne, which has 30 for patients under court order to stay there.
Lasko said the psychiatric staff handled 12,000 visits from inmates last year and he expects the numbers to go up.
Schlesinger said AltaPointe has gone above and beyond, taking care of anyone with a mental illness who has been charged with a misdemeanor through a jail diversion program, but the system’s hospitals aren’t set up to care for patients who’ve been convicted of a felony. He added that AltaPointe never turns away a patient sent from the jail who’s sent to them by probate court petition.
Oliver acknowledged that AltaPointe has a jail diversion program, but said it didn’t go far enough because it only dealt with patients once they had already been in jail.
“We truly need a jail diversion program so, instead of calling 911 and having the police show up let’s get mental health professionals to come and pick these people up,” Oliver said.
Schlesinger said maybe the affected groups needed to sit down and have a meeting.
“If the jail has a particular problem and the inmates aren’t getting adequate care, let’s sit down and put together a plan,” Schlesinger said.