After years of concerns from advocates, local and state leaders seem to be on the same page about addressing the rising number of mentally ill inmates, who are creating challenges in Alabama’s county jails.
Last month, State Senate and House leaders announced an unprecedented suite of bills aimed at improving Alabama’s overall mental healthcare system and reducing the number of people with mental illnesses who wind up in local jails — often for petty crimes like loitering or public intoxication.
This has particularly been a problem at Mobile County Metro Jail, where some inmates with severe mental issues have gotten caught in a revolving door of arrests and releases that, in some cases, has prevented them from getting access to the care they need.
Mobile County Sheriff Sam Cochran told Lagniappe in a recent interview it has become increasingly common to see those types of inmates in Metro Jail, which, despite a number of recent and planned improvements, remains ill-equipped to provide the level of service some of those inmates need.
“For a number of years we’ve seen an increase in the number of people with mental health issues in the jail. I think somewhere around 20 percent of our inmate population is on some type of psychotropic drug,” he said. “I hear similar stories from my colleagues across the state and we’ve seen national stories on this as the federal government has incentivized states to do away with mental institutions.”
One bill announced last month would require the Alabama Peace Officers’ Standards and Training Commission (APOSTC) to include mandatory crisis intervention training and continuing education for law enforcement officers to help them better understand and interact with the mentally ill.
Another piece of legislation would also give police more options to deal with those experiencing a mental health crisis by authorizing officers to place individuals who pose a threat to themselves or others into 72-hour protective custody. Currently, police can do little other than arrest suspects in those situations.
At the same time, Alabama Gov. Kay Ivey is requesting a $24 million increase in funding for the Alabama Department of Mental Health (ADMH) as part of her recommended budget — something some key members of the House and Senate have already expressed support for.
Malissa Valdes-Hubert, an ADMH spokesperson, said the bulk of the increased funding the department is seeking — around $18 million — would help support a transformation in the way Alabama provides care for those in a mental health crisis by creating facilities dedicated to serving those patients.
“Alabama lacks many services in a crisis continuum of care and has no crisis diversion centers,” she said. “These funds would be used to open three [of those centers] around the state.”
According to ADMH, crisis diversion centers would offer a physical access point for care that could prevent people having a mental crisis from ending up in jails or emergency rooms. They would offer walk-in access for individuals and let emergency departments and law enforcement transfer people to them for short-term admissions, medication management, case management and discharge planning.
At this point, it’s unclear where those centers would be located in the state if the Alabama Legislature agrees to include the funding needed for their construction. However, ADMH officials have been holding meetings on improving crisis care with stakeholders around the state, including in Mobile County.
Valdes-Hubert said ADMH is also requesting an additional $3.7 million needed to comply with a consent decree that ended a 2016 lawsuit brought by county inmates around the state who were unable to obtain mental health services due to a lack of beds in state-run hospitals and community provider locations.
Complying with the decree would require additional forensic beds, increased funding for outpatient forensic evaluators and the establishment of outpatient restoration services, according to Valdes-Hubert.
Finally, ADMH is also seeking — and state officials seem to be supporting — an additional $1.8 million to bolster the Stepping Up initiative that is already operating in 11 Alabama counties. That program is specifically designed to keep nonviolent offenders who need mental health treatment out of local jails.
One way Stepping Up does that is by helping local communities determine which inmates might be better served outside of jail. Valdes-Hubert said Stepping Up and its case managers can help reach those who wound up in jail before they could get the mental health treatment they needed on the outside.
“The Stepping Up initiative includes a case manager who works directly with local jails, law enforcement and in ERs,” Valdes-Hubert said. “They also help to gather resources that would benefit the individual based on their needs. That person, once released, would meet directly with the case manager.”
The Mobile County Commission put its support behind the program last month, though it is technically operating through AltaPointe Health Systems, the area’s mental health service provider. Commissioner Merceria Ludgood said it was good to see these issues finally gaining some traction in Montgomery.
“When a person who is mentally ill is placed in jail, it puts them at risk, it puts other inmates and staff at risk and they’re not getting the kind of services that are appropriate,” Ludgood said. “It benefits everyone if we can find an alternative to incarceration for what is ultimately a medical problem.”
As all of these efforts are being discussed in Montgomery, Mobile County Health Officer Bernard H. Eichold has also continued his efforts to have the state reopen Searcy Hospital, the publicly owned psychiatric facility in Mount Vernon that was permanently closed roughly eight years ago.
Many people in local law enforcement have attributed the increased numbers of interactions with and arrests of mentally ill persons in Southwest Alabama to Searcy’s closure in 2012. Others have argued that community-based services for the mentally ill have more than absorbed those patients, though.
Either way, ADMH officials said in 2018 — and again when asked by Lagniappe last week — that it would be much too expensive to repair and replace the ailing infrastructure that would have to be addressed in order to make the buildings on Searcy’s 120-year-old campus operational once again.
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