In Oklahoma, thousands with mental illnesses get to go to jail, not medical treatment

Click to enlargeChris Landsberger/The Oklahoman

❝ A monthslong investigation by The Oklahoman, including the examination of hundreds of pages of jail inspection reports, found that jail staffs across Oklahoma are tasked with attempting to be mental health professionals, often with little or no training…

❝ Since statehood, Oklahoma has grappled with how to create a sustainable, comprehensive mental health system. The state has spent among the least in the nation on mental health care, all while filling jails and prisons with people who wouldn’t be there if they could afford and access basic health care for their brain disorders.

Imprisonment is not only the least effective form of “treatment” but also the costliest.

The cost of a year of state-funded mental health treatment: $2,000.

The cost of a year in prison for someone with serious mental illness: $23,000.

At last count, 60 percent of the Oklahoma Department of Corrections’ population — 17,000 people — have either symptoms or a history of mental illness…

Often, before these Oklahomans are sentenced to prison, they spend months, if not years, cycling in and out of county jails.

I won’t try to precis this excellent article down to the size of a blog post. The article reflects the first two of a four-part series on Oklahoma’s lousy excuse for mental health care. I think a mirror image approach to the state’s mediocre criminal justice system would show the same.

Hypocritical ideologues run the state. They care not for science, modern medicine, current concerns and remedies to substance abuse or mental illness. They run Puritan jails the way they run a Puritan legislature. RTFA. Make up your own mind.

Police unit gets public health responsibility for mentally ill

Lieutenant Lionel Garcia – lead officer of Mental Evaluation UnitMaya Sugarman/KPCC

The Los Angeles Police Department’s mental evaluation unit is the largest mental health policing program of its kind in the nation, with 61 sworn officers and 28 mental health workers from the county…

Officer Ted Simola and his colleagues in the unit work with county mental health employees to provide crisis intervention when people with mental illnesses come into contact with police…

Triage duty involves helping cops on the scene evaluate and deal with people who may be experiencing a mental health crisis.

The triage officers are first and foremost a resource for street cops. Part of their job entails deciding which calls warrant an in-person visit from the unit’s 18 cop-clinician teams. These teams, which operate as second responders to the scene, assisted patrol officers in more than 4,700 calls last year.

Sometimes their work involves high-profile interventions, such as helping S.W.A.T. teams with dangerous standoffs or talking a jumper off a ledge. But on most days it involves relieving patrol officers of time-consuming mental health calls…

That’s the right approach, says Peter Eliasberg, legal director at the American Civil Liberties Union of Southern California. “The goal is to make sure that people who are mentally ill, who are not a danger to the community, are moved towards getting treatment and services as opposed to getting booked and taken into the jail.”

Detective Charles Dempsey is in charge of training for LAPD’s mental evaluation unit. He says pairing a cop or detective with a county mental health worker means the two can discuss both the criminal justice records that the health worker isn’t privy to and the medical records that a cop can’t access because of privacy laws.

About two-thirds of the calls are resolved successfully, he says…

But there are complicated cases, too. And these, Dempsey says, are assigned to the unit’s detective-clinician teams. Dempsey says most of the 700 cases they handled last year involved both people whose mental illness leads them to heavily use or abuse emergency services, or who are at the greatest risk for violent encounters with police and others.

“Jails were not set up to be treatment facilities,” says Mark Gale, who serves as criminal justice chairman for the LA County Council of the National Alliance on Mental Illness. “People get worse in jail.”

Gale and other mental health advocates praise the LAPD unit’s approach and call it a good first step. But for diversion to work well, they say, the city and county need to provide treatment programs at each point a mentally ill person comes into contact with the criminal justice system — from interactions with cops all the way through the courts.

Of course, there used to be a system that provided much of this treatment – The US Public Health Service and a chain of national PHS hospitals across the country. Ronald Reagan did his level best to close them all down. He didn’t get all of them – but, he did succeed in evicting tens of thousands of mentally ill patients and putting them out on the streets.

RTFA for anecdotal examples of the work being done by the LAPD.

Jailed, some mentally ill inmates are in permanent lockdown

Day or night, the lights inside cell 135C of central New Mexico’s Valencia County Detention Center were always on.

Locked inside, alone, for months, Jan Green – a 52-year-old computer technician with schizophrenia and bipolar disorder – rocked on a bench for hours, confiding in an imaginary companion…

Though isolated, Green was, in a sense, far from alone. In jails around the country, inmates with serious mental illnesses are kept isolated in small cells for 23 hours a day or more, often with minimal treatment or human interaction.

Some states have moved to curb long-term “solitary confinement” in prisons, where research shows it can drive those with mental illnesses further over the edge. But there has been little attention to the use of isolation in the country’s 3,300 local jails, the biggest mental health facilities in many communities.

Unlike prisons, jails hold those awaiting trial or serving shorter sentences, limiting time in lockdown. But inmates with serious mental illnesses are more likely to break rules and stay jailed longer, increasing the chances of weeks or months in isolation that risks inflicting additional psychological damage.

A report obtained by The Associated Press found mentally ill inmates in New York City’s jails were disproportionately put in lockdown, some for thousands of days. Inmates who spent time in isolation were far more likely to harm themselves, according to a second report by staff of the city’s health department…

Jails use isolation to punish inmates, but also to separate those with serious mental illnesses because they may be victimized by fellow inmates or are considered dangerous. Many end up in lockdown because of behavior linked to mental illnesses, experts say.

“If they can’t follow the rules outside the facility, how in the world do you expect a mentally ill person to be able to function as an inmate?” says Mitch Lucas, assistant sheriff of Charleston County, South Carolina, and president-elect of the American Jail Association. “So you end up having to deal with whatever tools you have at hand and, in many jails, the tool is restrictive housing and that’s it.”

The number of inmates with mental illnesses has been rising since the 1970s, when states began closing psychiatric hospitals without creating and sustaining comprehensive community treatment programs…

That’s putting it politely. Between Republicans and conservative Democrats, not only state psychiatric hospitals were closed, Reagan tried to end the very existence of the US Public Health Service including their system of Public Health hospitals. Often the sole chance for healthcare for the poor, survival for the mentally ill – Reagan created the avalanche of homeless that swept our nation in following years. Most especially among VietNam era vets who he also ordered blocked from collecting unemployment insurance if they decided against re-enlisting in the US military.

Homeless Veterans sue Feds over land dedicated to vets

It is a 387-acre campus of green fields and low-lying buildings in a prosperous neighborhood, donated to the federal government more than 100 years ago for use as a Pacific Coast home for wounded veterans. But over the last 20 years, as Los Angeles has become inundated with homeless veterans, advocates for the homeless say the campus has become a symbol of a system gone wrong: as veterans sleep on the streets, many of its buildings lie abandoned and one-third of the land has been leased for commercial use.

On Wednesday, advocates for the homeless sued the Department of Veterans Affairs, seeking to compel federal officials to use the campus to care for and house mentally ill veterans.

In the class-action suit, filed on behalf of four mentally distressed homeless veterans, lawyers contend that the department has violated the terms of the agreement in which the property was deeded to the government in 1888. They also contend that the department is required — under a federal statute barring discrimination against the mentally disabled — to provide housing to help mentally ill veterans…

By any measure, the lawsuit — the first of its kind, lawyers said — is a significant escalation in a battle that has simmered here for years, as homeless advocates contended that the Department of Veterans Affairs was bowing to residents of the property’s prosperous Brentwood neighborhood and commercial interests by refusing to rehabilitate abandoned buildings and use them to help veterans.

For the first 100 years of its existence, the campus was used entirely to provide housing and services to veterans; that began changing in the 1960s and ’70s, as some of the buildings were abandoned and the Department of Veterans Affairs leased about one-third of the property for use by, among others, a car rental agency, a laundry for the Marriott hotel chain, a golf course, a dog walk and a baseball stadium for the nearby University of California, Los Angeles. It now has a limited number of geriatric beds for veterans.

“It is a piece of land that has accommodated the interests of powerful people in L.A. for a long time,” said Bobby Shriver, a member of the Santa Monica City Council and one of the people pushing the suit. “Now, we are going to make it accommodate the interests of these veterans.”

RTFA. The lawsuit is overdue. The debt owed America’s veterans is one that politicians often speak of – without doing a damned thing to pay up.

L.A. doctors busted for bilking Medicare out of million$

Two physicians were arrested Friday for allegedly subjecting mentally ill homeless people to unnecessary tests and other procedures at a North Hollywood clinic in order to submit fraudulent bills to government insurance programs.

Dr. Eleanor Santiago Arthur and Dr. Rodney Stephen Barron participated in a scheme in which “cappers” recruited Medicare and Medi-Cal enrollees from as far away as Long Beach and drove them to the Victory Boulevard clinic in exchange for a fee…

The “patients” were subjected to abdominal ultrasounds and other procedures that were unwarranted, the complaint says. In some instances, their blood was drained into unsanitary, open containers, it says. One official said the clinics submitted the blood for tests under multiple patients’ names so they could bill multiple times.

After the visits, the cappers drove the patients back to where they picked them up and paid them $100 each, according to the complaint.

The clinic billed the government for up to $1,000 worth of medical care per patient, and each physician saw 30 to 50 patients a day, city attorney’s officials said in a news release. The investigation carried out by the Los Angeles County Health Authority Law Enforcement Task Force found that the scheme cheated the government out of millions of dollars over six months.

Santiago Arthur and Barron each face up to seven years in prison if convicted of charges that they conspired to cheat Medicare and Medi-Cal, the government medical insurance programs for seniors, the poor and disabled.

These are the cruds protected by lobbyists, insurance companies and teabaggers.

Throw away the key!

Ohio sued for dumping mentally ill inmates onto the street

Mentally ill prisoners in Ohio are more likely to get into trouble and end up back in prison after they are released because state officials turn them loose without the follow-up care they need.

A lawsuit, filed in U.S. District Court in Cincinnati, asked a judge to order the Ohio Department of Rehabilitation and Correction and the Ohio Department of Mental Health to provide the care necessary to help keep mentally ill offenders from returning to prison.

Advocates for prisoners and the mentally ill said they are suing to help not only the released prisoners, but also the taxpayers who must pay tens of thousands of dollars a year to keep them locked up when they commit new crimes and are sent back to prison.

They say the cost of providing treatment to a mentally ill person in the community is about $7,400 a year, compared to the $25,000 a year it costs to incarcerate them.

But instead of treatment, the lawsuit claims, ex-convicts with mental problems get $65 to $75, a bus ticket and two weeks of medication upon their release. The suit said many of those former inmates soon move into homeless shelters or drug-infested neighborhoods, where their mental health quickly deteriorates.

Dumping prisoners with mental illness at homeless shelters creates a revolving door phenomenon,” said Bess Okum, staff attorney with the Cincinnati-based Ohio Justice and Policy Center, which filed the suit on behalf of nine current and former prisoners. “Many of these former prisoners commit new crimes because of their untreated mental illness.”

Like the great state of Ohio gives a damn about civil rights or how they waste taxpayers’ money.

When it comes to wasting taxpayer dollars on warehousing the criminally insane, you can count on most American politicians – in their pinheaded intellects – to choose the opportunism of being “tough on crime” because it guarantees more votes than sorting the mentally ill and saving money.

And our favorite ignorant electorate will march in lockstep down that always-safe middle of the road.

Social networking for the delusional – reinforcing their fears

For years they lived in solitary terror of the light beams that caused searing headaches, the technology that took control of their minds and bodies. They feared the stalkers, people whose voices shouted from the walls or screamed in their heads, “We found you” and “We want you dead.”

When people who believe such things reported them to the police, doctors or family, they said they were often told they were crazy. Sometimes they were medicated or locked in hospital wards, or fired from jobs and isolated from the outside world. But when they found one another on the Internet, everything changed. So many others were having the same experiences.

Type “mind control” or “gang stalking” into Google, and Web sites appear that describe cases of persecution, both psychological and physical, related with the same minute details — red and white cars following victims, vandalism of their homes, snickering by those around them.

Identified by some psychologists and psychiatrists as part of an “extreme community” on the Internet that appears to encourage delusional thinking, a growing number of such Web sites are filled with stories from people who say they are victims of mind control and stalking by gangs of government agents.

Although many Internet groups that offer peer support are considered helpful to the mentally ill, some experts say Web sites that amplify reports of mind control and group stalking represent a dark side of social networking. They may reinforce the troubled thinking of the mentally ill and impede treatment.

Of course. True Believers – scattered, diverse, unconnected – can now gather into into a group reinforcing their shared delusions.

Individual medical care, discussion and mediation, now has yet another counter-current to reality blocking the way. More ways to choose dementia.

Red tape kept killer’s family from having him institutionalized

“I kill for God”

Isaac Zamora’s mother begged him to get help when he was released from jail a month ago. State and federal laws prevented her from doing much more for the man who has now been arrested after a shooting spree in rural northwest Washington that left six people dead and four wounded…

In the wake of the shootings, Dennise Zamora has said she wants people to know that “my son was desperately mentally ill and we’ve been trying to get him help.”

If someone resists help in Washington, a family member must demonstrate he is a danger to society or himself or is “gravely disabled” before he can be involuntarily admitted to a mental hospital.

Ron Honberg, an expert on mental illness treatment in the U.S., called it a sad irony that in most cases, the 8.1 million adults with schizophrenia or bipolar disorder in the United States are being cared for by their families, who have no legal standing.

Friends of Zamora’s said he had been diagnosed with both mental illnesses, but state officials would not say if such a diagnosis was part of his file.

All that counts with bureaucrats is what is “in your file”.

Zamora was in and out of jails and mental hospitals for years. Yet, when a judge ordered a mental health evalution, his parole officer and his family were stuck raising the money.

Foolish laws administered by an incompetent state.