By Barbara Trione | Posted: Thursday, September 6, 2007 12:00 am
At the beginning of July, the Gazette-Times ran a front-page article concerning mentally ill inmates and the new program in Linn County. On Aug. 21, an opinion piece in the Gazette-Times titled "Everyday crisis: Benton County Jail" began with support for a new jail, but diverted into the issue of the mentally ill and incarceration.
Yes, the mentally ill in jail is a big problem, not only in Benton County, but nationwide. However, both the front-page article and the opinion piece gave the impression that Benton County does nothing for mentally ill inmates. That is not true. I do not want to negate the necessity of a new jail, that is a given; however, mixing the issue of the size of the Benton County Jail (the smallest in the state for a county our size) and mentally ill in jails and prisons does a disservice to both issues.
Benton County does provide help for mentally ill inmates in the Benton County Jail. It is true that at this time, there is no dedicated staff hired by the jail for mental health services, but Benton County Mental Health provides staff to the jail for assessment and treatment for mental illness.
In the past six months, Benton County Mental Health assessed and treated 19 individuals. Of those 19, four had been prior clients of Benton County Mental Health, and their services continued while they were in jail. One individual was from Linn County, and Benton County facilitated this person's placement in the Psychiatric Unit at Good Samaritan Hospital. Contrary to many, not all people with mental illness require acute psychiatric hospitalization, but both articles left the impression that this was a necessity. Mental illness, like any other chronic illness such as diabetes and heart disease, may require hospitalization on occasion.
The jail staff does a tremendous job of triage of inmates for mental health issues. Those they feel require assessment are referred to Benton County Mental Health. The current evaluation criteria are:
• Current suicidal ideation, or reference to suicidal thinking - an immediate request is made to Benton County Mental Health - staff is available 24 hours a day.
• Reported recent past suicidal ideation or attempts.
• Requests for a mental health consult.
• Currently receiving psychiatric medications.
• Benton County Corrections staff needing assistance in evaluating problematic or odd behavior.
Inmates who do not meet the criteria above, are known to have a mental illness or treatment history, but do not wish mental health involvement cannot be forced to receive such treatment. Benton County mental health staffers can try to engage such individuals, but it is those individuals' right to refuse any and all treatment if they are not a threat to themselves or others.
In addition, the Benton County Jail contracts with a psychiatrist. This same psychiatrist works for Benton County Mental Health, providing continuity of care through that person's incarceration.
People booked and released also are evaluated if need be, with Benton County Mental Health providing education and prevention services and determining if follow-up care is needed.
Benton County Jail is small, having little space for meeting, assessing and counseling the mentally ill. Many mentally ill inmates seen by Benton County Mental Health are poor, but not poor enough to qualify for entitlements, which would help provide treatment and medication once they are released from jail. Without the continued follow-up after jail, the revolving door back into the jail continues.
To complicate matters, many of the mental ill also present with a co-occurring disorder - substance abuse, either with alcohol or drugs. This complicates treatment and follow-up care.
Will a dedicated Mental Health therapist at the jail help? Yes. A dedicated person at the jail will be able to provide more continuity, better engagement and more treatment while a mentally ill person is incarcerated.
Barbara Trione of Corvallis is a registered nurse who is chairwoman of Benton County's alcohol, other drug and mental health advisory committee