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Cook County Sheriff explains reforms in jail mental health system
Thirty percent of the more than 12,000 people in the jail’s custody have a mental illness, and most of those are receiving psychiatric medications

Sunday, March 22, 2015
by McClatchy-Tribune News Service

Tom Dart, the sheriff of Cook County, Ill., is making a difference for the mentally ill in the Cook County Jail. Cook County, which includes Chicago, is also home to the nation's largest single jail site.

Thirty percent of the more than 12,000 people in the jail’s custody have a mental illness, and most of those are receiving psychiatric medications. By default, Dart said, he has become a mental-health provider.

Mentally ill prisoners are not a problem unique to Cook County. In Allen County, about $325,000 was spent on psychiatric medications for prisoners in 2013. That was almost two-thirds of the money spent on medications of all types for prisoners that year. There are not group sessions for mentally ill prisoners or transition services for those being released in Allen County.

On Friday morning, Dart was in Indianapolis to speak at the National Alliance on Mental Health Indiana's 12th Annual Mental Health and Criminal Justice Summit.

One part of a solution is taking a harder look at what kind of people need to be jailed. Dart said many in his jail are repeat offenders who should not be there. Many of the cases in his jail are no threat to society and don't belong there.

Among the examples he offered, identifying them only by their initials:

*M.H., who was homeless, pregnant and mentally ill, stole two plums and three candy bars, then spent 135 days in jail at a cost of $19,305.

*D.E., who is seriously mentally ill and has nowhere to stay, was charged with trespassing at O'Hare airport and spent 86 days in jail at a cost of $12,298.

*W.M., a 57-year-old who’s been in jail 61 times, was charged with stealing eight snickers bars and a pair of scissors. He spent 114 days in jail at a cost of $16,000.

There is a complete disconnect in the criminal justice system between their crimes and their mental health issues, Dart said. The jail has become a warehouse. On a typical day, 2,500-3,000 people with a mental illness are housed in the Cook County Jail.

Since 2006, Dart has been pushing changes to help mentally ill inmates, and he’s trying to make the topic a national issue.

"With something as outrageous as what we are talking about, it needs to have people throughout the country mad and angry and fed up," said Dart, a former prosecutor and Illinois state legislator.

"I cannot believe that our society is so cold that they know what's going on and are OK with it," Dart said.

The largest mental health care provider in the country is the prison systems and the jails. According to Dart, in 2012 there were 356,268 inmates in U.S. prisons and jails with severe mental illness -- about 10 times the population of severely mentally ill in state psychiatric hospitals.

Meanwhile, government officials looking to cut costs often look to mental-health services for savings. Dart cited Illinois as an example, saying the state cut mental-health services 32 percent between 2009 and 2012. In 2012, Chicago's mayor closed six of 12 mental health clinics, he said.

Dart has been working on thoughtful strategies to treat these people.

Among the approaches he’s instituted:

*Dart had all 3,500 correction officers in the Cook County Jail go through crisis-intervention team training so they could better deal with mentally-ill prisoners.

*In the past, mentally ill prisoners were released with no coat and a baggy filled with two weeks of medication. Some wanted to stay in jail and hurt themselves to get back in. Dart instituted a system to help them transition out of jail.

Now the mentally ill are given better information for that transition, and professionals work with them in groups. They also have access to a crisis hotline, and authorities try to reunite families when they can.

*A former minimum-security “boot camp” for prisoners has become a mental-health transition center. Group sessions are held with prisoners, and staff help them find work. Dart said he wants to staff it so prisoners in transition can stay there 24 hours a day, seven days a week.

*Two years ago, the jail staff started signing prisoners up for Affordable Care Act insurance when they enter the system. When they leave, they have access to medical care they need.

McClatchy-Tribune News Service

"Mass incarceration is just not thoughtful. Morally and ethically, it’s wrong, and financially it just doesn't make sense," Dart said.

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