2 Investigates: The true cost of incarcerating mentally ill patients

ATLANTA — Local sheriffs across Georgia say their jails have become the dumping ground for the mentally ill, creating chaos and overcrowding that's costing taxpayers millions – but is there a viable solution?
 
"Every jail in every county in the state of Georgia now is the mental health hospital," Baldwin County Sheriff Bill Massee said.
 
As Georgia closes mental health hospitals across the state, they turn patients back into the community with little treatment or support. Many with mental illness end up in the criminal justice system.
 
James Satterfield is serving eight years behind bars after threatening to kill and eat a judge and his family.
 
Earlier this year, a jury found Candida Summerlin guilty but mentally ill for running over two Cobb County deputies in the parking lot of the county jail.
 
In perhaps the most well-known case, the man who took a gun into McNair Middle School is now serving a 20-year sentence. He has a long history of mental illness.
 
All three's first stops were county jails in Georgia, which, according to a federal report, house 77,000 inmates with mental illnesses.
 
Baldwin County was hit hard when Central State Hospital closed. The mentally ill population in the jail soared to 25 percent, leaving the small county with a huge bill for around-the-clock nursing staff and expensive psychiatric medications.
 
"The jails in this state spent $6 million in 2010 on nothing but psychotropic medication," Massee said.

Studies show mentally ill inmates spend more time in jail than other inmates and can get into more trouble, threatening other inmates and jail staff.
 
In September, inmate Bobby  Wynn was charged with murdering a fellow inmate in the mental health unit.
 
While the state saves money closing mental hospitals, county taxpayers foot the massive bill for warehousing patients in jail.
 
Gwinnett County Jail officials told a similar story. They get inmates medicated and stable enough to go to court, but without community resources, once they are released, they quickly return.
 
"You see those same individuals in a revolving door back into the jail facility. We have become the asylum, the jails have," said Gwinnett County Jail administrator Col. Don Pinkard.
 
Local jail's effort to rehabilitate inmates
 
At the Fulton County Jail, the sounds on the cell block for the mentally ill can be deafening. Half of the 2,600 inmates there suffer from some sort of mental illness.
 
"About half the inmates self-report or have been diagnosed with mental health issues upon intake," Col. Mark Adger of the Fulton County Jail told Channel 2's Justin Farmer.
 
Mental health staffs at county jails can stabilize the mentally ill, but they are not set up for the intensive treatment a mental hospital would offer.
 
"We're not trained to do this at the therapeutic level. We can intervene and handle people in crisis for a limited time," Adger said.
 
Adger took Justin Farmer on a tour to show the challenges his staff faces. The most severe of the 1,300 inmates with mental illness are housed in the acute mental health medical unit.
 
Inmates in that unit are one step away from being sent to Georgia Regional Hospital for forced medication. They see a psychiatrist every day and stay there until they are well enough to understand court proceedings.
 
"Do you have some folks on the bubble? They just sort of exist?" Farmer asked.
 
"They exist," Adger responded.
 
Adger said some inmates can stay in limbo in the acute mental health medical unit for their entire stay at the Fulton County Jail, sometimes for years at a time.
 
"Some are so psychotic, they don't realize their surroundings. They don't realize they are in the Fulton County Jail. They are sick. They are psychotic," Fulton County Jail Medical Director Dr. George Herron said.
 
For other inmates, the Fulton County Jail has a unique program to get inmates too ill to stand trial out of limbo. It's called the competency restoration program, one of only four programs of its kind in the nation.
 
Many inmates with mental issues get into trouble when they skip medication because they don't think they need it. The program teaches them to stay out of jail by staying on their meds.
 
"I take meds two times a day…really helpful, keeps you calm. Keeps you in the right place," one inmate told Farmer.
 
He said he didn't take meds before he landed in jail, but if he had, he might not have ended up there.
 
"At first I didn't think the meds were doing anything, then I realized (since) I've been here, I changed a lot," the inmate said.
 
Once inmates are stable, they get counseling from Emory and Grady Memorial Hospital staff. They are taught about the justice system so they can deal with criminal charges.
 
"Now we are seeing people as soon as we determine they are incompetent to stand trial and work with them right away," Herron said.
 
The biggest problem is finding help once inmates are released into the community. They quickly relapse without support.
 
"They should have a lot more programs on the outside than the inside," the inmate told Farmer.
 
Advocates say it's cruel to put the mentally ill in jail. It also costs the taxpayers far more to jail them than to give them treatment.
 
"We shouldn't be treating our mentally ill people in jail. We don't have the system in the community to support all the people in Atlanta," said Victoria Roberts, program director of the competency restoration program.
 
San Antonio: Police and courts work together to keep mentally ill out of jail
 
Channel 2 Action News traveled to San Antonio to see how the model program saves taxpayers millions of dollars while getting mentally ill people the help they need.
 
Ernie Stevens and Joseph Smarrow are San Antonio police officers, but their job is not to arrest criminals, it's to help the mentally ill. They are two of six mental health officers who patrol San Antonio 24 hours a day, taking people to a hospital instead of jail.
 
"If they have mental illness, we need to treat them with dignity and respect and get them into care as needed," Smarrow said.
 
During a ride-along, Smarrow and Stevens responded to a call of a person on the roof of city hall threatening to jump.
 
The person was a distraught homeless teen who was brought down by patrol officers. When Stevens and Smarrow arrived, they freed up several officers to return to street patrol.
 
"We are just here to help you. You are not in any trouble. Understand?" Stevens said.
 
Before the mental health unit was created, the teen would have likely been charged with trespassing and taken to juvenile jail. Now, they take him to a hospital with no criminal charges.
 
"I got him to agree, 'You really don't want to die, you just want the pain to go away,' and tears ran down his eyes and he said, 'Yes,'" Stevens said.
 
San Antonio was once like metro Atlanta. Police encounters with the mentally ill were tying up police and EMS units for an entire shift, creating overcrowding at the jail and clogging the courts.
 
By diverting the mentally ill from jail, San Antonio and Bexar County have saved taxpayers at least $55 million so far.
 
"You shouldn't criminalize somebody for having an illness," Leon Evans said.
 
Evans created the restoration center where police can take the mentally ill for crisis treatment. There is also a facility where police can take alcoholics and drug addicts to sober up and enter detox programs.
 
"Everybody wins. People get into treatment and recover and become productive citizens," Evans said.
 
Back on the streets, mental health officers searched for a former Marine suffering from PTSD. He had left a suicide note for his family and they tracked him to a motel.
 
Officers kicked in the door just in time, finding a handgun next to the bed.
 
Smarrow, a former Marine himself, calmed down the man and talked him into going to a hospital for help.
 
"We took the cuffs off. He didn't do anything wrong," Smarrow said.
 
San Antonio and Bexar County are training all police officers and jailers in crisis intervention, teaching them to use words instead of force to calm down the mentally ill in intense situations.
 
For Stevens and Smarrow, there's no better feeling than taking someone in crisis to get help.
 
"It's not the cliché, 'We helped someone today,' in reality, we really did help someone today," Smarrow said.
 
"Mental health and crisis intervention is the future of policing," Stevens said.
 
The program in San Antonio began with the police, courts and jail all working together. They created the police unit and then built the crisis center to help when hospital beds were not available.
 
Local tax dollars and federal grants funded the program in the beginning, but what really helped was a $30 million donation from a local businessman to help fund the treatment and housing programs. HE had watched a documentary on the homeless and wanted to do something to help San Antonio residents.
 
 

Cox Media Group