A federal grant would fund a secure psychiatric treatment site for the mentally ill charged with felonies.
By DEBORAH O'NEIL
© St. Petersburg Times, published June 4, 2001
They have thrown feces at guards, attempted suicide, attacked others and sometimes sat and cried endlessly in their cells. Every day, the Pinellas County Jail houses more than 300 inmates who need psychotropic medications to stabilize mental illnesses ranging from depression to schizophrenia.
"Jails have become the mental health facilities of the 1990s," Pinellas-Pasco Public Defender Bob Dillinger observed in a recent report.
Dillinger is behind an effort to reverse that trend in Pinellas County.
He is seeking $6.75-million in federal funding so Pinellas County can establish a secure psychiatric treatment facility for severely mentally ill jail inmates charged with felonies. Windmoor Healthcare of Clearwater is interested in accommodating the program and could provide about 40 beds in a section of its psychiatric hospital on U.S. 19, near the county jail.
The request spotlights a problem that mental health advocates and criminal justice officials say needs attention. As the mentally ill have been turned out of treatment facilities nationally, adequate resources to help them have not been established, advocates say. As a result, some end up homeless, without treatment and ultimately in trouble with the law.
Those who commit minor offenses can be treated at area mental health facilities. But Sheriff Everett Rice has long said that there is nowhere to bring the mentally ill charged with felonies, except jail. The proposal would change that.
"As someone who operates the jail, I know very well there are folks who don't belong there," Rice said. "I think it's a good idea."
Windmoor would not be a sentencing facility. It would be for mentally ill inmates awaiting a determination of competency or trial. The average stay would range from a couple of weeks to a few months.
The hospital would provide treatment at a cost of $2.95-million a year, and the sheriff's office would transport the inmates and staff the hospital with detention deputies for $2.5-million annually. Part of the money also would pay for mental health evaluators to work in the jail's booking section to screen the mentally ill when they arrive.
Dillinger also wants to set aside $45,000 a year to hire personnel who would help the mentally ill inmates find housing when they are released from jail. And he would provide $810,000 annually to help up to 150 released inmates pay rent.
The idea is to stop the cycle of mentally ill individuals becoming homeless, committing crimes, going to jail and being released back onto the street with nowhere to go, Dillinger said.
"The ultimate goal is they don't come back into the criminal justice system," Dillinger said. "They can have quality of life and they can be productive as citizens."
The request was submitted to U.S. Sen. Bill Nelson's office April 25, where it is still being reviewed, said Bryan Gulley, a spokesman for the senator. The office still is receiving funding requests from around the state, he said.
"We certainly support the concept," Gulley said. "We're going through all the requests and figuring in light of the tax package what realistically we are going to be able to support."
Dillinger's request would pay only for the first year of the program. But he said he hopes it would prove its worth to the federal government so that the funding would be renewed.
He plans to lobby for the money in July when he attends the annual convention of the National Alliance for the Mentally Ill in Washington. If Pinellas receives the money, Dillinger said the program could be in place by January.
The Pinellas County Jail houses an average of 2,700 inmates a day. Nurses inquire about mental health during medical screenings when inmates arrive. Some inmates lie, and some have never had mental illnesses diagnosed, which are later diagnosed by jail doctors.
The mentally ill who have commited misdemeanors can be taken for psychiatric evaluation to mental health facilities like PEMHS, or Personal Enrichment through Mental Health Services, in Pinellas Park. But PEMHS is not designed to accept serious offenders, said executive director Thomas Wedekind, who supports the proposal.
"The prevalance of mental health problems at the jail really has amazed me. There's more and more people ending up coming in contact with law enforcement," Wedekind said. "The crux of the thing is to move everyone into a treatment setting and keep some of the controls of law enforcement."
Mental health advocates say the mentally ill don't belong in the jail to begin with. Mental illness is a chemical imbalance in the brain that is treatable, like physical problems, said Indian Shores resident Elliott Steele, president of the Pinellas chapter of the National Alliance for the Mentally Ill.
"If we were putting people in jail because the side effects of cancer had them loitering on the streets, how moral would that be?" said Steele, whose 26-year-old daughter has schizophrenia. "If it's cancer or any other illness, we're not in that situation."
Law enforcement officials and advocates for the mentally ill agree that untreated mental illness can lead to criminal behavior. Often, people stop taking their medications because they feel better, then they have a relapse, Dillinger said.
"Many times it's because voices are telling them to do it," said Dianne Steele, who is on the Florida Commission on Mental Health and Substance Abuse, which issued a report in January calling for a statewide effort to divert the mentally ill from incarceration to treatment. "Delusions can send a person doing a lot of very bizarre things, and some of it falls into crime."
At the jail, the psychiatric inmates are housed in cells with bars in the maximum security D-wing. There is a full-time psychiatrist and two psychiatric nurse practitioners, along with counselors and part-time psychiatrists.
Maj. Ken Remming, jail director, said the staff does what it can to treat mentally ill inmates, but he recognizes it is not the ideal setting.
"The physical environment of the jail is not conducive to mental health treatment," Remming said. "No matter what we do to try to treat them, probably, it doesn't have the same effect as it would have if they were given the same treatment in a non-jail setting. That's part of the problem, treating people in this environment and trying to get the same effect as if you were in a hospital environment."
Windmoor Healthcare, formerly Horizons, is a 163-bed comprehensive psychiatric hospital for adults that offers mental illness and substance abuse programs.
President C. William Brett, who has a doctorate in clinical psychology, said the hospital has a two-story, 40-room unused section that could be dedicated for the inmates. The rooms have solid doors and are clustered around a common area.
Dillinger's proposal includes $300,000 to make one-time security renovations.
Windmoor would provide psychiatrists, nurses, social workers and psychologists and tailor treatment programs to the needs of the inmates at any given time. Brett said he does have concerns about how the hospital's other patients would respond.
"I don't want to be known as a jail," he said. "I think if we do this right, it won't happen. I think we can provide excellent service for the population in an isolated part of the hospital."
Forty beds, everyone agrees, would easily be filled. Dillinger said they could probably fill hundreds, so these will be reserved for those with the most serious illness.
"That's our start," Dillinger said. "It's better than what we've got."