Yakima County jail takes a new approach toward mentally ill prisoners

March 31-- Mar. 31--Nine inmates gathered one recent afternoon in a group therapy class at the Yakima County jail to talk about ways to manage their emotions, such as taking deep breaths, exercising and thinking positively. A counselor wrote their ideas on a whiteboard.

When a medication cart passed through the room, one inmate said, "The class is the real medication."

The jail hasn't always provided group therapy sessions, where inmates dealing with mental illness can express themselves, interact with others and share helpful ideas.

Not long ago, in fact, such inmates often landed in extended solitary confinement.

A probe by Disability Rights Washington -- a Seattle-based nonprofit -- uncovered alarming problems in the way the jail treated mentally ill inmates.

Investigators found mental health screenings, followup treatment and the administration of medications were inadequate.

Those findings are outlined in a 33-page federal lawsuit filed in U.S. District Court in December that led to drastic changes in how the jail treats inmates with mental illnesses, as well as a $160,000 settlement.

Yakima County isn't alone. Jails across the state and nation are housing greater numbers of inmates with mental illnesses. Those inmates are typically arrested for minor to mid-level offenses and land in solitary confinement because of behavior related to their mental condition. They're eventually released without any mental health treatment, only to be arrested again later -- a cycle that's stressing law and justice systems, budgets and prisoners.

A movement that began in the 1970s to phase out government-funded mental hospitals is mostly to blame. The result can be seen on the streets and in jails and prisons across the country, including Yakima.

Further complicating the problem is a lack of enforceable statewide operating standards for jails.

"We have increasingly criminalized mental illness and arrested people we should have been helping," said Kim Mosolf of Disability Rights Washington. "I don't think the jails are doing anything maliciously -- I think jails are left with these problems."

Yakima County's jail

Investigators with the disability rights group investigated all 38 county jails in Washington, but only sued Yakima County, Mosolf said.

DRW investigators visited the Yakima County jail six times, interviewing inmates and reviewing jail records and policy governing the treatment of inmates with mental health issues.

The jail lacked a mental health unit and there were no group or individual therapy programs, according to the lawsuit.

The jail's mental health provider -- Comprehensive Healthcare in Yakima -- had not prepared a policy governing the treatment of mentally ill inmates. Instead, the jail had three policies prepared by security staff governing mental health appraisals, suicide prevention and commitment to a hospital.

The administration of medication was found to be inadequate. One inmate reported during booking that he was bipolar and prescribed medication. Jail staff made no effort to contact his provider until he asked about his medication three weeks later. He attempted suicide a day after he finally met with mental health staff, the lawsuit said.

Two other inmates with serious mental health problems had been placed in extended solitary confinement on several occasions. Jail staff had not been consulted about the potential harm of such confinement, the lawsuit said.

Mental health staff frequently met with inmates in the jail's hallway or through cell door ports where discussions could be heard by other inmates and corrections staff, a breach of privacy, the lawsuit said.

There's another side of the story, said Jeremy Welch, chief the Yakima County Department of Corrections.

Jail's aren't designed to house mentally ill people, he said.

"They're a little bit more difficult to manage," Welch said. "They have outbursts and can be assaultive at times."

At one time, the jail perhaps had a handful of mentally ill inmates at any given time. Today, anywhere from 240 to 260 of the jail's 900 inmates -- 26 to 30 percent -- suffer from some degree of mental illness, Welch said.

Welch said jails are learning how best to handle this mentally ill prisoners, and state standards would help.

"That's something I think should happen because that is part of the problem that is out there right now," he said. "This is something jails didn't have to deal with in the past."

Lack of statewide standards

State Rep. Roger Goodman, chairman of the House's Public Safety Committee, has worked on legislation that would establish and enforce state operating standards for jails. But to no avail.

There were statewide standards in the 1980s that focused on jail structures, but none assuring the civil and human rights of inmates, he said.

"The bottom line is there is not enough money to provide jails what they need to live up to those standards," said Goodman, a Kirkland Democrat. "I've contemplated introducing legislation that would require access to 24-hour care in all jails, but I haven't introduced that bill because I know it won't pass."

The Washington Association of Sheriffs and Police Chiefs has devised standards for accrediting jails, but they're voluntary and unenforceable.

That program was established in 2014, and so far three jails -- Clallam County, Kent, and South Correctional Entity Regional Jail in Des Moines -- are accredited, said Mike Painter, director of professional services for WASPC.

There's a national accreditation program through the American Correctional Association, but few, if any, Washington jails currently meet those standards, Painter said.

Nationally, nearly 300,000 inmates -- about 16 percent of the entire incarcerated population -- suffer from mental illness, according to the Treatment Advocacy Center.

"This isn't just Washington state -- this is a national phenomenon," Goodman said.

Yakima County improvements

Yakima County began working with Disability Rights Washington on improvements at the jail before the settlement was reached in December, Mosolf said.

"They've been open and willing to make changes -- they've been great," she said.

The jail established a mental health unit with 16 beds for men and eight beds for women and private areas where they can talk to therapists.

Weekly group and individual therapy sessions also have been established, and improved screening procedures were implemented in booking, Welch said.

The jail has added a private booking area where mental health evaluations can be conducted.

Programs have been devised to not only help inmates while incarcerated, but also after they've been released, Welch said.

"So they don't cycle back through," he said. "That's the ultimate goal."

In the settlement, the county agreed to pay the disability rights group $100,000 plus an additional $20,000 a year for three years while the group monitors the jail's progress.

Comprehensive Healthcare had been planning such improvements before the probe into the jail, said Vice President Ed Thornbrugh.

"Would it sill have happened without Disability Rights? I think so," he said. "It just would have taken a little longer."

Goodman said he's kept his eye on Yakima County, and applauds its efforts despite the lawsuit. The county has developed a mental health court in effort to divert people with mental health issues away from incarceration and into treatment.

"They're doing a really good job right now," Goodman said.

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