Utah county may forbid jailing of people with MHMR diagnoses

From The Daily Herald in Provo, Utah:

A massive statewide storm brewing for years on how to handle mental health is about to break loose over Utah County.

At the request of the sheriff, county commissioners will likely declare that mentally retarded adults and those diagnosed with long-term mental illness will no longer be
accepted at the jail when they commit acts of violence. No one seems to know
where they should go instead.

"We have children -- in their minds -- going into the jail," said a clearly angered Commissioner Gary Anderson, who has seen the situation first-hand as a former prosecutor and public defender. While the commission does have to vote on the matter -- likely on Tuesday -- Anderson said he thinks it will pass.

Sheriff Jim Tracy says he can't justify taking in mentally retarded or ill suspects -- because of manpower or morals -- and is apparently willing to risk the consequences.

"I do it at the peril of even being thrown in my own jail because of a judge's ruling," he said of turning away mentally retarded or ill suspects. "I believe it's a civil rights violation on behalf of those individuals."

"When I have to buy coloring books and crayons ... to keep them occupied so they won't cry all night and ask why the mean man won't let them go home, I have a problem with that."

Tracy is careful to distinguish between those who may have a temporary mental problem and those who can't commit a crime by definition.

"You can still have a mental illness and still be competent," he said. "That's not the issue I'm fighting."

Tracy is in a battle with families or care facilities who call police after an attack or ther incident that would normally require law-enforcement intervention. The sheriff says the calls often boil down to "convenience issues" in which people are simply looking for someone to take an out-of-control person off their hands.

It does indeed remove a mentally ill or mentally retarded person from their immediate situation -- by placing them in the justice system, where it can be weeks or even months to get back out of a place they shouldn't be in the first place.

Tracy outlines how it works:
• The "suspect" goes before the court and the issue of mental competency is brought up.
• The judge orders a competency exam, which can take weeks to complete.
• The report is sent to a judge who puts the case back on docket, likely weeks down the road.
• The judge gets the results showing incompetency and releases the person back to
caretakers or family.
• Then the person lashes out again, and "guess where they go back to?" sighs Tracy.

He said he sees three or four such cases a month, and the person often spends months in the jail just being processed. One went nearly six months.

"There have been [healthy] people who were in on attempted homicide who didn't do 176 days," he said.

County officials say their jail is not the answer, and hospitals are better suited for those who are mentally challenged.

Dr. Ken Tuttle at Utah Valley Regional Medical Center in Provo agrees, but says his hospital isn't the right place.

The psychologist and regional director of mental health said his facility is for short-term treatment of mental illness and already has a waiting list for that class of patient, let alone long-term requests from law enforcement.

"There needs to be a residential-type facility where they go," Tuttle said. "We're not a residential treatment facility."

He's on task forces with both the Utah Hospital Association and American Hospital Association tackling the long-term handling of the mentally ill. He says the problem is extremely complex, but says it centers around de-institutionalization, or the process of taking the mentally ill out of historically state-run treatment centers.

While population growth has contributed to the shortage of available space in programs for the mentally ill or retarded, the state has removed or stopped funding for thousands of beds for long-term care over the decades at places like the Developmental Center in American Fork and the State Hospital in Provo, which
has participated in the discussion over the jail issue with the county. He blames, in part, mental health advocate groups that would rather see such people try to be integrated into society.

"Every time it happens, it ends up criminalizing mental health patients," he said of
de-institutionalization, because it means there is no place else to go but the jail.

Sherri Wittwer agrees that there is a major problem with the treatment of the mentally ill, though the executive director of National Alliance on Mental Illness-Utah believes there are community models that can be instituted that will solve the problem. She testified Tuesday before a state legislative interim committee meeting about the need for better public education on how to access solutions within the community.

"It all goes back to families that are desperate. They're burnt out. Oftentimes their insurance has run out. They're encouraged to seek help through the criminal justice system," she said.

NAMI has multiple programs aimed to help the mentally ill and those who support them, from family circles to mentoring. The alliance has a conference Sept. 26 that will, in part, address exactly the issue of the criminalization of the mentally ill.

"The way the mental health system is structured, it's something the local communities need to address and the state to address," she said.

Tuttle says the only long-term answer is to build more government-run institutions that can handle the seriously mentally ill and mentally retarded. Private industry can and does build them but only takes patients who can afford it. That presents a major problem for a segment of the population that rarely has much cash.

In the short term, Tuttle said the facilities that currently handle such patients need to add professional staff instead of foisting patients on his hospital or the jail.

For his part, Tracy has gone from exasperated about being ill-equipped to handle that segment of the population to fuming over what he sees as a moral failure of society.

"I am just outraged. I'm outraged."