New Hampshire creates Mental Health Court to help people get treatment rather than jail

From Nashua Telegraph in N.H.:

MANCHESTER, N.H. – Jail isn't the place to send mentally ill people who commit minor crimes.

Perhaps no one knows that better than James O'Mara, superintendent of the Hillsborough County Department of Corrections and head of what is more commonly referred to as Valley Street jail in Manchester.

"We're not a hospital. We're not a psych ward. We're not a rehabilitation facility," O'Mara said. "It's very important that people go to an environment that's conducive to their overall health."

The Community Connections Mental Health Court Project, one of instead of serving jail time for misdemeanor offenses.

O'Mara said there are too many inmates at the jail who would benefit more from therapy than incarceration.

The jail's average daily population is about 600 inmates. Most of them stay for about 60 days, although some are held there years awaiting trial, O'Mara said. Annually, almost 5,000 people are booked there, and all of them undergo a health screening, including a mental health history, he said.

Of the 5,000 intakes a year, 24 percent say they have some form of mental illness and 70 percent of those say they've been prescribed medication for that illness, O'Mara said.

Those numbers are similar to other state jails and prisons. About 25 percent of New Hampshire prisoners receive medication for mental illness, not including those who refuse treatment or have not been evaluated, according to a study by the New Hampshire Association of Counties.

Nationally, an estimated 14 percent of male inmates and 31 percent of female inmates have a mental illness, according to a recent study by the Council of State Governments Justice Center and Policy Research.

However, O'Mara knows his numbers are likely low because it is based entirely on what he calls "self-reporting." Some inmates, he said, either do not know or realize they have a mental illness, or just refuse to admit it.

O'Mara said the jail has sufficient staff – a psychologist, one full-time and one part-time social worker, a doctor, several nurses and physician assistants and a part-time psychiatrist – to treat mentally ill prisoners. But if a prisoner denies having a mental illness or refuses treatment, that staff isn't left with many options.

When that happens, staff are reduced to visiting the inmate twice a day, every day to "cajole, beg, implore" them to accept treatment, O'Mara said.

Another hurdle the jail faces even when an inmate admits to having a mental illness is getting that prisoner's medical history from outside health agencies. Jail officials request the information but often have to wait two weeks to a month to get it, O'Mara said.

"If we could get that process expedited, we can get these folks treatment sooner," he said.

O'Mara said he's a supporter of the Nashua court because it helps keep mentally ill people out of his facility and into facilities where they have a chance at getting better. It is hard to watch a prisoner get sicker and sicker when the jail's options aren't enough, he said.

"It's always frustrating when someone refuses to participate in a regimen that will make them better. It's tough to see someone decompensate. It's heart-wrenching, it really is," O'Mara said. "They make my staff's job much easier when they keep people in the community."