Diversion works for mentally ill at jail

Fed up with watching the Pinellas County Jail become cluttered with the mentally ill, many of whom spend weeks or months sitting in a cell, Public Defender Bob Dillinger won a $1-million federal grant last year to tackle the problem.

Since then, some mentally ill inmates have been pulled from the jail within days after their mug shot is snapped. The program, which Dillinger thinks is a first-of-its-kind in the nation, places these folks in treatment facilities that do a better job of meeting their needs than a jail ever could.

As the program celebrates its one-year anniversary _ and success _ Dillinger is now seeking a grant to create a similar one in Pasco County.

"We're not trying to put people who are a safety risk out in the community," said Dillinger, though he acknowledged that "we're all on the edge of our seat about that."

Of the 432 mentally ill people pulled from the Pinellas jail, 157 have successfully completed their program, while 275 remain in treatment today. Only a few have re-offended while in treatment, though their new crimes have been no more serious than "getting high," Dillinger said.

In addition to helping the mentally ill, Dillinger says the program is easy on the bottom line.

He estimates it has saved the jail about $5.7-million. While the cost of housing a person in the jail averages about $79 per night (though it's usually more for the mentally ill), the diversion program can find beds in treatment centers that run as low as $30 per night.

Dillinger said he recently secured another year of funding from the justice department for Pinellas.

That's good news to Maj. Kirk Brunner, commander of the jail. As public psychiatric hospitals have shuttered or shrunk over the years, jails and prisons have been forced to pick up the slack by caring for an increasing number of people who suffer from severe mental illness. They receive little or no treatment and sap the jail's staff with suicide attempts, violent outbursts or trips to the medical wing.

"Anything we can do to get them out of jail is a good thing," Brunner said. "They keep coming back without any type of diversion."

Brunner's jail can squeeze 3,100 inside if it needs to, but lately has seen its population swell to record numbers near 3,500. A number of recent factors have led to overcrowding.

Some of it is due to a recent state Department of Corrections crackdown on probation violators, a move that was partially prompted by the high-profile Carlie Brucia case in Sarasota last year. In that case, a man with a history of violating probation was charged with killing a teenage girl. Public outrage provoked a get-tough stance from the state.

But jails also have become repositories for the mentally sick. It's not uncommon for the Pinellas jail to house more than 350 mentally ill inmates at a time. The problem is not just in Pinellas.

In the February issue of Corrections Today, the executive director of the American Correctional Association, James A. Gondles Jr., says the two largest providers of mental health services in the country are the Los Angeles County Jail and Riker's Island in New York.

It wasn't always that way.

In the 1950s, more than a half-million people were treated in psychiatric hospitals nationwide. Today that number is about 70,000.

A report by Human Rights Watch in late 2003 said American prisons and jails contain three times more mentally ill people than the nation's psychiatric hospitals. One in six prisoners suffers from mental illness, the report stated.

Gondles writes in a column in Corrections Today that the criminal justice system has become "dumping ground" for the mentally ill.

Dillinger cites studies that show 70 to 90 percent to today's homeless population would have been in psychiatric hospitals 25 years ago. Today, with hospital budgets slashed, the homeless are left to wander communities. They often end up in handcuffs and jails, many times for minor crimes like drinking in public, shoplifting or loitering.

It should be no surprise then, Dillinger says, that more than 60 percent of the inmates chosen for the Pinellas diversion program are homeless.

Typically, when a person booked into the jail is determined to be mentally ill, it can take months for that person to qualify for a treatment program. So they sit in jail until they qualify and a judge approves their diversion to treatment.

In the meantime, the inmate can cause major headaches in the jail by attempting suicide or fighting with other inmates. The inmate also can strain the medical staff.

"The mental health inmate is a high-risk inmate," Brunner said. "It's a high-maintenance inmate."

Under the diversion program, which is run with the cooperation of the sheriff's office, the Pinellas-Pasco State Attorney's Office and circuit and county judges, case workers identify mentally ill inmates who qualify for treatment.

Inmates who have no desire for help or who would rather stay in jail are disqualified from placement in the program.

"We want people who want to better their situation," Dillinger said.

Though the candidates for diversion are not suspects in murders or the most violent of crimes, some are charged with felonies; a few have been registered sex offenders, Dillinger said.

The treatment is designed to last about 60 days, but in many cases it's taking longer. Though many of the chosen inmates head to treatment facilities, others are sent home, though they are kept under close supervision, Dillinger said.

The programs also can be tailored to the inmates' needs. Those with addictions can be sent to treatment facilities; female inmates can be sent to centers that focus on mental health issues for women; there also are facilities for domestic violence victims.

Those are much better options than the jail, where inmates receive only a slice of the treatment they really need, said Vicki Scotti, the Pinellas jail's program administrator for inmate health care.

"It's an easy fix to just send them to jail," Scotti said. "But it's not an appropriate fix. The jail doesn't do treatment. For many it's a revolving door here."