Sedgwick County Sheriff Robert Hinshaw says he doesn't want to be warden of a mental hospital. "But in one respect, I already am," he says. In June, 330 of the 1,520 inmates in the jail he oversees were considered mentally ill.
Eleven of them were considered dangerous when off their medication — seeing things that aren't there or hearing voices. Voices that sometimes tell them to hurt themselves or others.
Hinshaw wants to redesign a portion of the jail to house some of those inmates together, a move he thinks will allow corrections officers to better manage them.
In January, Hinshaw will have access to $700,000 to deal with mental illness at the jail. Commissioners approved the money last month as part of a contingency fund for public safety.
But exactly how that money will be spent is still being debated.
Commission chairman Karl Peterjohn, for example, isn't yet convinced a mental health pod is the best solution.
"I know it's in the budget and the sheriff really wants to proceed, but I have the responsibility to make sure every last nickel screams before it leaves the Treasurer's Office," Peterjohn said.
A problem across the U.S.
Communities across the country are dealing with how best to manage mentally ill jail inmates, said Stephen Goldberg, executive vice president of Conmed Healthcare Management Inc. and president of its mental health division.
Conmed, a Hanover, Md., company, provides medical services at the jail, including mental health services. It works in seven states and provides correctional care in 37 counties.
"Mental health issues are becoming paramount issues in jails," Goldberg said. "They become the largest mental health treatment center in most communities."
That's the fear of Peterjohn and Commissioner Gwen Welshimer. Board member Kelly Parks, a former Valley Center police chief, has expressed concern that law enforcement will take people who could be better served by mental health services to jail because it might be quicker and easier to do so.
Hinshaw says he understands that concern, but the jail needs resources to deal with the mentally ill inmates it already has.
He noted that of the 330 in jail in June, 212 were pretrial inmates, meaning they were being held on suspicion of a crime and had not been convicted. The 50 inmates facing the most serious charges were accused of crimes such as murder, aggravated battery and aggravated indecent liberties with a child, according to statistics the Sheriff's Office recently provided to the Criminal Justice Coordinating Council.
"I'm not sure how else you're going to address the population in the jail I'm concerned about," Hinshaw said. "Why I need a mental health pod is because these inmates are not suitable for anything other than a secure facility because of what they're charged with and the severity of their mental illness."
Goldberg said mental health management units "really provide an opportunity to concentrate the services for that group."
While such a unit bears a cost, he said, "there is a much higher hidden cost of not doing it: visits to emergency rooms, inmates getting re-arrested and staying longer."
Goldberg said that the larger jails Conmed works with generally have a dedicated section for inmates with mental illnesses.
"I always try to advocate for a mental health management unit," he said.
More staff, training
Part of Hinshaw's proposed budget for a mental health pod includes money for additional Conmed staff.
Marilyn Cook, executive director of Comcare, the county's mental health center, is helping lead a group that will recommend how to spend the $700,000 the county has budgeted.
"I understand why the sheriff wants a specialized place for individuals so staff will have the expertise they need to deal effectively with inmates," Cook said, adding that the group will study all options.
She said that Crisis Intervention Team training for law enforcement to learn how to deal with the mentally ill in crisis situations and help keep them out of jail has "made an incredible difference in how officers view individuals who have these presenting issues."
"It's been very effective in de-escalating some of those situations," she said.
The Sedgwick County Offender Assessment Program, which provides an alternative to incarceration for people identified with mental illnesses, also has helped, she said.
"We are seeing while some people do end up in the jail again, many do not," she said. "For those who do, there are much longer periods between periods when they are arrested."
Commissioner Dave Unruh says he is supportive of a mental health pod.
"It's clear to me we need to make special arrangements for our detainees with mental illnesses," he said.