January 22, 2019

Mental health rising issue in jails

Cortland County Jail taking initiative to solve the issue

Photos by Joe McIntyre/staff photographer

Inmate coats are on hand Wednesday near the recreation yard at the Cortland County Jail complex in Cortland.

Of all the people who have come through the Cortland County Jail, the first to come to Undersheriff Budd Rigg’s mind was a man from out of town who broke a window at Tops supermarket.

The man was under the influence of drugs, and brought to jail. But during the man’s initial screening, Rigg said it was discovered there may be more of an issue than just drugs.

“As time went on, it became more and more evident it was a serious mental health issue,” Rigg said.


Bringing it all together

This is the first part in reporter Nick Graziano’s five-part piece on the Cortland County Jail. To view all the parts, click here.


Referrals were made to get help for the man. It got to the point were he had to be on constant watch, due to the worry of self-harm, Rigg said.

“We can’t force medication in jail like they can in an institution,” Rigg said. “So we finally got this individual to an institution through OMH (state Office of Mental Health), got him stabilized on medications, came back, he was like a different person.”

The man had worked on wiring for helicopters in the military, Rigg said. “He was no slouch.”

Once back on his medication, the man came back to jail and went to court.

“The charges weren’t that severe, they realized it was mental health, psychosis, at the crime, did a little restitution, got the guy back home to North Carolina,” Rigg said.

He was just one example.

Mental illness in jail

Of the average 90 inmates in the Cortland County Jail, about 10 percent have a high level of severe mental health issues Rigg said. Another 10 percent or more are diagnosed with having a mental health issue. Those who have a severe mental illness — needing to be in an institution not in jail — make up about 2 to 3 percent at any time in the jail, he said.

With a rated capacity of 57 beds, and a temporary capacity of 30 more in exercise space converted to a dormitory, the difference of 20 inmates with mental-health problems is a significant factor in crowding at the jail, which the state has ordered the county to correct.

However, the county’s ability to divert inmates with mental-health troubles to other facilities and programs is limited; the number of mental-health facilities is dropping. And the number of mentally troubled inmates isn’t getting any lower.

“It’s something that’s increasing for sure,” Cortland County Jail Capt. Nick Lynch said.

It’s an issue nationwide. People who have serious mental illnesses are admitted to jails across the United States about 2 million times a year, according to the Stepping Up Initiative — a national effort to divert people with mental illness from jails and into treatment. Also, almost three-quarters of those inmates have drug and alcohol use problems.

“A lot of mental health is masked with self-medication, drug use,” Rigg said.

The state having closed several mental health facilities has caused many people with mental health end up in jail, said Bill Zipfel, superintendent of the Genesee County Jail, which is part of the Stepping Up Initiative. “That’s an issue.”

The state Department of Mental Health closed about nine centers in a three-year period.

In 2017, the state served about 139,000 people with mental health issues, a fraction of the estimated 865,000 mentally ill people, reports the Manhattan Institute, a policy think tank. The Cuomo administration has continued a long-term policy of trying to reduce mental-health facilities Non-forensic state psychiatric centers lost 15 percent of their capacity since 2014, while their average daily census dropped 12 percent.

Assembly Member Gary Finch (R-Springport), a member of the assembly corrections committee, said the state’s closure of mental health facilities just created another problem “putting people on the street” with no resources for help. Then they end up in jail.

“We need to solve that problem,” Finch said. Instead of providing funding for new programs, Finch said the state should look to invest funding in existing programs that can help people.

Chris Cushing, the forensic mental health counselor in the jail, said inmates use to be sent to a state mental facility in Rochester, but it is always full.

“There’s no openings, so they’re here (in the jail),” Cushing said.

Root of problems

There is a lot that goes undiagnosed, Rigg said, because people don’t want to say they have a mental health issue.

In the last five years, Cortland County’s female population in jail has gone up about 300 percent — the largest growing inmate population in the county and state.

“Women that are coming in are a real mess,” Rigg said.

In many cases, the women are labeled as having a mental illness, but eventually it is discovered the women have endured years of various kinds of abuse — just about all of them, he said.

“It’s 100 percent a mental health issue,” Rigg said.

Abuse is not always the reason for mental illness among inmates, Rigg said, although it is the reason for most. In some other cases of those with severe mental issues, it’s something they were born with.

A lot of it is environmental, he said, where they grew up, how they were raised. Lynch added psychological, social and physical experience can also be the cause.

There are some who have had a mental health diagnosis all their life, went off their medication because they started feeling better — from the medication — and did something they normally wouldn’t, like tax evasion, Rigg said.

“Some of them are truly only here because of the mental health and people just didn’t know what to do with them,” Rigg said. “They have done something, annoyed someone on Main Street and ended up in jail.”

Counseling help

The Sheriff’s office is not sitting around waiting for someone to fix the problem for them, Rigg said. “We’ve been working on it.”

Unlike many jails, the Cortland County Jail has a full-time forensic counselor on site, with Cushing.

“With a full schedule,” Rigg said. “So we have 35 hours a week of one-on-one counseling that we’re doing in the jail all the time.”

Having Cushing on site, through the county Mental Health Department, saves the jail, and county, a lot of money, Rigg said.

“She meets with people regularly so we don’t get those flair ups like you see in other jails, and, knock on wood, that helps with our suicide attempts,” Rigg said. “That one office, 35 hours a week, is worth its weight in gold.”

If there was more space in the jail, Cushing said more could be done to help inmates.

“They really do need a lot of mental health assistance,” Cushing said about the inmates.

She would like to see space in each cell block where she can have an office to meet with them, rather than them being escorted through the jail, one by one to her office.

The inmates can’t be forced to see her either, she said, unless they are a danger to themselves.

“There could be more resources if we had more room,” she said.

In her 20 years of working with the county Mental Health Department, she said she’s seeing inmates come in sicker and sicker every year. A lot of it from drug abuse and past trauma.

“There’s not enough time to see them often enough,” she said.

If the counselor is not on site, Lynch said the Cortland Regional Medical Center is contracted to provide immediate evaluations.

Genesee County’s jail has a capacity of 97 inmates. Zipfel said he did not have specific numbers on inmates with a mental illness in the jail, but said it is a fairly significant amount. All get help, but it may take a while because the jail doesn’t have a counselor.

While the county is a part of the Stepping Up Initiative, it did not receive grant funding to explore options to further address its mental health issue.

Addressing the issue

Every inmate who comes into the Cortland County jail is screened for mental illness, Rigg said.

“One hundred percent of our staff are trained in lower-level mental health issues,” Rigg said. “Our staff is trained in screening and identifying any emergency needs.”

A correction officer watching a housing unit is able to identify behavior changes and knows when to intervene, Rigg said.

Some inmates may slip through the mental-health screening process when first admitted to the jail because drug effects may mask it, Rigg said. But once they start to detox, the officers notice a difference.

“We don’t want to put out the fire, we want to stop it before it gets to that point,” Rigg said.

When people come to jail, they’re not put together, they’re scattered, Rigg said. Corrections officers are trained to be a solid object for the inmates, a peer to look toward.

The Sheriff’s Office will advocate for services on behalf of inmates with mental illness with judges and the county district attorney, Rigg said. In doing so, they’ll offer a solution so there is a plan in place for when the person is released, Lynch added.

Along with help from officers, several local agencies work with inmates at the jail. Even competing agencies work together, Rigg said, because there are enough people in the jail with a mental illness for them both to have a full schedule.

The Wishing Wellness Center in Cortland comes twice a month to discuss mental health and well-being. Service providers come into the jail on Fridays, and the forensic counselor in the jail helps connect inmates who have mental illnesses with the services they need, Lynch said.

The jail works with Veterans Affairs a lot. Inmates with post-traumatic stress disorder get help quickly when Veterans Affairs is called, Rigg said. Sometimes they’re at the jail the day they’re called.

“Cortland is advanced as far as a community-wide effort,” he said.

Cortland’s crisis team

The lack of mental health centers does create a void, Rigg said. But Cortland County has a Mobile Crisis Team, which he said helps make sure those with a mental illness never make it to jail, or so police don’t have to get involved.

The team, formed at the beginning of the year, is a grant-funded program run by Liberty Resource of Syracuse, which assists all law enforcement agencies in Cortland County — there are teams in four other counties, too. Those on the team in Cortland Cortland all live in the county, and work for local agencies, such as the county Mental Health Department, Cortland Regional Medical Center, county Probation Department and others.

In the past three years, between the five counties, the Mobile Crisis Team has diverted 80 percent of the people its helped from either going to the hospital or jail, said Theresa Humennyj, regional program director for Liberty Resource.

While sometimes police involvement may be necessary, Rigg acknowledged having an officer present, and potentially having to handcuff someone could escalate the situation. That’s where the Mobile Crisis Team steps in.

“People get anxious or scared,” Humennyj said about how people act when there is a police presence. “It turns into he said-she said blaming, and a person might make bad choices. We try to come in so it doesn’t get to that point and they avoid jail.”

The teams divert 2 to 3 percent of the jail’s population to other services, Rigg said.

Solving the issue

“Our local community has done so much on the outside,” Rigg said. “So the more we address the issues in the community, the more it helps the jail.”

The more people they can divert from jail, the more happy families there will be, such as the parents of the man from North Carolina.

“His mother called like a month later, crying, thanking us for going over the top and recognizing mental health, and not just throwing him in a cell and locking him away, or sending him off to prison,” Rigg said. “That’s just one.”

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