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KCBX Two-Way: Jailing the mentally ill

Greta Mart/KCBX

Jails across California are struggling to keep up with inmates who are deemed incompetent to stand trial. Oftentimes, there's not enough space for these inmates in mental health facilities. They're sent to jail instead, because it's the only place left for them.

Chris McGuinness is a reporter for the San Luis Obispo New Times and he's been covering this issue in San Luis Obispo County. KCBX invited McGuinness to the studio to talk about his recent cover story. 

KCBX: You begin your piece with the death of San Luis Obispo County Jail inmate Andrew Holland, the 36-year-old Atascadero resident found incompetent to stand trial. And he wasn't supposed to be in the jail in the first place. He was being held there for transfer to the county's mental health facility [where he would be housed] until he was deemed competent to stand trial. Can you tell me more about the details surrounding Holland's death?

MCGUINNESS: Sure. Mr. Holland suffered from schizophrenia. At the time of his death, he had been waiting for about 12 days for a transfer to the county's mental health facility. From what I was told both by the county and by the sheriff's department, Holland was waiting because there was not a bed available for him. Mr. Holland was apparently placed in an isolated-type cell initially for assaulting one of the jail staff. At some time into that stay, he was discovered to be harming himself. And so he was taken from that cell and was placed in a restraint chair, where the records show he stayed there for nearly 48 hours - in this chair. And soon after, he was released from the chair and placed back [in the cell]...he apparently lost consciousness and died.

KCBX: What's the process like for being declared incompetent to stand trial, or IST?

MCGUINNESS: Usually their defense attorney raises a question as to whether or not this person has the ability to participate in their own defense, or understand what's going on in the criminal proceedings. From there, the court actually has them evaluated by, I believe, two psychiatrists. From there, they are basically recommended to a psychiatric facility, where they can get treatment and they remain there getting treatment until the doctors believe that they are able to participate and understand what's going on in their criminal proceedings.

KCBX: If a person is declared IST, how many spaces are available for these people in the county right now?

MCGUINNESS: Bed space is limited and part of that is because all the beds and the facilities aren't specifically designated for these inmates.

KCBX: Is there any sort of separate or specialized treatment in jails or prisons for inmates who have mental illnesses right now in San Luis Obispo County?

MCGUINNESS: I know that the jail does have some psychiatric and mental health staff as well as some medical staff. But it's nowhere near the staffing levels that you would see at a state hospital or other psychiatric facility.

KCBX: What's the effect of being in jail for people who struggle with mental illnesses?

MCGUINNESS: What happens often is when these people are having a mental health crisis in the jail and are refusing their medication, their condition often deteriorates and gets worse. That usually could mean anything from them becoming violent with themselves or other people, like jail staff. And it also could result in them ending up in these isolated or observation cells by themselves for long periods of time. Researchers have shown that [it] also can make their conditions deteriorate.

KCBX: What's being done about this in the county and the state?

MCGUINNESS: This is a problem that pretty much any county jail in California is dealing with. They seem to be trying to find smaller measures to address some of this stuff. I know over at the San Luis Obispo County Jail, they are currently beginning a second phase of the jail expansion, [which] will include a small facility that will have some rooms or areas available for medical and mental health treatment. And on a statewide level, the Department of State Hospitals has begun contracting with some county jails within the state to provide in jail treatment to bring inmates that are competent to stand trial back to competency.

McGuinness's SLO New Times cover story is on newsstands this week. 

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