12Sep 2015

Oklahoma County jail not set up for mental health patients

According to the National Survey on Drug Use & Health Oklahoma has one of the highest percentages of people with serious mental health issue in the country at 13.3%. Approximately 12,600 offenders have a mental health needs as indicated by the Oklahoma Department of Corrections. In addition, the Oklahoma County Jail has as many as 500 persons with a mental illness at any one time and 57% of inmates diagnosed with a mental illness were incarcerated for non-violent offenses.

Dr. Leland Dennis the Oklahoma County jail psychiatrist, while working came across a lady barely 100 pounds with mental issues, The lady had suffered from untreated mental illness for the past 16 years. When she was asked if she had ever had treatment, she replied that she had tried on many occasions but was told that she was crazy.

She has been tormented by voices in her head, constantly telling her to hurt people.

“She is the sickest patient I have ever seen in my career of more than 20 years practicing psychiatry.” Said Dennis
Just like the statistics confirm, she is just one of the many cases of people who come through the Oklahoma County jail with substance use disorders and complex mental health issues and do not get any form of treatment because the facility does not have enough resources.

Oklahoma’s largest mental hospital is the Forensic Center, with approximately 200 beds. On the other hand the county jails in Oklahoma City has 2,900 inmates and Tulsa 1,800 inmates with about 500 mentally ill inmates, certainly holding more mentally ill individuals does than the state hospital. A 2014 estimate claims that one-third of the inmates need mental health care. The two state prisons in Lexington may do so as well.
According to Dr. Leland Dennis, in the past 5 years, the number of state prison inmates with mental illness has nearly doubled from 20 percent to 36 percent.

As the hospitals in Oklahoma downsized and closed, the county jails noted an increasing number of mentally ill inmates. In Tulsa, 12% of patients discharged from Eastern State Hospital ended up in prison just within 6 months after leaving the hospital. In 2013, mentally ill inmates were said to be “a fast-growing category” and 16% of inmates were taking psychotropic drugs. As early as 2001, John Whetsel, the sheriff of Oklahoma County, had already identified the problem and was quoted referring to the jail as “the state’s largest mental facility”.

When speaking to Maj. Jack Herron, the jail administrator he said that when building the facility, they never thought that inmates would ever get sick.
Growing problem
According to the National Alliance on Mental Illness, more than 5,800 adults with mental illnesses were imprisoned in Oklahoma prisons in 2008. In addition, an estimated 14% of male and 31% of female jail inmates nationally live with serious mental illness.
According to the Treatment Advocacy Center, a nonprofit organization that researches and advocates for people with mental illnesses, in Oklahoma, the probability of someone with mental illness being in prison rather than in hospital is 4 to 1.

Federal data shows that generally, Oklahoma is ranked number 2 in the country for the highest rate of residents with serious mental illnesses. On the other hand, the state is ranked number 46 countrywide in terms of the money assigned for those residents’ care, according to Kaiser Family Foundation.

Most treatment facilities have long waiting queues and as a result, many of those waiting to be served end up either dead, homeless or in jail, mental health leaders say.

As Oklahoma County Sheriff John Whetsel often says, the Oklahoma County jail has become the state’s largest mental health facility.
The state jails have now become the mental health hospitals of yesterday, this should not be the case since jails were never meant to be mental health facilities. However, today we have close to 350 inmates that have at least a mental health Type 1 diagnosis and require treatment by a full-time psychiatric staff, said Whetsel.

A report on the Oklahoma County jail documenting 60 federal civil rights violations was released in 2008 by the U.S. Department of Justice. Since the release of the report leaders have had numerous debates on what are the best approaches to ensure that the federal agency does not file any lawsuit against the county for those violations.

Among the things in the report, was that the jail did not provide any mental health treatment.
Lawsuit likely Whetsel said that if no action is taken, the current jail is neither renovated nor another one built, he expects a lawsuit to be filled by the Justice Department.

Through the federal court they will push for a consent decree, and if the judge issues the consent decree, Oklahoma County will have to fix the issue within two years or less, said Whetsel.

Dennis, who is the only jail’s psychiatrist, is always busy. He is supported with a team of 4 people who are master’s level mental health workers. However, he hopes that more medical professionals will join him soon. Currently the jail has 2 openings for psychiatric nurse practitioners.