Mental help

Mentally ill people make up a disproportionate number of former inmates who are most likely to return to jail


In Ohio and elsewhere, county jails have, tragically, become their communities’ largest mental health institutions. Mentally ill prisoners often don’t receive needed medications and get little, if any, psychiatric or medical care.

Holding mostly pretrial detainees and misdemeanor offenders for short periods, county jails are not designed to provide treatment. The symptoms of mentally ill prisoners typically worsen there, causing them to cycle in and out of the criminal justice system at enormous expense.

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The average cost of mental health treatment in the community, including medications, is $7,500 a year, according to state officials. That’s less than a third of the more than $25,000 it costs to incarcerate a person for a year.

Local governments, with help from the state, must do more to help mentally ill people stay out of jails and prisons and lead productive lives. Ohio is making a good start with its recently announced Community Innovations initiative.

The state plans to invest $1.5 million a year — $3 million over the biennium — in projects that link nonviolent offenders to local community-based behavioral care and addiction treatment. The first round of funding covers 12 projects in 24 counties, including Lucas County.

To pay for Community Innovations, the state used central-office administrative savings from consolidating, as of July 1, the departments of Mental Health and Alcohol and Drug Addiction Services, said Eric Wandersleben, spokesman for the new combined department.

Besides saving money, the merger enables the state to coordinate treatment better. The two departments often served people with both mental-health and alcohol and other drug problems.

Lucas County will get $134,000 next fiscal year, including money for a case manager to work with mentally ill inmates after they’re released. The county also will use some of the money to pay for prescription drugs needed by mentally ill inmates, County Sheriff John Tharp said.

A survey found that mentally ill people make up a disproportionately large number of those most likely to return to jail. Scott Sylak, executive director of Lucas County’s Mental Health & Recovery Services Board, said early intervention can reduce the number of re-arrests.

In Lucas County, a case worker will meet with prisoners before they’re released, help them get needed medications, and connect them to community mental health services after they’re released. If necessary, case workers will provide transportation for their clients. Many mentally ill prisoners lack insurance, money to pay for prescriptions, and transportation.

“We’re not providing the help people need,” Sheriff Tharp told The Blade’s editorial page. “We need to do what we can to slow the revolving door. I’m excited about this program.”

Mr. Tharp said he didn’t know how many of the more than 400 Lucas County jail inmates are mentally ill. Other sheriffs have estimated that 25 percent or more of their population is mentally ill. The National Institute of Corrections says that 17 percent of the U.S. jail population has a serious mental illness, and 68 percent of inmates abuse drugs or alcohol.

Helping more of them stay out of jail, where their disorders simply get worse, is both humane and cost-effective. The state will evaluate the 12 pilot projects to determine which ones can provide models for other counties.

By encouraging better cooperation between local criminal justice and community mental health agencies, the state should make significant improvements in mental health care, while keeping a lid on county jail populations.