Monday, September 4, 2017

[Monterey County] Officials disagree that jail serves as 'de facto mental health facility'

Although the Monterey County Civil Grand Jury asserts that the county jail still struggles to meet the needs of inmates with mental illness, county supervisors and Sheriff Steve Bernal disagree, maintaining that many of the cited issues are of the past. 
In the civil grand jury’s report released earlier this summer, they write that with 45 percent of the inmates dealing with mental illness, the jail is serving as a “de facto mental health facility,” and although jail standards have been improved, mental health care issues still aren’t adequately addressed. 
In his formal response, Bernal disagreed with the characterization, writing that the jail is “not designed, staffed, or equipped to function as a mental health facility, in the way we believe the Grand Jury to mean.”
The entire report represents “more of a history lesson than a representation of current jail conditions,” Bernal wrote.
Mental health care at the jail has been a focus for years, particularly since 2013 when a class-action lawsuit was filed on behalf of current and former inmates at the jail. The lawsuit cited serious structural and systemic problems which endangered inmates at the jail. 
In 2015, the lawsuit against the county reached a $4.8 million settlement, which the civil grand jury noted could have been better spent elsewhere, and required various jail improvements.
Examples of changes at the jail since the settlement include having a registered nurse, as opposed to a deputy, conduct an inmate’s medical questionnaire; nearly 300 updated cameras have been added to the facility to improve safety; the number of “tie-off” points were reduced in hopes of preventing suicide by hangings; and chain link fencing has been added along stairs and second-floor platforms to prevent people from jumping.
With six inmate suicides between 2009 and 2015, three in 2015 alone, several changes focus on suicide prevention, such as increased classification reviews for inmates placed in segregation, increased time outside for those placed in segregation and expansion of programming on subjects such as addiction recovery.
The civil grand jury wrote that Reagan-era closures of state hospitals contributed to the issue and that having inmates with mental health issues in jail for months or longer before being transferred to a state hospital is “cruel and inhumane.”
Bernal wholly disagreed with the civil grand jury’s assertion that standards are still not adequate, stating that the jail and its health provider have been working closely with the courts to meet settlement requirements. 
The board of supervisors concurs with the sheriff in the majority of their responses, including this one, and argued that the county and sheriff began modernizing the jail before the lawsuit was filed.
In the county board of supervisors meeting on Tuesday, Supervisor John Phillips questioned where the civil grand jury received some of the data, such as the 45 percent estimation of inmates with mental illness, and further stated that he felt some of the findings were “way out of bounds.”
Supervisor Luis Alejo also didn’t agree with all the findings but commended the civil grand jury for their work.
“They are not easy topics but it’s important to help shed light on them and where perhaps the county can do a better job,” he said. 
Alejo added that it’s important to look at the situation within the context of Assembly Bill 109, which required certain inmates to serve time in county jail instead of state prison.
“Under this generalization of our jail being a ‘de facto mental health facility,’ that would be for every prison, every jail across the state because there’s a significant percentage of inmates who have mental health needs so, again to put it into context, it’s not anything unique to our county, it’s something seen across the board within our inmate population at all levels,” he said. 
In Bernal’s response, he wrote that the sheriff’s office works to minimize jail time for those with serious mental health conditions and to transfer acute case inmates to appropriate locations as quickly as possible. Inmates also receive mental health care at the jail that meets constitutional standards until they can be transferred, he added.
“Every inmate at the county jail has been arrested or convicted of a crime ... Inmates cannot simply be transferred to a mental health facility," Bernal wrote. "Inmates are entitled to due process of law. If a judge determines inmates meet the legal requirements for commitment; they are referred to state or local mental health facilities.”
Several of the findings point to a lack of publicly funded mental health facilities, but Bernal defers to Monterey County Behavioral Health Professionals in his response. 
Of the dozen findings from the civil grand jury, there was only one with which Bernal agreed with entirely: “It would appear that Monterey County’s Behavioral Health Agency’s expertise would benefit those needing mental health care in the jail.”
While two of the civil grand jury-made four recommendations on the subject are already in place, according to Bernal, they also advise that the board of supervisors should fund the building of a new mental health facility, study available properties for one as well as study other existing models of integrated mental health facilities in the jail. 
Bernal’s response was that those recommendations will require “further study.”
The civil grand jury’s report also included a section citing concern over the number of deputies on patrol. 
To comply with the settlement and changing needs resulting from AB 109, staffing increased at the jail and this resulted in fewer deputies on patrol. An overall shortage of deputies contributed to $6.2 million in overtime last year, according to their report
In discussing efforts to fill deputy positions during Tuesday’s meeting, supervisors expressed concern that while the county covers the costs of the academy for applicants to the sheriff’s office, nothing prevents them from then leaving and applying to another agency. 
Monterey County Undersheriff John Mineau responded that while 21 applicants were put through the academy recently, 16 graduated from the academy and will join the sheriff’s office this week. The sheriff’s office is also looking into what other agencies, such as down in Los Angeles, are doing to boost retention and protect the investment in recruits.
However, he added that the department lost far more employees to retirements last year than to other agencies.
All of the six civil grand jury recommendations for addressing the staffing issue, such as using correctional officers in the jail instead of deputies, will not be implemented "as it is not warranted," Bernal wrote in his formal response. 
Bernal clarified that while new employees will reduce overtime, they will only raise numbers enough to provide adequate staffing at the jail with little relief to patrol coverage, which is at an "all-time low."
August 29, 2017
Salinas Californian
By Chelcey Adami


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