Let’s grant that current state leadership, particularly Gov. Nathan Deal who seems more aware of underlying causes of social ailments than most who have held the office in recent years, is finally trying some new approaches although, to get them past a public largely uneducated on such topics having to cloak them in the disguise of “money-saving moves.”
Those who usually turn to this space on Sunday for some pointed barbs, clever turns of phrase and diverting witticisms be warned: You are about to deal with an unrelenting stream of facts/statistics that, while intended to inform, might well scare you to death.
Such must be preceded by a cautionary note that, in jail suicides and such, it is not the fault of the sheriff’s department nor similar agencies all across the state now finding the jails they by law must operate have become to considerable degree the “mental hospitals” that Georgia is systematically closing. That’s not law enforcement’s job and it sure isn’t funded or staffed to do such a task.
The latest local case simply makes a sad but extremely relevant starting place for explaining what is happening in Greater Rome, in Georgia, around this nation. The inmate who hung himself with bedsheets in a locked cell was in the County Jail’s “O block” reserved for mental-health inmates most of whom, before Northwest Georgia Regional Hospital (NWGRH) in Rome was closed a year ago, would have been kept/treated there.
IT’S NO SECRET that the jail, for many years, has been acutely understaffed with underpaid and overworked personnel. Additionally weird as it seems to say it, mental hospitals tend to be far more pleasant environments than jails and charged with “helping” their clients. The main purpose of jail is to make sure the clients (some of them not yet found guilty of anything) don’t escape. In the case of those in O block, many are likely there for “acting odd” or violating some social etiquette of which they may not even be aware (such as urinating in public), particularly when “off their meds.”
In this instance, the inmate had twice earlier attempted suicide while in the jail. Had he been confined for evaluation at NWGRH he thus would likely have been put on “one on one” – a staff member with him every second, even when going to the bathroom, on orders of an attending psychiatrist/psychologist. Such demands and responsibilities are part of why state mental hospitals cost a lot more to operate than jails and why NWGRH had about 750 employees.
The Floyd County Jail probably has less than 10 percent that number keeping watch over an average of 2 to 3 times as many charges and has no full-time staff psychiatrist, much less a half-dozen of them plus dozens of nurses, therapists and guardian personnel.
Conditions are largely similar statewide in a shift now only starting, and already mostly implemented for the mentally disadvantaged, to what is known as “community-based care.” How that is working out is impossible to confirm as they are scattered far and wide with “patient privacy” protecting everything about them starting with their names. It’s not impossible that some might similarly now be in jails.
There’s nothing wrong with a shift away from institutionalization-only, although it appears being done for the wrong reason most of time: saving tax money. Actually, if properly done with adequate supervision and monitoring whether by public or private employees, the community supervision approach would very likely cost more. That is particularly so if anything much beyond “making sure they take their medications” is involved.
AS NATIONALLY syndicated columnist Mona Charen recently summed it up:
“Since the 1960s, when deinstitutionalization became intellectually fashionable and fiscally alluring to states looking to save money, the mentally ill have been dumped onto the streets. Today, 95 percent of the inpatient beds that were available for psychiatric patients in 1955 are gone. The Treatment Advocacy Center explains that ‘the consequences of the severe shortage of public psychiatric beds include increased homelessness; the incarceration of mentally ill individuals in jails and prisons; emergency rooms being overrun with patients waiting for a psychiatric bed; and an increase in violent behavior, including homicides, in communities across the nation.’”
Against this background Brian Owens, the Georgia corrections commissioner, recently declared “It’s about time to decriminalize mental illness.” He doesn’t mean releasing all those mentally ill, only the 3,300 now in state cells who are nonviolent. And the 32,000 probationers he estimates suffer from mental illness of which, according to Owens, in 2011 some 2,400 were returned to prison not for committing a crime but for failing a urine test, not taking medications and failing to report to a probation officer.
There’s got to be a better way that actually leads to either permanent stabilization or actual cures. If memory serves, psychiatry originated in treatments that did not include turning patients into chemically lobotomized zombies.
Owens is also wrong in putting this into a tax-savings cast: “A mental-health counselor there who will help keep somebody on the streets while continuing to take their medications costs us $14 a day. If we revoke them to the state prison, it’s $50 a day. That’s a huge difference.”
“On the streets” is not without a potential high price. It is not where true mental patients should be, nor is keeping them “high” or “down” with drugs supplied by taxpayers an actual end to the problem. Dealing with mental illness is certainly not easy, true cures extremely difficult, but what is being done now is only somewhat better and less cruel than how lepers were long treated in this country.
THE INSTANT dollars-and-cents are brought to the table on this topic then it should be considered evidence there’s not as much common human decency involved as some like to pretend.
And while many of the mentally disturbed may only pose a danger to themselves, this “on the streets” — and not cured —thinking means increased dangers for the general public. Statistics show that 5 to 10 percent of the seriously mentally ill who go untreated (or have not been diagnosed, or aren’t watched closely enough to guarantee they are on their medications) will commit a violent crime in any given year. They account for 5 percent of all homicides annually in this country — and for 50 percent of those involving mass fatalities such at the Colorado movie-theater massacre.
Let’s concede all this is an area with no easy answers nor even really good ones. However to cast it, and many other concerns most would rather not think about, into money terms reflects very poorly upon our society. Feeding the starving, tending the sick, making the elderly comfortable in their final days are not up to somebody else to worry about. It is a shared responsibility.
“On the streets” is not where mental patients should be, no more than a young child should be there without constant supervision. Mental care in a confined hospital setting for some has a role and purpose, just as being in a truly concerned community has value for others — and early detection because of all being aware of and educated about this problem would actually reduce the worst aspects of this, such as seems to have been the case in Colorado.
County jails should not be holding tanks for problems society prefers not to think about. This is certainly not a worry to dump off on county sheriffs and county taxpayers to handle as best they can while hoping the body count from suicide or homicide does not become too noticeable.
Neither is it gun control — or bedsheet control — that is the solution. Neither guns nor bedsheets kill people. It is the condition of the mind involved that is the determining element — as it is in most wars, too, due to the distorted thinking in the mind of opponents. There’s an excellent example continuing right now.
YET IT IS mental health to which society, as a whole, pays little attention, offers too little funding, works too little on improving.
That in itself fits the description of “crazy.”