Thursday, November 8, 2012

Better Mental Health Services For Local Inmates?

restraint chair
Daniel Robayo, rector of Emmanuel Episcopal Church, and I had a productive meeting with Rockingham County Sheriff Bryan Hutcheson and Lieutenant Steven Shortell on Monday to discuss the following:

1) How can our community support an increase in the number of hours and personnel available to provide much needed mental health services to jail inmates, including enlisting professional mental health volunteers if necessary?

2) How could an expanded staff help provide alternatives to the use of the restraint chair and the isolated padded cell when dealing with mentally ill and suicidally depressed persons?

3) How could the jail and/or the Community Services Board better respond to numerous concerns expressed by inmates who reporting problems accessing medications as prescribed?

Uses of Restraint Chair and Isolated Padded Cell (January 1 through June 30, 2012)

Unlike the above photo, our local jail does not strip inmates who are confined to their restraint chair, but when suicidally depressed or incorrigible inmates are placed in the isolated padded cell for similar safety or medical (suicidal) reasons they are stripped of their clothing and given only a paper gown to wear. While there they have no access to reading material, mattress, pillow, blanket, or eating utensils. A hole in the floor serves as a commode.

We can understand the occasional need for such restraint or confinement for incorrigible inmates, but the primary purpose of Monday’s meeting was to discuss more humane ways to treat mentally ill and suicidal detainees.

We had recently asked for, and kindly received, documentation from Sheriff Hutcheson’s office about all uses of the jail’s restraint chair and padded isolation cell from January 1 to June 30, 2012.
 Their report showed there were 19 cases of mentally ill persons (usually suicidal) being confined to the restraint chair during that time, an average of three per month. In restraint, belts and cuffs have the prisoner's legs, arms, and torso immobilized.

In an additional 8 cases inmates were in restraint for things like “were intoxicated,” “wouldn’t listen,” “were bouncing off the walls,” or who were otherwise seen as possibly harming themselves. The average time spent in the chair for these 27 persons (for medical and these other reasons) was four hours, with the shortest time being two hours and the longest ten hours.      

In addition, there were 22 other reported cases of the chair being used for inmates demonstrating violent behavior and who were considered potentially harmful to others. Some of that number may also have been suicidal, but this was difficult to determine because many were under the influence of alcohol or other drugs. The average time spent in the chair in these cases was six hours, with two hours being the shortest time and 24 hours being the longest.

As to the isolated padded cell (the “rubber room”), there were 7 cases of it being used for medical reasons (inmates deemed suicidal) during this six-month period. In an additional 13 instances an ordinary segregated cell was used and a guard assigned to regularly check to make sure the prisoner did no harm to him or herself. Here the inmate does have access to a Bible, mattress, blanket and a commode.

Segregation cells are used routinely for disciplinary purposes in jails and prisons, and sometimes for the protection of an inmate who is in danger of being harmed by his or her cell mates. Such sentences to the “hole,” for either the prisoner’s protection or for in-jail violations, may be for weeks at a time.

In all fairness, extreme overcrowding at our local jail, along with challenges of limited budget and personnel have Sheriff Hutcheson and his staff stretched to their limit. Our jail, built for 208, is double bunked and typically houses from 325-375 inmates, some having to sleep on the floor. As a result, jail staff feels they have few choices at times but to resort to the use of the restraint chair, segregated cells, and even to the dreaded isolated padded cell. They do report, however, a definite trend toward fewer uses of such measures.

Current Medical and Mental Health Resources

Our local jail has a contract with Southern Health to provide one or more nurses on site around the clock to meet the medical needs of inmates. In addition, a retired MD from Staunton is available on a very part-time basis.

For mental health needs, the jail contracts with our local Community Services Board to provide a Psychiatric Nurse Practitioner for 2 1/2 hours once a week and two professional mental health counselors for a part of two days per week and to be on call for emergencies.

Two very part time volunteer chaplains are also available for male inmates and one for female detainees.

Ongoing Challenges

Over the past year a number of concerned citizens in our community have been meeting to explore alternative sentencing options and other ways of reducing jail overcrowding, as well as brainstorming better ways of dealing with mentally ill and suicidally depressed inmates. 

One idea is to assign such persons to regular segregated cells with trained volunteer mental health providers or interns taking turns being next to the cell and relating to that person until he or she is able to be returned to general population. Such volunteers, coordinated by the CSB, could also be useful in the booking area, where persons may be kept for as long as 24 hours (occasionally longer) until they are sober and can be appropriately assigned to regular population.

In this holding area, inmates are normally not allowed a mattress, pillow or blanket for fear they may attempt to harm themselves, and are typically denied their medications during that time, especially if they are intoxicated.

I believe a community like ours can work together to provide more effective and humane treatment of our incarcerated citizens. Monday’s meeting gave us new hope that together we might be able to make that happen, with Sheriff Hutcheson suggesting in his last email that “the CSB is a primary factor in this matter of discussion”. 

Check out the following links for more background information:

P. S. SAVE THIS DATE: A community forum is being planned for the Massanutten Regional Library from 12-1:30 pm Monday, November 19, to discuss the expanded use of GPS bracelet monitoring technology for pre-trial and post-trial non-violent offenders. The program features a panel of speakers that includes the founder of Nexus Programs (a non-profit agency that provides such monitoring), a representative from the bail bond industry that offers similar technology, and a Clerk of Court and national expert on these issues from North Carolina. Their input will be followed by a Q & A time with participants. The event is free and open to the public.
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