Mental-health advocates expressed alarm that mentally ill inmates in Santa Barbara County Jail could soon find themselves forcibly injected with psychotropic medications as part of a new jailhouse strategy to get them psychologically competent to assist in their own defense. At a round-table discussion on Monday hosted by the Santa Barbara Chapter of the National Alliance on Mental Illness in the County Administration Building, speakers conjured grim scenarios in which squads of six deputies — one videotaping the proceedings — would rush into inmates’ cells, hold them down, and forcibly inject them with medication.
“It looks like the scenario out of a horror movie that will traumatize them for the rest of their lives,” objected Suzanne Riordan, a longtime advocate for mentally ill inmates in County Jail. Riordan argued that inmates should be induced to accept their medications with incentives like warmer blankets or better food.
Jail commander Vincent Wasilewski took exception to the term “forced medication,” preferring “medication over objection” instead. Before it ever got to that, he stressed, medical personnel in the jail would have spent considerable time talking with inmates to achieve compliance.
“We’re not just going to roll up and hold people down so we can give them shots,” he stated. “That’s not the right thing to do, and it’s not very therapeutic, either.” Wasilewski added that many would allow the injections to take place even if they didn’t affirmatively consent.
This practice has become an issue in the first place because of a 2017 state law change that allows the forced medication of mentally ill inmates. Throughout the state, county jails have increasingly become repositories for inmates charged with crimes they’ve not been tried for because they’ve been deemed “incompetent to stand trial,” or psychologically unable to assist with their own defense.
This population places a strain not just on county jails but on the state’s bulging network of public psychiatric hospitals. Typically, inmates deemed incompetent to stand trial — ISTs for short — are supposed to be shipped to one of a handful of state psychiatric hospitals within 90 days of being found incompetent. Because the state psychiatric hospitals have a waiting list 800 inmates long, such placements have been routinely delayed well past the 90-day deadline.
Wasilewski conceded some ISTs have been held in County Jail awaiting placement for more than a year. A few years ago, the problem had grown especially acute, with as many as 50 ISTs awaiting placement. Now, it fluctuates between 8 and 16.
Last year, Judge Brian Hill declared the issue “a civil rights problem,” noting that the time many inmates spent behind bars waiting to be placed exceeded the sentence carried by their alleged offenses. Last summer, Hill found the Department of State Hospitals to be in contempt of court for not making space for a particular inmate who’d been waiting far more than 90 days. He fined the department $1,500 for its failure. Hill now presides over a special court calendar devoted exclusively to ISTs.
The Public Defender’s Office has assigned one attorney to handle nothing but IST cases. The Sheriff’s Office is about to open a new special 10-bed unit within the County Jail where incompetent inmates can be “restored” without waiting for hospital space to open up. The new unit will have carpeting and softer furniture. “No more tables bolted to the floor,” Wasilewski said. (The county just won a $2.65 million grant to divert six mentally ill inmates a year from County Jail for the next three years.)
This program has yet to be ratified by the Board of Supervisors, and negotiations between the Sheriff’s Office and the private contractor providing medical services at the jail remain ongoing. The state, however, will pick up the tab, which is estimated to be $418 a day per inmate.
For mental-health advocates like George Kaufmann, Jan Winter, and Lynne Gibbs, the issue is not just the draconian measures allowed under the new state law but the notion that the County Jail will be seen as a viable venue for mental-health treatment. The new program, they fear, will undermine the county’s collective sense of urgency to create a new therapeutic space for mentally ill people looking at criminal charges. Mentally ill people, they argue, should be put into treatment facilities, not jail.