Despair | Lesley Grogan

Santa Barbara County is soon to be hit with a multimillion-dollar fine! We can and urgently must make lemonade out of this lemon!

The fine is being imposed upon the county by the Department of State Hospitals (DSH) as we are one of the state’s worst offenders — in the top 15 of 58 counties — in the percentage growth of mentally ill IST, or incompetent to stand trial, felony offenders in our jail. A person is deemed incompetent to stand trial by a judge in conference with two psychiatrists. For years the number of IST felonies in jails across California waiting for state hospital beds, and the number of months they wait untreated, has grown. It will now be the county’s responsibility to reduce this jail population by getting folks into treatment. The Department of State Hospitals’ charge is to reduce the number of those being referred to state hospitals. And this is where our county has failed miserably.

Competency to stand trial, required by law, means the ability of offenders to understand the charges against them, and participate in their own defense. The IST population are among the most acutely mentally ill. Like patients with a heart attack, they require intensive treatment. Yet California has a waiting list of nearly 2,000 for its state hospital beds, and no alternative treatment beds are available in our county. While they wait for a bed, our IST inmates languish in jail, their untreated illness getting worse.

Clearly, jail is no place for someone who has a severe mental illness. Yet, each month in Santa Barbara County, many offenders in crisis are jailed for lack of inpatient beds. Those held on felonies remain in the jail for lack of intensive residential treatment options on the outside. It is estimated that one third or more of our jail population is composed of persons with serious mental illness. Some are so ill they are placed in “safety” cells with padded walls, no furniture, and a hole in the floor to relieve themselves.

Except for their distraught families, most of us remain blissfully unaware of their suffering. Incarceration is traumatic for someone who enters the jail relatively healthy. For someone whose connection with reality is already tenuous, the suffering is intense, as is the worsening of symptoms.

So how to turn this lemon of a fine into lemonade?

The state’s IST fine provides that the penalty’s proceeds be deposited into the state’s Mental Health Diversion Fund that the counties may apply to for financing jail diversion strategies that divert mentally ill offenders into mental health and substance abuse treatment. The $8 million to $9 million available to our county can finally provide the impetus for us to generate community-based residential treatment, when added to other available funds.

For example, in fiscal year 2017-18, the Santa Barbara County’s Community Corrections Partnership set aside more than $3 million for treatment beds for jail diversion. Yet the Community Corrections Partnership has yet to seriously pursue a plan to utilize that funding.

Santa Barbara County has already mounted a major collaborative jail diversion effort (Behavioral Wellness, Public Defender, Law Enforcement, Probation, the District Attorney) that is having some gratifying successes. However, this effort is missing an essential remedy: Intensive Residential Treatment. The need for treatment beds has been largely ignored in Santa Barbara County while other counties move toward remedies we can learn from:

Los Angeles County’s example should be instructive. In September 2022, the L.A. Board of Supervisors mandated a time-limited focus on the incarceration crisis, charging the study group with returning within several months with a plan as to how the county can significantly increase the number of treatment beds. Forty percent of L.A. County’s jail inmates suffer from mental illness. (L.A. County counts and characterizes them). Through its Office of Diversion and Reentry, the county is focused on concerted efforts to significantly reduce the jail population. The goal, adopted in 2019, is to close the Men’s Central Jail, their largest jail facility, in favor of investing in community-based care for those with mental illness and substance use disorders. The Los Angeles County Board of Supervisors has stated that instead of spending $1.7 billion to rebuild the jail, dollars should instead be applied to the community-based treatment and treatment beds needed to support real mental health recovery.

What can we do in Santa Barbara County?

Immediately the county should apply for the new funds under the Department of State Hospitals’ IST Diversion Infrastructure Project. The deadline for an initial RFP (Request for Proposal) is May 1.

The county should urgently place an intensive, time-limited focus on the crisis of incarceration of those with mental illness. We need a cohesive plan to reduce the jail population, a significant proportion of which is composed of persons with mental illness and substance use disorders.

Consequently, we need a robust system of treatment across the continuum of care, including inpatient and longer-term treatment beds, such as we have for other major chronic illnesses, like heart disease. We provide an inpatient bed and hospital care when someone is in life-threatening heart attack crisis with stepdown to skilled nursing care as indicated. Persons with serious mental illness deserve the same level of life-saving, medically necessary care.

We are being heavily fined for years of neglect of our mentally ill jail population. Now that millions are being extracted from us — with a carrot-and-sticks provision that we can get it back if we put it to use for IST diversion — it is time to act.

Jan Winter is a member of NAMI, and Lynne Gibbs is a member of NAMI and Families Act.


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