Mental health services in jail

Mandate requires services be provided

By Charlie Claywell - For The Register-Herald

EATON — On the surface an Ohio mandate, which went into effect in 2016, is a relatively simple concept. It requires that a full-service jail, like the Preble County Jail, “provide the opportunity for alcohol and drug abuse treatment, academic training, psychological and social services and other community services.”

Providing this opportunity, though, means implementing changes in how inmates are processed at the Preble County Jail.

Protocol changes

One of the issues is creating procedures and policies which comply with the new law. Besides the hours required to produce the documents, compliance also means training staff and implementing the new procedures.

“First thing we do is before they (inmates) are booked is a pre-screen questionnaire…. The goal is simple — does the inmate need mental health services,” Jail Administrator Robert D. Schneider said.

If, in the pre-screening process, it is determined immediate mental health care is required, the person is transported to the local emergency room by the agency which brought the individual in.

For inmates not needing immediate care, a second questionnaire is used to see if they need ongoing mental health services. When mental health services (as determined by mental health personnel, not jail staff) are required local mental health service providers are assigned the case, Schneider said.

Increased costs

Preble County Sheriff Michael Simpson and Schneider speak highly of the work done by the Preble County Mental Health & Recovery Board, the local agency which ensures an inmate has the opportunity for the services mandated by Ohio law.

“They (mental health personnel) are here every day. It is kind of a partnership. If we had to hire a mental health professional or contract with a larger organization or something not local, it would be more expensive. We are getting a heck of a deal for the taxpayer,” Simpson said.

In 2016, both organizations budgeted $5,000 to comply with the mandate — an amount that increased to $10,000 apiece for 2017.

In some cases, the cost of treatment has been completely absorbed by the local mental health board, which receives federal and state funding in addition to grants and a local levy.

“The Preble County Mental Health & Recovery Board has provided 100 percent of the funding for inmates to receive drug and alcohol assessment and treatment in the jail for those whose Medicaid has ended due to their incarceration,” Executive Director Amy Raynes said.

But, not all the inmates receiving mental health service have a drug or alcohol addiction.

Schneider noted, mental health is a much broader issue and many of the inmates were receiving care before they were incarcerated. His assertion is echoed by Raynes, who, in describing the clients, said, “most individuals have had past treatment and are currently on psychotropic medications.”

Shuttering state facilities

Although the county’s cost for 2017 is capped at $10,000 since the MHRB has agreed to pay any costs above the $20,000 threshold, providing the services can be a strain for counties like Preble. The county is a geographically designated Mental Health Professionals Shortage Area by the Primary Care Office, a division inside the Ohio Department of Health, which means the county lacks sufficient mental healthcare-related resources for its population.

This lack of resources can be seen when an inmate requires a mental health facility.

Over the past few decades Ohio reduced the number of state-operated mental health hospitals from about 20 to six. This created a significant shortage of available bed space, forcing jails to compete for the beds – and requiring a deputy to transport an inmate longer distances. Local inmates requiring a mental health facility are transported to Summit Behavioral Healthcare in Cincinnati.

This can be a four-hour time commitment for a deputy due to transporting and processing time.

Reducing prison population

Although, in some ways, the mandate is moving mental health services out of institutions and into jails, it appears to be an effort to tackle Ohio’s growing prison population — which set a record last summer.

This year is the first full year the program has been implemented in Preble County.

Mandate requires services be provided

By Charlie Claywell

For The Register-Herald