Disturbing the peace is a common one. So is public intoxication.
Not everyone taken to the East Baton Rouge Parish Prison for these kind of misdemeanor violations has a mental illness or a substance abuse problem. But for those who do, which is a growing portion of inmates, do they really belong in jail?
“We don’t think that Parish Prison is where mentally ill people should be taken,” said William Daniel, Mayor-President Kip Holden’s chief administrative officer. “It’s morally wrong, and it’s very expensive to taxpayers.”
When Earl K. Long Medical Center closed in April 2013, its specialized mental health emergency unit disappeared, too. Since then, the already overflowing Parish Prison and local emergency rooms have been strained even further than they were before, a trend that a growing group of Baton Rouge leaders wants to slow down and perhaps, eventually, reverse.
To accomplish this, officials are drafting plans to build what’s being called a “mental health restoration center.” The facility would serve as a place where law enforcement officers could drop off non-violent people who need mental health or substance abuse treatment instead of taking them to jail. The facility would function much like the EKL mental health unit did before it was shuttered, according to officials familiar with the plans.
“We kind of knew there would be a fallout losing the mental health emergency room,” said Jan Kasofsky, director of the Capital Area Human Services District, which coordinates community mental health and addictive disorder services in the Baton Rouge area. “We are seeing what we thought would happen: More people are going to jail and more people are going to the emergency rooms. And that’s a problem.”
Adding to the concerns, three Parish Prison inmates with mental illnesses died while incarcerated in the past two years, although parish medical officials ruled all four of the most recent jail deaths resulted from natural causes.
Many local officials, including Holden, District Attorney Hillar Moore III and Sheriff Sid Gautreaux, referenced the recent closures or downsizings of state mental health facilities as a major contributor to the challenges now faced by the local criminal justice and health care systems. All three law enforcement leaders expressed the need for a facility where police officers and sheriff’s deputies can take mentally ill people other than jail or an ER.
“Having this separate facility seems to be the best way to go,” Gautreaux said.
In addition to drop-offs by law enforcement officers, the proposed restoration center also would accept walk-in patients suffering from psychotic breakdowns or bouts of depression, people with suicidal thoughts and people who just need a place to sober up. A key component of the facility, which is in the early stages of planning and is tied financially to Holden’s latest public safety tax proposal, would be the outpatient treatment offerings.
In other words, the patients wouldn’t just be medicated, calmed down or sobered up. They also would have the opportunity for follow up visits, people familiar with the plans said.
Based largely on programs in cities such as Lafayette and San Antonio, Texas, the restoration center would be one component of a broader plan to overhaul the way Baton Rouge handles nonviolent misdemeanor offenders, particularly those dealing with mental illness and substance abuse.
“The key thing is we just kind of firmly believe that if you start providing the treatment and care for those individuals, they would be less likely to get in trouble and end up back in jail,” Holden said. “There’s a lot of compassion in our community, especially for those who are suffering from mental illness. Although they may have committed a crime, we can’t treat them inhumanely.”
Proposed operating and construction costs for the center haven’t been released yet; it’s too early, officials said.
The potential funding sources are far from finalized as well. What’s clear, though, is that the entire plan and other proposed changes hinge largely on the passage of Holden’s tax proposal, which would raise an estimated $350 million geared toward public safety construction projects.
“I think it’s a politically hard thing to do without a tax,” said John Davies, president and CEO of the Baton Rouge Area Foundation, a local nonprofit that has been involved in developing plans for the restoration center.
Any proposed tax increase likely will face some opposition.
“I think we’re all taxed enough,” Metro Councilman Ryan Heck said.
Heck said he had not been briefed on details regarding the restoration center. But he added, “if there’s something we can do in house to save money, then that’s definitely something that I’m interested in.”
Officials in San Antonio and Lafayette said the changes they’ve implemented in the past decade have netted savings in the tens of millions of dollars. And officials in both cities faced similar problems as Baton Rouge before creating the new programs.
“The impetus was the overcrowding in our emergency rooms with persons with mental illness that were brought in by law enforcement,” said Gilbert Gonzales, the mental health director of Bexar County, which includes San Antonio. “And the second impetus was an overcrowded county jail.”
Baton Rouge’s proposed restoration center is based largely on the one operating in San Antonio. Gonzales said a combination of private and public dollars from all levels of government helps fund the system.
Getting started wasn’t easy though.
“This community was willing to say, ‘We are going to do this. We may not have enough money to do it. But somehow, we’re going to make this a priority,’” Gonzales said.
His advice to Baton Rouge: “Work collaboratively with city and county entities, specifically with law enforcement.”
Since San Antonio implemented its programs more than a decade ago, it has seen fewer people booked into its county jail and less crowded ERs. The city’s homeless population also decreased, and, perhaps most appealingly, they’ve saved money, said Leon Evans, a developer of the ideas behind the programs and director of The Center for Health Care Services in San Antonio, which runs the restoration center and several other treatment programs tied to it.
The Lafayette Parish Sheriff’s Office operates the Acadiana Recovery Center, a 24-bed inpatient and outpatient facility, next door to the Lafayette Parish Correctional Center. It treats people who are arrested and people who show up on their own accord, said Rob Reardon, director of corrections for the Lafayette Parish Sheriff’s Office.
In addition, at the correctional center, trained workers conduct an extensive screening of every individual booked into the jail. The goal is to divert every willing and qualified person away from a jail cell and into out-of-jail monitoring programs and treatment facilities.
“Having mentally ill people in jails is bad for everybody,” Reardon said.
The parish’s model saves money by steering as many nonviolent inmates as possible away from incarceration, which is generally more costly than prevention and treatment. Ultimately, treatment on the front end also works to reduce recidivism, which cuts down the long-term costs of incarceration, too, Reardon said.
Linda Ottesen, director of Prison Medical Services, which handles health care at the East Baton Rouge Parish Prison, estimated that a vast majority of the inmates there suffer either from a mental illness or a substance abuse problem. The staff there offers what treatment it can between its nurses, a licensed clinical social worker and a contract psychiatrist who is always on call, among other medical workers. It also screens people booked into the facility for mental illness.
But inside the jail, Ottesen said, medical personnel are often hamstrung by laws allowing inmates to refuse their medication. Meanwhile, the number of mentally ill people booked into the Parish Prison continues to grow, Ottesen said.
“If we keep doing the same thing, we’re going to have the same results,” Ottesen said. “So we’ve got to do something different.”
Regardless of what happens with plans for the restoration center, officials with the East Baton Rouge Parish Sheriff’s Office, which runs the general operations at the Parish Prison, are collaborating with Prison Medical Services employees to improve care for mentally ill inmates.
Officials with both agencies, beginning in January, will meet regularly to share information about specific inmates. Right now, medical personnel aren’t reviewing security reports, Ottesen said, while deputies, mostly by law, can’t review individual medical files.
For example, if an inmate is acting bizarrely or tearing up a cell, nurses might not know. If the same person isn’t taking medication, deputies might not know. Sharing information hopefully will make everyone’s lives — inmates, deputies, nurses — a little bit easier.
“We want to partner together to do as much as we can for these patients,” Ottesen said.
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