November 21, 2014

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Jails shoulder cost of treating mentally ill

CLEVELAND — Jails are under increasing pressure to provide treatment to the mentally ill, a consequence of an underfunded mental health system, a newspaper reported Saturday.
About 2,000 inmates pack the Cuyahoga County Jail in Cleveland on any given day, and about 15 percent have serious mental health problems, jail administrator Ken Kochevar said.
“If the average inmate is costing us $80 a day, the mentally ill inmate is costing us twice that, and they’re here for a much, much greater time,” Kochevar told The Plain Dealer.
Inmates with mental illness often sit in cells for weeks, waiting for psychiatric evaluations. And once those evaluations are complete, defense attorneys frequently insist on second opinions, so inmates wait again, the newspaper said.
Medications are another expense. About 40 percent of the $1 million that Cuyahoga County spends on prescription drugs for inmates goes to those with mental health disorders.
“If we had intensive treatment services in the community, then we wouldn’t be forced to operate a mental hospital here,” Kochevar said. “We’re a jail. … Don’t ask us to do all these specialized services.”
Costs are also a problem in the state prisons system, where taxpayers will spend $68 million this year treating nearly 10,000 prisoners with a diagnosable mental illness — that’s 19 percent of the state’s 50,000 inmates.
The Ohio Department of Rehabilitation and Correction pays the salaries of 538 psychologists, therapists and other mental health workers. The state also spends $13 million a year to bring in outside psychiatrists. Another $8 million pays for psychotropic drugs.
“Unfortunately, we’re probably one of the larger mental health providers in the state,” said Debbie Nixon-Hughes, chief of mental health services for Ohio prisons. “And that isn’t exactly what our mission was intended to be.”
After prisoners are released, they rarely get little more than the 14-day supply of medication they’re handed when they walk out of their cell, she said.
“As people leave our system, it is extremely difficult to access community mental health services,” Nixon-Hughes said.
“The mental health systems are strapped,” she said. If you listen to what they’re saying, they don’t have enough money to provide services to people in the community in general.”
Ohio had a 16 percent decrease in the number of private hospital psychiatric beds from 1997 to 2002, as well as a     21 percent decrease in state hospital beds over the same period. Thirteen private psychiatric units were also closed during those years.