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Spartanburg County makes some progress on mental health care for inmates

Herald-Journal - 3/17/2017

March 17--Seven months after Spartanburg County made a public commitment to reduce the number of inmates with a mental illness, progress has been made in some areas but not in others.

Among the advances, more inmates are being screened for behavioral health issues. In September 2016, the jail began a pilot program with the Spartanburg Area Mental Health Center in which a psychiatrist visited the facility two afternoons a month to evaluate and assess individuals with chronic and persistent mental illness. The psychiatric services have continued beyond the pilot period.

The schedule has allowed a psychiatrist to see about seven to eight people per visit, or about 15 per month.

The program joins an existing one at the jail that brings in a licensed counselor from the state Department of Mental Health and volunteer counselors from West Gate Family Therapy Institute to evaluate inmates.

Spartanburg County agreed take part in the Stepping Up Initiative in a July 2016 resolution. The nationwide effort seeks to reduce the number of people with mental illness in jails.

Stepping Up is run by the Council of State Governments Justice Center and other partners that provide counties with resources and expertise on how to implement strategies and track data.

Some of the Stepping Up goals overlap with work already being done by the Spartanburg County Behavioral Health Task Force.

The task force has initiated more than 20 programs to improve access to mental health care, including some that have helped identify more inmates with behavioral health needs in the Spartanburg County jail. Other programs are working to provide post-incarceration support to reduce recidivism rates.

"The detention center has been very involved with the Behavioral Task Force," said Spartanburg County Administrator Katherine O'Neill.

One area of Stepping Up that's still being worked on is baseline data collection. Stepping Up suggests tracking the number of inmates with a mental illness booked into the jail, the length of their stays, their connection to treatment and their rate of re-arrest.

"The data piece is crucial," said Kati Habert, the deputy program director at the Council of State Governments Justice Center. "The goal of initiative is to reduce the number of people with mental illness that are in the jail. In order to be able to do that, you have to know who is in jail in the first place. Use that information to then plan the best sort of strategies for them and use those numbers to track their progress."

According to Kathy White, the jail's medical administrator, there is currently no process for tracking such information, but discussions are ongoing for how best to do so.

"The detention facility, as a general rule, needs a mechanism for tracking recidivism rates for all inmates, which we do not currently have," White said.

She said a database would allow staff to cross-reference inmates and their connections to services and treatments. That would allow the county to determine which services are working best at reducing recidivism, she said.

Data that is available shows the percentage of inmates taking psychotropic medications is unchanged from a year ago. A recent tally found 229 out of 840 inmates, about 27 percent, were on psychotropic medications.

Stepping Up also recommends counties work to connect inmates to mental health services upon their release, and suggests ways to accomplish the task.

White said that piece also is still lacking, since it's not always easy to coordinate an inmate's release.

"Planning ahead by scheduling appointments in advance doesn't always work," White said.

Most of the inmates who are directed to follow-up appointments with mental health professionals already know when they're getting out, she said.

Jail personnel do attempt to provide inmates with information about services that are available once they're released, White said, such as a list of agencies with contact names and numbers. Inmates may also receive information about resources such as the National Alliance for Mental Illness, AccessHealth or New Day Clubhouse, White said.

But she noted there are other factors besides treatment that can affect recidivism rates, such as access to housing, transportation and family support.

"Through the programs and services at the jail, we are able to assist with stabilization and initiating treatment, but mental illness is lifelong and what we provide is only the beginning," White said. "Focus must not simply be on treating the mental illness, but also recognizing and addressing those barriers to care and treatment. I feel confident through the efforts of the Behavioral Health Task Force and our community partners, we will be able to begin addressing those issues as well."

Spartanburg County Councilman Michael Brown said the county and its partners will continue to work toward meeting the Stepping Up guidelines and helping inmates with behavioral health needs.

"Jails should not be a first line for treatment," Brown said. "Our goal is to help them get the long-term help they need."

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(c)2017 the Spartanburg Herald-Journal (Spartanburg, S.C.)

Visit the Spartanburg Herald-Journal (Spartanburg, S.C.) at www.GoUpstate.com

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