The way to eliminate current longstanding problems in the system for treating mentally ill people who have been charged with a crime is to make significant facility expansions, experts agree.
Earlier, KTLO, Classic Hits and The Boot news reported without trial or treatment inmates spend months in local jails waiting for state hospital beds.
CRISIS STABILIZATION UNITS FUNDED
In 2017, a bill was passed and funded to establish four Crisis Stabilization Units in the state, designed as alternatives to jails and emergency rooms for people in crisis who encounter law enforcement.
The four centers are located in Pulaski (Little Rock), Sebastian (Fort Smith), Washington (Fayetteville/Springdale) and Craighead (Jonesboro) counties.
Dr. Buster Lackey, executive director of the Arkansas Branch of the National Alliance on Mental Illness (NAMI), told KTLO, Classic Hits and the Boot news the creation of the crisis centers was a welcome step forward.
But, he is quick to point out, the units do not address the lengthy wait times inmates spend before being evaluated or admitted to the Arkansas State Hospital for inpatient treatment.
STATE HOSPITAL MUST EXPAND
Lackey said the Arkansas State Hospital (ASH) in Little Rock must be expanded to cut down on jail wait times.
He said ideally, “The expansion of ASH would be accompanied by the creation of additional inpatient treatment units of the hospital in various parts of the state.”
The time spent waiting in county jails presents major problems for inmates, the inmates’ families and jail staff.
Experts say when people have to wait in local jails for months to receive treatment for mental health problems, their conditions, more often than not, get worse, much worse.
Some kill or mutilate themselves, attack fellow prisoners and jail staff, or are assaulted by other inmates — often because of their disruptive, strange behavior.
The inmates in the Baxter County Detention Center slated to be admitted to the state hospital when a bed opens do receive medications prescribed for them and are seen by the nurse at the jail.
But, no one even begins to claim they are receiving the intensive therapy offered at a residential mental health treatment facility, such as the Arkansas State Hospital.
FEDERAL SUIT BROUGHT
A federal court suit concerning the wait times was filed in mid-July 2001 and decided about a year later. It was initially brought by family members on behalf of a handful of prisoners being held in a county jail in western Arkansas.
The inmates had been incarcerated for a lengthy period of time, after being ordered by a circuit court to be transferred to the Arkansas State Hospital for treatment.
The court approved making the litigation a class action suit — representing all pretrial detainees in the state who had been on the waiting list for long time.
During testimony in the federal suit, it was reported that one of the original inmates, in whose name the lawsuit was filed, had gotten much worse while being held in a county jail waiting to be taken to the state hospital. He was reported to have “become increasingly unable to follow jail procedures, was often put in solitary confinement, and was more violent. The inmate was said to have displayed increasingly bizarre behavior and threatening conduct.”
VERITABLE CAVALCADE OF HUMAN TRAGEDY
In his ruling, Judge Stephen Reasoner said testimony he had heard during the course of the litigation could best be described as “a veritable cavalcade of human tragedy being marched through the trial record.”
Arkansas’ own Constitution declares that an “express duty” is owed by the state to the mentally ill. ASH is designated as “the sole responsible authority for implementing this duty.”
But, the Arkansas State Hospital is not a large facility, and not all of its beds are dedicated to treating the mentally ill who have allegedly committed a crime.
In the 2002 federal court case, Dr. Larry Miller, medical director of the hospital at the time, testified that the facility was actually licensed for 315 beds but did not have the space, funding or qualified professionals to fill more than 186 beds.
A licensed bed is one staffed with recommended levels of nursing, psychiatric and psychological services.
And, at the time of the suit, the hospital had set aside about 64 beds for patients ordered by courts to receive mental health treatment.
During the suit, testimony was given on a plan that had been presented to the state legislature to help reduce the number being sent to ASH.
The proposal would have allocated $11.5 million dollars to set up local crisis intervention programs and to pay for inpatient care at the local level.
The legislation passed the Senate and House and was signed by the governor. But, the funding mandate was stripped out of the bill, meaning there was no money to make anything happen.
One of the main goals of the plan was to provide more mental health treatment at the local level, rather than having to overfill the state hospital.
The waiting list leaves mentally ill inmates to sit in cells without trial or treatment for up to a year or more.
MORE PEOPLE LOOKING TO THE COURTS FOR RELIEF
Lackey said an increasing number of lawsuits were being filed in both state and federal courts to force changes in the mental health evaluation and treatment procedures for inmates.
“We get calls from across Arkansas asking how to go about filing suits, or for suggestions on ways to help those in this situation,” he reported.
ASH officials testified during the 2002 federal trial that hospital administrative staff were aware of the long wait times but had few options available to address the problem.
Testimony also disclosed that individuals on the waiting list are sometimes advanced up the list if a judge, prosecuting attorney, or family member complains about the wait time.
Those individuals for whom no one speaks up — simply wait and wait and wait.
One administrator at the Arkansas State Hospital said the person in charge of the waiting list of inmates waiting for a bed to open in the facility “has a job much like rearranging deck chairs on the Titanic.”
WebReadyTM Powered by WireReady® NSI