POSTED ON FEBRUARY 22, 2012:
Tulsa's Biggest Psych Unit: County Jail
Some proactive services are cut while prison spending goes up
An ounce of prevention is cheaper than a pound of cure, the old proverb goes. So how much does punishment weigh?
Oklahoma spends millions each year on a broken prison system that punishes non-violent offenders, breaks up families and doesn't rehabilitate the incarcerated. Instead, those dollars line the pockets of the private prison industry without addressing the root problems -- like severe and untreated mental illness and substance abuse -- Oklahomans face.
Private Prison Industrial Complex
Year over year, Oklahoma's private prison expenditures have gone up while services for those suffering from mental illness and substance abuse have been cut. In 2004, Oklahoma spent $57,473,196 on private prisons, a cost that ballooned to $76,693,152 in 2010.
Meanwhile, the budget for the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) was cut by $36.6 million in the last three years. Statewide appropriations for the proactive services dropped to a total of $183.1 million for the fiscal year 2012.
But bigger budgets for our jails and prisons aren't enough to keep up with the rapid growth of incarcerated Oklahomans. To cut costs, our jails and prisons have become overcrowded, outdated, and now even lunchtime has been cut for our inmates (because nothing sounds safer than thousands of hungry, caged, possibly violent humans, right?).
The Oklahoma Department of Corrections (DOC) began contracting private prison beds in April 1996. Three separate prison companies rent space to the DOC.
So who's sleeping in all those beds? After decades of conservative legislation, those with severe mental illness have been gradually deinstitutionalized.
As state mental health hospitals close and beds are taken away, the percentage of offenders with serious mental illness increases.
According to best estimates by Treatment Advocacy Center, the nationwide percentage of prisoners with psychiatric disorders hovers around 10 percent. Nowadays, there are more severely mentally ill people in the LA County Jail, Chicago's Cook County Jail or New York's Riker's Island Jail than any single psychiatric hospital (based on Bureau of Justice statistics).
Not one county in the U.S. has a psychiatric facility that serves as many people as the county jail. And Tulsa is no exception. At least 200 people with mental illness are sitting in Tulsa County Jail at any one time, according to ODMHSAS estimates.
Overall, the most recent DOC estimates indicate about 12,600 offenders are in need of mental health services (2,130 out of 2,700 female offenders or 79 percent, and 10,350 of 22,500 male offenders or 46 percent).
Another indicator of the shift from mental institution to jails and prisons is the rising number of offenders who require psychotropic medications (read: not just Prozac, we're talking serious meds to treat severe mental illness).
In 1998, 20 percent of Oklahoma offenders required psychotropic meds. Twelve years later, the percentage has increased 292 percent, according to the Oklahoma Criminal Justice Resource Center. Oklahoma's incarceration rate rose at the same time the number of citizens committed to mental health hospitals dropped, the center reported.
Another Bad Report Card
Overall, Oklahoma earned a 'D' for failing to make the treatment of our mentally ill a priority, according to the National Alliance on Mental Illness' annual state report card. The price tag for not prioritizing or funding or supporting an important segment of our population? Oh, about $1.8 billion annually in disability payments, emergency treatment, lost productivity and an overflowing criminal justice system.
At 13.3 percent, Oklahoma has one of the nation's highest percentages of people with a serious psychological disorder, according to a National Survey on Drug Use & Health.
A year ago, ODMHSAS wrote 70 percent of those needing treatment for a serious mental illness, and 77 percent of adults in need of substance-abuse treatment, were not receiving appropriate care.
"Cuts over the past three years have markedly impacted state-funded behavioral health services," ODMHSAS indicated in their annual report. "Thousands of Oklahomans -- either directly or indirectly -- have felt the magnitude of these cuts, and the number of Oklahomans needing services continues to increase."
But with Governor Mary Fallin's plans for eliminating the state's income tax moving forward, there's no end in sight for the de-funding of Oklahoma's social services.
Unfunded Services Cost in Other Ways
In addition to spending more on prisons and jails, Tulsa Police Department has been spending an increasing amount on taking mentally ill patients to facilities out of town. Several times a week, officers must take mentally ill people from their homes to get help. But there aren't always enough beds in Tulsa to fit all of the people who need care.
Officer Leland Ashley said Tulsa Police officers don't spend a lot of extra time on calls about mentally ill people. That is, unless officers must take a patient out of Tulsa to get them into treatment. "When an officer receives that call on a mentally ill subject, normally it's because it appears that [the subject] indicates they're a threat to themselves or a threat to others," Officer Ashley said.
"We'll take them for a [psychiatric] evaluation. And that could go from 45 minutes to an hour," he said.
From there, the person is admitted or sent home, based on a doctor's evaluation. "If a doctor says they need to be admitted and there's no bed in Tulsa, we might have to transport them, and that's possibly an eight-hour shift," Ashley said.
In the case of an out-of-town transport, two officers take the patient(s) to their destination. Beginning in June 6, 2010, TPD began to track the time and costs associated with taking mentally ill patients to facilities around the state. In the past year and a half, officers have driven a total of 65,719 miles to take 357 patients to seven different cities in Oklahoma.
The most common spot for mentally ill patients to be taken to is Oklahoma City, with 139 drop-offs, while Norman is the second most-common, with 77 drop-offs. Officers took patients to Muskogee 35 times, to McAlester 18 times, Clinton 14, Fort Supply 9, and Lawton twice. The date of the last entry is Dec. 28, 2011.
According to their own figures, officers are driving between 90 and 300 miles for drop-offs, and it's taking them longer than an eight-hour shift. The average timeframe is almost 10 hours (running up to 16 hours) to take a mentally ill patient from T-Town to an out-of-town facility. And it's an expensive errand to run, as personnel costs run from about $250 to $480.
For those with severe mental illness, illogical thinking, delusions, auditory hallucinations and mood swings often lead to bizarre behavior. Under the best of circumstances, this behavior can upset others but in jails and prisons, it's a recipe for disaster. When inmates are confused or disoriented by a brain disorder, they are more vulnerable to reactive, violent attacks and assault. They are also less able to report and describe attacks or the physical symptoms of other illnesses.
To help divert non-violent, mentally ill inmates into programs better suited to their needs, ODMHSAS has implemented a system of mental health courts.
In addition to more effectively treating the mentally ill, the program is designed to save money while protecting the public. The average yearly cost to house an inmate with mental health needs is $23,000, the Oklahoma DOC has indicated. The average annual cost for mental health court is $5,400, for a savings of $17,600 per participant.
Oklahoma's mental health court programs boast other savings, too, through improving unemployment rates while decreasing jail days, re-arrests, and hospitalization days.
Statewide, mental health courts operate in 14 of 77 counties, which include Tulsa, Wagoner, Cherokee, Craig, Rogers, Creek, Okmulgee, Okfuskee, Hughes, Seminole, Pontotoc, Cleveland, Oklahoma and McClain Counties.
The goal of this therapeutic courts program is to break the cycle of worsening mental illness, which reduces criminal behavior, through effective treatment instead of criminal sanctions.
To be eligible for the program, defendants must have no current or prior violent charges. Once a defendant pleads into the mental health court program, the person is supervised as they work toward re-establishing their lives and family ties.
No Change in Recidivism
Oklahoma is fighting the same battles as the rest of the nation. In 2008, the National Association of State Budget Officers reported that local, federal and other funding on corrections cost the U.S. $68 billion.
A 2009 Pew Center for States Report showed that over the past twenty years, states' general fund spending on corrections increased by more than 300 percent. This pace exceeds other fundamental government services like education, transportation and public assistance. What have we gotten in return for our spending? An unchanged recidivism rate. Broken homes. Broken families. And broken minds.
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