Support Grows for Reducing Use of County Jails for Nebraska's Mentally Ill

Too many people are being housed in Nebraska’s county jails without getting necessary mental health treatment, according to local law enforcement officials and mental health professionals.

A group of county officials recently urged the state to take part in a much-lauded program designed to reduce the incarceration rate of non-violent individuals with mental health issues. The initiative pioneered a decade ago in Florida, suggests a change in how the justice system views those jailed when acting out because of mental illness.

“Instead of treating this like an illness, which it is, we end up treating it like a crime, which it isn’t,” said Judge Steve Leifman from the Miami-Dade Court system, one of the creators and proponents of the Stepping Up Initiative. By locking-up those with mental illness, Leifman claims “we get the kind of results which no one should be surprised about because we aren’t relying on the right models.”

Since the different approach was adopted twenty years ago in the Miami-Dade metropolitan area jail populations have been cut almost in half resulting in a huge savings for taxpayers.

The National Institute of Mental Health estimated four percent of the U.S. population faces a serious mental illness in their lifetime. An annual federal survey of local jails found one out of four jail inmates reported experiences that met the threshold for serious psychological distress.

The issue is a familiar one for local law enforcement in Nebraska. Marcus Siebkin, the former sheriff of Butler County, says “unfortunately, it's getting worse.

“Mental health issues are huge now, compared to what they were 10 years ago,” Siebkin said.

Many local officials trace the root of the current crisis back to the 2004 decision of Governor Mike Johanns and the state legislature to shift responsibility for mental health treatment to local communities.

The policy change eliminated more than 200 inpatient beds at the state's three psychiatric hospitals, shifting their mission to the treatment of sex offenders and substance abuse rehabilitation. In theory, those seeking treatment for serious conditions like bipolar disorder, schizophrenia, and severe depression would find assistance at local hospitals and therapists. The demand for services has never matched the scarcity of service providers.

Jefferson County Sheriff Nels Sorenson often finds a few days in jail are necessary when non-violent offenders face charges of disturbing the peace or are at risk of harming themselves.

Recently one man housed in the Jefferson County Jail kept prisoners awake and jail staff on edge with his constant growling and obscene rants. A judge ordered him sent to psychiatric care at a state facility, but there was no room.

“Since they closed down the regional center 15 years ago or such the beds are at a premium,” Sorenson said. At the time of his sentencing, the growling man was “number 30 on the list so there are 29 people ahead of him at the regional center.”

The sheriff feared he might have custody of the man for “a month, two months, four months.”

When the man would not stop collecting his urine and feces in his cell the sheriff convinced the state to put the case on the fast track. While he got the hospital bed it’s likely someone else being held in another county jail had to wait to be placed in the state’s care.

Recently the Nebraska Association of County Officials invited its membership and mental health officials to a day-long meeting to talk through the problem. During opening remarks Jennifer Brinkman, the chair of the Lancaster County Commission told the group “our ever-changing understanding of mental illness and the evolution of our justice system, demand that we do some heavy lifting to make sure we end this cycle where people with mental illness end up in our corrections system.”

The day’s agenda focused on the Stepping Up Initiative promoted by the National Association of Counties (NACo). The goal is to reduce jail stays for the non-violent mentally ill.

Nastassia Walsh, a program manager with NACo, told the audience some of the success in the Miami-Dade model grew from training police officers to recognize symptoms of mental illness. She asked the Nebraska officials if they were making a systematic effort to identify whether local jail inmates had mental health concerns.

“Once you do that screening process, are you connecting them with someone who can do a full mental health assessment to confirm the presence of mental illness to get them connected to those services?” she asked.

Ryan Larson serves as coordinator for Region One Mental Health Authority covering counties in Nebraska’s panhandle. He believes “law enforcement need training because they can’t handle those mental health crises.”

Larson says he has heard from “a lot more people saying we need something else because jail isn’t working. We need something else.”

County Commissioner Robert Post representing Banner County likes the idea of having an alternative to jail time for mentally ill individuals.

“Honestly, if we can help these folks and not have them in jail or only have them in a short time, and not have them come back to jail it’s a financial benefit to us as well,” Post said.

Banner County, with one of the smallest populations in Nebraska, has no jail and pays Scotts Bluff County to house its prisoners.

There are only eight beds available in the Regional West Medical Center in Scottsbluff. The nearest comparable facility in Nebraska is a three-hour drive to North Platte.

Meanwhile, short-term emergency mental health services remain scarce in rural Nebraska.

No one expects quick reform for Nebraska’s process of detaining, evaluating, and providing services to those troubled by their mental illnesses. Few say the current system works in anyone’s best interest.