State convicts arrive in L.A. County with costly mental illnesses
released state prisoners are arriving in Los Angeles and other counties
with incomplete medical records and mental illnesses that have
officials struggling to provide treatment.
January 08, 2012|By Anna Gorman, Los Angeles Times
California begins shifting supervision of thousands of newly released
state prisoners to local probation agencies, ex-convicts are arriving
with incomplete medical records and more serious mental illnesses than
anticipated. And mental health officials are scrambling to provide
appropriate — and often costly — treatment.
"At the start, every
day ... there was a crisis," said Dr. Marvin Southard, director of the
Los Angeles County Department of Mental Health. "There was somebody we
didn't know what to do with."
In some cases, he said, released
inmates have had to be immediately transferred to hospitals or
residential centers for psychiatric care.
A new state law
designed to reduce prison crowding and cut costs requires that certain
nonviolent convicts serve their time in county lockups rather than
state prisons. It also makes counties — rather than the state parole
agency — responsible for supervising such inmates after their release.
transition, called "realignment" by Gov. Jerry Brown, has raised
well-publicized concerns among law enforcement officers across the
state, as they try to accommodate more inmates in already crowded local
jails. But realignment also presents less-visible challenges for local
probation and mental health officials dealing with an influx of
patients with drug and alcohol addictions, schizophrenia, bipolar
disorder and depression.
Mental illness and drug addiction are
common in California prisons, where more than half of inmates report a
recent mental health problem and two-thirds report having a drug abuse
problem, according to a Rand Corp. study. Many don't receive the
treatment they need while incarcerated and may skip care once released,
said the study's author, Lois Davis.
"If you have individuals
struggling with depression and anxiety ... they are going to have a
much harder time linking to services," she said. "It limits their
ability to find a job and reunite with their family, and they will be
at greater risk for recidivism."
Roughly 3,300 people have been
released to Los Angeles County so far. The probation department is
expecting about 6,000 more. County mental health officials estimated
that about 30% will require mental health services and about 60% will
have drug addictions.
Continuing treatment after inmates are
freed is essential to preventing them from relapsing, having mental
breakdowns, ending up in hospitals or landing back behind bars,
"We took it very seriously from the start," said
Reaver Bingham, deputy director of the Los Angeles County Probation
Department. "We knew that if we didn't address those risk factors,
people would revert to what they know, and that is committing criminal
Realignment, which began Oct. 1, has been bumpy. Many
released inmates came without comprehensive medical records. It was up
to the patients to pass along information about their diagnoses and
medications to probation and mental health staffers. When county
workers requested mental health records from the state, they often were
told to get the information from individual prisons.
has improved, but getting complete medical and mental health records
remains difficult, officials said. One complication: Prisoners can
block the transfer of records.
"A lot of it depends on the
inmates' attitude at the point of the release — do they want to be
treated more or to be left alone?" said Don Kingdon, deputy director of
the California Mental Health Directors Assn.
the importance of counties having complete information on prisoners
before they are released to local supervision. "That can create a
problem in the community if they release prisoners and they have mental
health needs and you didn't know," he said.
officials "made a whole lot of effort to make the [transition] be as
smooth as possible," said Denny Sallade, deputy director of the state's
Division of Correctional Health Care Services. But inmates may be in
one mental state when they leave the prison and another when they
arrive in the community, often because they stop taking their
medication along the way, she noted.
The inmates also may turn
down help once they arrive. In Los Angeles County, about 30% of the
released state inmates seen by mental health staff refused to either
meet with clinicians or be referred for treatment.
the probation department, said the state has tried to address problems.
"If we can be successful in Los Angeles County, we can be successful in
the rest of the state," he said.
But county officials are
warning there may not be enough resources to accommodate former inmates
in need of supervision. The state allocated $18 million to Los Angeles
County to pay for mental health and substance abuse treatment and other
social services. But the money isn't guaranteed to continue past June.
Mike Antonovich is very concerned about the inadequacy of realignment
funding to effectively rehabilitate this population, which includes
costly mental health services, housing and supervision," said his
justice deputy, Anna Pembedjian. "It all boils down to resources."
Angeles, like most counties around the state, is already stretched thin
after years of budget cuts and may not be equipped to close gaps in
health and social services for the newly released inmates, said Davis,
of Rand. To help defray some costs, counties across the state are
working to enroll the eligible released prisoners in public programs
such as Medi-Cal.
Counties are at the very early stages of
understanding how to make realignment work, especially for those former
inmates with mental illness, Davis said. "It is going to be a
challenging time for the next couple years," she said.