Long wait for justice: Prisoners face delays in earlier mental health care

The long wait for Beau Hampton’s psychiatric treatment began last year, when her foster father was charged with assault and a misdemeanor charge.

Hampton, 18, who has a long history of mental illness, spent four months in an East Atlanta prison waiting for an expert assessment to determine if he was mentally fit for trial. In February, a state psychologist ruled Hampton ineligible.

Hampton then had to wait to be admitted to a state psychiatric hospital so he could receive treatment to meet the legal requirements for eligibility. The delay in treatment disappointed a Walton County judge who said Hampton’s condition worsened in a crowded prison and in March ordered him transferred to a state hospital within 24 hours. The Georgia Department of Behavioral Health and Developmental Disabilities, which operates those mental hospitals, did not comply, and a month later, the judge charged the agency commissioner with contempt of court.

Such long delays for state psychiatric hospital services continue to run rampant across the United States. Prisoners with severe mental illness – and those who may not face trial because of their condition – have been waiting months or more to begin taking the necessary care to “restore” their ability to stand trial. The legal standard is that a person must be able to participate in their defense if they are to be charged with a crime.

In Georgia, 368 people who have been deemed ineligible are awaiting treatment in a local jail, according to the state. More than 900 are waiting for the first step of the process, a “forensic assessment”.

Similar delays have led to lawsuits in many other states.

The Indiana Protection and Advocacy Services Commission filed a lawsuit against state officials in May for mental retardation, claiming the delay violated defendants’ right to due process. Oregon faced stricter deadlines set by a 2002 court lawsuit, and its backlog stood at 55 as of May 20.

Alabama is facing a consent decree, but “people are still waiting, on average, for hundreds of days to be admitted to benefits that must go through assessment or treatment,” said Shandra Monterstelli, a senior staff attorney at the Alabama Disability Advocacy Program.

North Carolina’s waiting list for “recovery” treatment has risen to 140, Colorado – another state under a consent decree – is waiting for 364. In Texas, the number is much higher – more than 2,000 – a backlog that triggered a lawsuit. Montana has also waited dozens.

“It’s hard to overstate how big the mental health issues are in the county jail,” said Michelle Deach, a criminal justice expert at the Lyndon B. Johnson School of Public Affairs at the University of Texas at Austin.

According to a 2020 report by the National Association of State Mental Health Program Directors, more than 2 million people with serious mental illness are sent to prisons nationwide each year, often for nonviolent “harassment” crimes such as looting or travel. Once in prison, mentally ill people are twice as likely to be incarcerated as other defendants, the report said, and few receive treatment for their condition.

Philip Farnassi, a senior staff attorney at the National Disability Rights Network, says people with mental illness usually get worse in prison during long waits for a mental hospital bed. “It’s an obvious constitutional issue,” he said. “Prisons are really chaotic, pretty violent places.”

For some people accused of a misdemeanor, it may be longer than what is known to recover inpatient skills if that person is tried, convicted and convicted of such charges, says Dr. Robert Trestman, chairman of the Council of the American Psychiatric Association. Healthcare systems and financing.

State officials say delays in shifting to in-patient treatment facilities during the epidemic have increased amid a growing shortage of state hospital staff. Yet a number of lawsuits – including the states of Alabama, Colorado, Oregon and Washington – were filed just years before the release of Covid-19.

Shannon Scully, a senior adviser to the National Alliance on Mental Illness’s Justice and Crisis Response Policy, said delays in rehabilitating defendants’ mental health were likely to worsen as the shortage of mental health care providers continued.

In Georgia, the state mental health agency says that since January 2020 it has caused net losses to about one-third of its mental hospital staff. Temporary staff are filling some vacancies, but the state has reported a number of unfinished jobs responsible for evaluating forensic psychologists. The skills of the people in custody.

According to court documents, Beau Hampton has a history of mental care starting at age 3, including multiple hospitalizations. He has been diagnosed with autism, bipolar disorder and other mental health disorders.

In March, while in Walton County Jail custody, Hampton was injured in a fight and needed stitches. He is facing a pending criminal charge and a misdemeanor battery charge in a nearby county.

But state officials say Hampton did not rise to the top of the waiting list for inpatient treatment despite a court order, his age, his diagnosis and his inconvenience in prison. The list is based on the date of the court order for hospitalization and the patient’s condition.

Georgia averages 10 months for a male detainee in need of such care, state officials said at a Hampton court hearing in April. Judge Cheveda McCammy gave the state 21 days under a contempt order to keep Hampton in a hospital.

Hampton could not be reached for comment. Julia Holly, the public defender in her case, said most of her time was spent on questions of competence – and not her actual criminal charges. Because of Hampton’s age and condition, and because of his pastoral care system, he said, the lawsuit “broke my heart the most.” He added, “He deserves a chance.”

Prisons like Walton County are feeling the burden of caring for the mentally ill. Such prisoners often cannot carry bail or bonds, and smaller prisons have less service than adults, Trestman said. Prisons are “not a place designed for treatment,” he added. “It’s not a warm and fuzzy environment.”

The cost of incarceration is much higher for those with a mental illness – about four times more than others, said Capt. Terry Mess, administrator of Wayne County Prison in southeastern Georgia.

In southwestern Georgia, Capt. Steven Jones, acting administrator of the Thomas County Jail, said one person had waited more than a year for such an appointment. At the time, Jones said, the man attempted suicide by jumping off a railing, breaking both ankles and damaging his spine. The delay for the psychiatric hospital bed was “ridiculously long,” Jones said.

Especially for the crime of misdemeanor, experts say, getting treatment faster in a community setting can mean more. And several states are going to increase the treatment of outpatients

Neil Gowensmith, an associate professor of forensic psychology at the University of Denver, says there are several benefits to restoring the skills of outpatients. “It costs a lot less,” he said. “Public safety is not compromised. From a humanitarian point of view, this is a civil liberties problem. “

He referred to the 1999 Supreme Court judgment Olmstad vs. LC, A landmark decision to support a minimum-limiting level of care for persons with disabilities. “It could be a group home, it could be a caregiver, it could be an independent life,” Gowensmith said.

South Carolina passed legislation this year that would allow both outpatient and prison-based recovery options.

Georgia has limited options for outpatient services. Ashley Fielding, assistant commissioner of the state’s mental health agency, said in a statement that it was “actively working to address” the capacity backlog, noting the increase given to all state employees and the expansion of non-hospital recovery options.

On the 20th day of the Walton County Judge’s Contempt Order – a day before his deadline – the agency transferred Hampton to a state psychiatric center in Millzeville. The state mental health agency declined to comment on the case without saying it would comply with the judge’s order. More than eight months have passed since Hampton was arrested.

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