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News It's no crime 

Diversion Program aims to keep mentally ill out of jail

When Eliseo Smith's son, Danny, awoke in the lobby of an apartment building at Vance Jackson and West Avenue, he was surprised to see police. "He thought he owned the building," Smith says.

But instead of hauling Danny to jail, San Antonio police officers, who had been specially trained to recognized symptoms of mental illness, took him to a local hospital where he was evaluated. Danny was later transferred to the San Antonio State Hospital, where he remained for a month.


"That was the best thing that ever happened," says Smith, who also serves on the local board of the National Alliance for the Mentally Ill. "The cop was understanding."

In the Bexar County Jail Diversion Program, non-violent offenders with mental illness go to crisis centers, the San Antonio State Hospital, or have other treatment options instead of jail, where the personal, social, and financial costs of incarceration are high. City and County police, the courts, and mental-health agencies are working to keep the mentally ill out of jail, or if they do go, to release them as soon as possible into treatment centers.

"One of the biggest modern tragedies is the criminalization of the mentally ill," says Leon Evans, executive director of the Center for Health Care Services. "It's an absolute shame that people with mental illnesses are jailed."

The Jail Diversion Program begins with Crisis Intervention Training, which teaches police officers how to recognize the symptoms of mental illness and to defuse potentially volatile situations. Within the sheriff's department, mental-health professionals accompany a trained deputy on calls involving those with mental illness or mental retardation.

According Center for Health Care Services data, 996 people were diverted from jail in the first year of the program, which started in 2003.

Evans often tells the story of a man in a local McDonald's who quieted the voices in his head by reciting the Lord's Prayer.

A restaurant employee called police, who took the man to jail, where, without money to post bond, he stayed for the next six months.

Digging through trash, eating at a convenience store without paying, disturbing the peace: Minor offenses can land people with mental illness in jail, where they may be preyed upon by fellow inmates. Often homeless, they have no money or family, and are left to languish behind bars until their court date. According to the City's 2001 Continuum of Care Gap Analysis, more than 3,500 homeless adults needed mental-health care. Only one-third of them received treatment.

"Once they are stabilized and get on the right path, these are not bad folks," Evans says. "It just so happens they got involved with law enforcement."

SAPD Captain Harry Griffin supports the Jail Diversion program, although he acknowledges it hasn't always been an easy sell to his superiors, many of whom fear it's soft on crime. "It's not," he told an audience at a recent mental-health conference. "If they're violent, they're going to jail whether they're mentally ill or not."

The cost of jailing people with mental illness

An estimated 15-20 percent of inmates æ or more than 500 people æ in the Bexar County Jail have a severe, persistent mental illness. Most were non-violent offenders jailed solely as a result of untreated symptoms of their illness.

People with mental illness are 64 percent more likely to be arrested than those who are not mentally ill but committed the same offense.

Those with mental illness who go to jail stay there an average of six times longer than those who are not mentally ill.

It is expensive to incarcerate persons with mental illness: $200 per day per inmate compared to $49 per day per inmate for the general population.

If all mentally ill prisoners were diverted from jail to treatment, the annual savings is estimated to be $8 million.

Source: Center for Health Care Services

However, patrol officers see the program as a more efficient use of their time. "Before we'd have to sit in the emergency room for hours," Griffin said. If an arrestee has medical problems, even minor ones such as athlete's foot, officers must receive medical clearance before taking him or her to jail. Depending on the caseload in the ER, this can take as long as 24 hours, several shifts, and significant overtime pay.

SAPD was spending upward of $500,000 annually on overtime and additional shifts to cover officers stuck in emergency rooms. To reduce personnel costs, Chief Albert Ortiz allocated $100,000 of drug-seizure money toward a new downtown center within the University Health Systems' Brady Green Hospital that will provide mental-health care and minor medical emergency services in one place. Officers will spend only 15 minutes to fill out paperwork and drop off the person - without an arrest.

The Sheriff's office contributed $87,000 and the Metropolitan Health Department kicked in $36,000 toward the center, which is scheduled to open in December.

Still, Bexar County Sheriff Ralph Lopez said state funding for mental-health programs is lacking. "Mental health is not a priority. We need to be more sensitive to the needs of people with mental illness."

Overcrowding in Bexar County Jail is severe with an average daily population of 3,500 inmates. Local data suggests at least 500 inmates have a mental illness; most of them are non-violent offenders taking up space in a packed facility. With 16 inmates, the jail's psychiatric unit is also full.

When people with mental illness are arrested on a misdemeanor charge - and there was no assault - the Jail Diversion staff can qualify them for a mental-health bond with the condition they comply with a treatment plan while out on bond.

If their charges are more severe, the Jail Diversion staff alerts the assistant district attorney's office and jail employees that they have a mental illness. Staff members then advocate on their behalf to receive appropriate psychiatric treatment while in jail and to follow up with their care when released.

Had Eliseo Smith's son gone to jail for sleeping in the apartment building, it would have been his second time. Last year, Danny was released after doing three years of a five-year sentence for drug possession in a state jail near Lubbock, where he was diagnosed with schizophrenia. With another arrest, his probation could have been revoked, Smith says, and Danny would have returned to jail.

"He used to write me `from jail` and say 'This is terrible. My head is going to burst,'" Smith recalled. "Eventually they put him in a cell by himself."

Danny's story illustrates the need for mental-health services for those released from jail, many of whom have no money, home, or transportation. When Danny became eligible for early release, Smith said Lubbock prison officials called him and asked where his son could stay. "We couldn't keep him at home; he thought we were aliens. We were being threatened at home. So the jail rediagnosed him as depressed and gave him $10 and a bus ticket to San Antonio."

Although Danny enrolled in Genesis, a program for parolees and probationers with mental illness, by day he roamed the streets and by night he slept in a room at the Salvation Army. Eventually, even the Salvation Army didn't want him. "They wanted to put him in a boarding home, but they were ridiculously bad. I said, 'He will not make it here. He will end up in prison again because of his paranoia.'"

A felon, Danny didn't qualify for federally subsidized housing. His Social Security disability check pays the rent, but he cannot work because of his prison flashbacks and paranoia. Smith says caseworkers have determined his son's condition isn't severe enough to qualify for cognitive adaptive training, a service offered through CHCS that pairs people with mental illness with caseworkers to help them readjust to society.

"They're trying very hard and some people do care," Smith says, "but some would prefer to put money into the prison system instead of mental health. If people had been helped before, they wouldn't be in jail."

By Lisa Sorg

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