Walla Walla County Jail takes on mental health issues

May 29--It's an oft-stated fact: About a quarter of the people in city and county jails have symptoms of serious mental illness, females at higher rates than males.

Plus, according to the federal Bureau of Justice Statistics 2009 study of county jails, 31 percent of women inmates and 15 percent of male inmates have at least one such disorder: depressive, bipolar, delusional, psychotic and schizophrenia.

The National Alliance on Mental Illness and a host of other groups agree jails have become the de facto largest mental-health institutions in the nation. And prisoners not exhibiting outright signs of mental illness often arrive at jails carrying significant drug and alcohol issues -- usually as a result of self-medicating for mental-health problems.

Eight months ago Walla Walla County Jail officials began more actively working on that reality.

When county commissioners appointed Michael Bates as director of the Corrections Department in September, he discovered no treatment plan in place for inmates struggling with behavioral problems.

"I didn't like what I saw," Bates recalled. "I told commissioners we had to make changes."

Money was available for funding mental-health programs, but it wasn't being used at the jail, he added.

Initially, Bates reached out to community providers to come to the jail to meet with people for chemical dependency and mental-health assessment and counseling. That allowed inmates to talk about their addictions, their struggles and their lives, Bates said.

Best practice recommendations, however, call for a full-time mental-health worker in the facility. Such a position allows inmates to build trust and gives correctional officers a resource to turn to for help or advice about inmate behavior, he noted.

Last fall, commissioners adopted that concept. Using county sales tax money designated for mental health, Commissioners Perry Dozier, Jim Johnson and Jim Duncan established new programs to provide behavioral heath treatment inside the jail.

Partnering with Serenity Point Counseling, Central Washington Comprehensive Mental Health, and the Department of Community Health, a plan to prioritize inmate mental-health care.

In March, Walla Walla native Shane Longmire took over the counseling office on the second floor of the jail.

Longmire, a 1986 Walla Walla High School graduate, holds a master's of education in school counseling from Walla Walla College and has taught in area schools for 15 years. Before working at the County Jail, he headed education at Jubilee Leadership Academy for troubled teens in Prescott.

All of which turned out to be the perfect credential and experience for the job.

"I just didn't know it at the time," Longmire said.

Prescribing in-house help

Although he is still getting his feet wet, Longmire said he has seen everything from mild anxiety and depression to full-blown psychosis since arriving.

His new job is a mesh of responsibilities. Longmire provides talk therapy, works with a medical prescriber to get an inmate on the right medications and lines up outside resources for those about to be released.

It's rare that someone is in the jail long enough to get long-term treatment.

"I might only see someone one time. In some ways it's like a doctor who works in an emergency room," Longmire explained. "You're not going to follow up on their care."

Longmire's mental stability assessments help determine a number of factors about the jail stay, limited or longer.

"That decides where in jail they live and how officers interact with them," said jail Capt. Mike West.

Before Longmire's position was created, jail officers had to call Comprehensive Mental Health's crisis response team for out-of-control or suicidal inmates. Team members would arrive, assess the situation and advise officers on handling it.

While that still happens at times, Longmire's presence has created stability. He is able to see inmates day to day, build relationships with officers and be the go-to resource.

"Hopefully, before it becomes a crisis," West said.

Two weeks ago an inmate provided a good example.

"A young man went on suicide watch. I went to talk to him and he was actually amped up by a family situation," Longmire said. "He really just needed a time out and knew if he said 'suicide,' he'd get that space."

What the inmate didn't need in that instance was a full-blown suicide response, and Longmire was able to determine that.

"Shane gets to know the inmate," West said, whereas the crisis response team has to go by policy.

Being behind bars also can provide people a first-time mental-health opportunity.

"They get a chance to talk about something they may have never talked about," Longmire explained. "They think, 'Heck, I'm locked up. I might as well try counseling.'"

There's no denying inmates first responded to Longmire with the wrong kind of excitement, however.

"Some saw it as a chance to get drugs they weren't being prescribed," West said.

Heading off bigger costs

Until recently, Walla Walla County Jail was the only one in Comprehensive's service network of 11 counties not staffed by the behavioral health provider, said Rick Weaver, chief executive of the Yakima-based agency. For the first four months of this year, Comprehensive served 50 people at the jail.

The next step is to bring in a prescriber on a regular basis, the sort of team approach Comprehensive employs in other counties.

The jail program costs are part of Walla Walla County's two-year, $718,500 contract with Comprehensive to provide mental-health services to people otherwise unable to access such services, said Debbie Dumont, county contracts manager.

Comprehensive also receives funding through its state contracts specific to the provision of jail services.

The county is billed $3,680 a month for Longmire's work, she added.

Those expenses will save the county money over time, Weaver predicted, explaining that every dollar spent on treatment could save $6 spent on future incarceration.

As well, Comprehensive's on-site counselor approach allows corrections officials to more quickly judge an inmate's mental competency.

"We are the first group that's ever done it outside state hospitals. We can prioritize who needs to go into the state hospital, we can get people in quicker, especially when they are hard to manage and the jail wants them out," Weaver said.

"We want to minimize disruptions in the jail. We want people to be safe -- safe from suicide and assaults."

In addition, jails everywhere face high risks of lawsuits for failure to recognize and treat people with mental illness. Franklin County, for example, settled a federal lawsuit in February over alleged gross mistreatment and neglect of inmates' mental-health needs.

Bates said not every inmate is going to be helped, no matter what programs are in place: "There are some inmates who are hard-core devious in their thinking."

But, he added, there are "some really nice people who are locked up.

"There are lot who can become productive. When they are in jail and not drinking, their brains start working better again. And they just need a hand up ... They did a crime, but while they're here, let's see if we can make a change."

Sheila Hagar can be reached at sheilahagar@wwub.com or 526-8322.

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