Jail is no place for the mentally ill, Santa Clara County sheriff says

There’s a mental health crisis in Santa Clara County jails. Everyone agrees it’s bad, but Sheriff Laurie Smith isn’t sure people recognize just how bad it’s getting.

The sheriff, who oversees the jail system, says what she sees worries her. In an exclusive interview with San José Spotlight, Smith estimates that approximately 25% of the county’s 2,393 inmates have a serious mental illness. As of Friday, 53 inmates are waiting for beds at psychiatric facilities, with the longest wait dating back to July 8.

“I think the bottom line is that the jails have become the de facto mental health system,” Smith said.

Mental illness has ostensibly been the subject of weeks-worth of county meetings targeting Smith’s oversight of the jail system. The Board of Supervisors recently voted no confidence in Smith, following a decision to request state and federal investigations into alleged civil rights violations in the jails. The inquiries are partly in response to three inmates—Michael Tyree, Andrew Hogan and Martin Nunez—injured, and in Tyree’s case, killed, over the past six years while experiencing mental health crises.

But the board’s inquiries have mostly focused on removing Smith and investigating whether she squashed an internal affairs investigation of the Hogan incident. Smith believes officials are ignoring the strain mentally ill inmates place on the jail system and the need for an alternative place to put them.

“Jails are not the place for people who have serious mental health issues,” Smith said.

A strained system

The county’s ability to treat mentally ill people is indeed strained. In 2017, Santa Clara County had 12.69 acute psychiatric treatment beds per 100,000 people, according to a study. The study said the county needs 969 more beds to meet demand.

Earlier this year, the Board of Supervisors announced plans to build a 77-bed psychiatric hospital for $233 million in the existing Santa Clara Valley Medical Center. But capacity is still limited, and officials and advocates are concerned that the only way many people get treatment is by getting arrested and booked at the county jail.

“The percentage of seriously mentally ill people they’re being tasked to house has drastically increased over the last 10 to 15 years,” said Paula Canny, an attorney who represented Hogan’s family, as well as the family of Tyree.

Canny won a $10 million settlement for the Hogan family last year following injuries he suffered in 2018 from banging his head against the walls of a van while being transported for psychiatric treatment.

Canny is a fierce critic of the Board of Supervisors’ attacks on Smith, who she claims has the impossible task of improving the jail system for mentally ill inmates.

“Everybody wants the jail to be a better place,” Canny said. “It’s hopeless.”

Addressing the problems

Smith said the jail has psychiatric resources for inmates, but her deputies can’t take the place of clinicians and psychiatrists.

She noted that the jail once had personnel known as multi-support deputies—officers highly trained in mental health work who helped give individualized attention to inmates in need—but those positions are gone. She said the department is also struggling to transport inmates for treatment.

“We have fallen down on getting people to medical appointments on time,” Smith said. “That’s something the Prison Law Office is on us about.”

The office sued Santa Clara County in 2015 over allegedly unconstitutional conditions in the jail system. The parties settled in 2018, and the county agreed to several improvements in the jail, including enhancing the booking process to better identify mental health conditions of incoming inmates and improving mental health care in custody.

Smith said COVID-19 restrictions make transportation tougher because multiple inmates can’t be placed in a holding cell to await vans.

“We now have to do them individually. So that’s another thing we are not doing as well as we should, and it’s terrible to make doctors wait,” Smith said.

Smith has repeatedly said the best solution is for the county to establish a psychiatric hospital—a move that makes her an unlikely bedfellow with some criminal justice advocates.

“My hope in all this is they would build a psychiatric hospital, which would be the priority over a jail,” Smith said. “I honestly believe if we have a good, meaningful psychiatric hospital, it will decrease our jail population.”

‘We are piecemealing it’

Earlier this year, the county appeared to waffle on a pledge to scrap plans for a new jail in favor of a mental health center. The alternative would take years to build and would also divert resources from improving conditions in the existing jails, officials decided.

“A bit of misinformation that people tend to grasp onto is that there’s a magical pot of money somewhere waiting for a new jail, and if we don’t build the jail we can simply transfer the dollars somewhere else,” Supervisor Susan Ellenberg told San José Spotlight. “The dollars don’t exist.”

Ellenberg and Supervisor Cindy Chavez recently asked the county attorney to explore ways to reduce the jail population. Ellenberg said mentally ill people need to be connected with services as quickly as possible to prevent them from being incarcerated in the first place.

“We have to ensure people have access to regular mental health care, including crisis care, that can scale up and down to address the individual’s level of need,” Ellenberg said.

She cited as an example Silicon Valley De-Bug, which runs a program called the Community Release Project that provides navigators who can connect recently arrested people with housing, employment, court date reminders and other essential support.

She also referenced the county’s Blackbird House, a voluntary peer-run program that gives temporary housing and non-clinical crisis support to people who might otherwise end up in a psychiatric hold—or in jail.

Raj Jayadev, a criminal justice advocate and founder of Silicon Valley De-Bug, told San José Spotlight that one of the challenges of keeping mentally ill people out of jail is the fact that many services are siloed from one another, creating gaps that a person can slip through.

“In a lot of ways we are piecemealing it,” Jayadev said.

Jayadev noted that there is a shared responsibility for keeping mentally ill people out of jail, which rests on the recognition that jail is the wrong place to send them. He said this approach to decriminalizing mental health care will require a significant shift in resources.

“That’s about getting investments in mental health treatment providers, residential programs, programs that are community based, so you don’t feel like you’re just going into another version of a jail that has ‘mental health’ on it,” Jayadev said.

Contact Eli Wolfe at [email protected] or @EliWolfe4 on Twitter.