Should Jails Help Inmates With Mental Illnesses Recover? Retired Veteran Sheriff Says “Yes!”

(8-26-22) Several years ago,  Michael L. “Mike” Wade, then the Republican sheriff in Henrico County, Virginia, and I argued during a state-wide meeting about the value of mental health courts. We still don’t agree, but I have come to admire his unwavering efforts to help those with mental illnesses and substance abuses, his humor, and his vast experience based on his forty-five years in law enforcement.

Why do individuals with mental illnesses have to be in crisis to get help?

Guest blog by retired Sheriff Michael L “Mike” Wade

I started my career right out of high school as a clerical employee of the FBI, at 21 years old, I became a police officer in Henrico County (Va.) where I served for 22 years as a patrol officer, investigator and sergeant.  In 1999, I was elected Sheriff of Henrico County and took command of Court Security, Civil Process and the County’s two jails.  I retired, on December 31, 2019. While serving as a police officer, I graduated from Virginia Commonwealth University (VCU).

Those are my law enforcement credentials.

In 1985, my father passed away and the cause of his death on his death certificate reads, “Alcoholic Liver.”  I struggled with his written cause of death.  In the fall of 1985, I took a class in Alcohol and Drug Rehabilitation at VCU. In that class a movie was shown on Medical Aspects of Alcoholism. It could have been about my father because it documented all of the medical problems that led up to his death.  I wanted to learn more so I earned a Master’s Degree in Alcohol and Drug, Education and Rehabilitation Program (A.D.E.R.P), graduating in 1990.

I believe years in law enforcement, my education in substance abuse and my own family experiences have given me a perspective that might be helpful to your readers.

Why Do We Wait?

Daily the news reports there is a rise in crime. The blame is placed on prosecutors no longer using bail or our government leaders, and legislators.

Outcries by the public; ‘We need to keep the mentally ill and substance abusers out of jail.”  “They need to be treated in the community not kept behind bars.”  “Stop the pipeline from low-income communities directly to jail.” “Law enforcement needs to stop arresting and taking them to jail.”

Let’s start here. Neither corrections officers nor law enforcement officers are responsible for the mentally ill and substance abusers being incarcerated.  Mental illness and substance abuse may be the cause for incarceration, but it is never the reason.  The reason is associated with a consequence of their behavior due to mental illness or substance abuse.  The consequence law enforcement deals with are the crimes committed by the offender.  Speaking from the law enforcement and corrections perspective, I ask the question: “Why hasn’t someone intervened prior to the commission of a crime to get the appropriate help for the mentally ill and substance abusers.If government leaders, legislators, and civic leaders can’t find a solution, why do we think law enforcement and corrections can?”

The reality is our elected leaders simply force the responsibility for those with mental illnesses and substance abuses on law enforcement, without providing any resources other than the jails.

The Impact of Shutting Down State Hospitals

In October of 2008, I attended a conference sponsored by then Governor Tim Kaine to discuss the mental illness crisis in the Commonwealth of Virginia.  I remember in his opening remarks, he said we are not going to build any more mental health beds.  The conference brought together leaders of the counties and cities across Virginia.  Each locality was assigned a table and began discussing how to handle various mental health issues.

Clearly, the intent was to move the responsibility from the State to the localities.  One of the new programs introduced was Crisis Intervention Team Training (C.I.T.) for law enforcement.  To train the officers on the diversion of mentally ill from mental hospitals.  The training was outstanding, and it gave each officer a greater understanding of the problems associated with mental illness and how to handle these situations.

The problem was C.I.T. was sold as a solution to the mental health issues. It is a great tool, but it is not a solution.

We have learned there is an expressed need is for more mental health beds to get the mentally ill into treatment quickly.  Mentally ill individuals are sometimes held in custody for 48 hours prior to finding a mental health bed.  The longer you hold someone in custody, the greater chance of being assaulted.  Many of the individuals are arrested prior to treatment charged with assault.  The burden of dealing with the mentally ill person is transferred from the community to the jail.  Transferring an inmate from the jail to a mental health facility is very difficult, so the inmate is incarcerated waiting for their court hearing.

Importance of Medications/Programs

In the Henrico Jail, we had a great relationship with the county mental health services.  They had a free reign of the jail and assisting those with mental illness.  Mental health workers are met with a number of roadblocks in their efforts to facilitate the inmate being transferred to a mental health facility.  The arrest of the mentally ill person in a crisis only lengthens the crisis.  In most cases, the inmate needs to be put on psychotropic drugs to stabilize their behavior.  Local Mental Health services and jails are not allowed to force medication, but the mental health hospitals can force the medication.  It is amazing to see the difference when the medication is effective.  We had an inmate who was constantly fighting staff and would not comply to any directions. She was a total wreck.  We finally got her into mental health facility.  After being stabilized and released she came back to the jail apologized and thanked the staff for helping her.

The de-institution of state mental health patients beginning in the 1960s was caused by the development of new and effective drugs.  The medications work. The problem is making sure the patients take their drugs.  Mental Health workers in Henrico have a program to visit daily with their clients at home to make sure they are taking their medications.

I was encouraged, recently by a conversation occurring on an aisle in Walmart.  A young male walked up to me and called me by my last name.  He told me he had just been released from my old jail and he had completed the O.R.B.I.T. program. (Opiate Recovery by Intensive Tracking). He was proud of the fact he had a job, working for the county he was jailed in.  He told me he was living drug free, he wanted to thank me because he knew I started the O.R.B.I.T. program.  I told him it was I who needed to thank him, knowing a program I started changed his life, touches me in ways he would never know.  In my views, this is what jails should be doing.

Jails As Solutions/Not Part Of The Problem

Prior to retiring, we surveyed the inmate population. 87% of inmates responding indicated alcohol and drugs were the cause of their incarceration.  We knew from the use of psychotropic drugs prescribed for inmates in the jail that over 30% of the population had some mental illness.  If you incarcerate an individual with a mental illness or substance abuse addiction and don’t treat them, they are released into the community with a mental illness or addiction.

As sheriff, I attended conferences with American Correctional Association (ACA), American Jail Association (AJA), and Large Jail Network.  I have met many great leaders in correction and know they are determined to return their inmates back to the communities in better condition then they were when first arrested. I read about many successful programs in jails, that are helping inmates.  The problem is these programs are not created by governmental leaders, legislatures, or community advocates.  The programs are created by the correctional officers that work with the inmates daily.

Can you image what would happen if all these leaders got on the same page, I would be happy if they got on the same planet.

We need to develop programs for the individuals confronted by law enforcement when they are in crisis.  It is the best time for the individuals to get treatment.  Jails should not be looked at as part of the problem.  Jails should be the beginning of the solution to the individuals’ problems.  We cannot address the crime problem in in the United States without first dealing with the mental health and substance abuse problems.  I assure you that the hard-working men and women in corrections are willing to do their part in solving the crime crisis.

There are many questions about how the criminal justice system works and after 45 years I don’t know the answers:

• Who is responsible for individuals with mental illnesses getting treatment? Is it local government, state government or federal government?
• Why do individuals with mental illnesses have to be in crisis to get help?
• Why do police officers and correctional officers have to have two weeks of mental health training and judges are not required to have any mental health training?
• Why is law enforcement and corrections looked at as the problem, when they are forced to solve a problem no other part of government wants to be involved?
• If treatment is not available in the community, why shouldn’t jails be looked to provide the treatment?
• Since, most inmates have a substance abuse or mental health problem, why are we arguing for their release without planning for their treatment?
• Why is the pipeline blamed on law enforcement and corrections and not the underlining causes of substance abuse and mental illness?
• Why do we look to the governmental leaders, legislatures, and community leaders for the need for change in correction, and not the current and past incarcerated individuals?
• Why haven’t we studied the overdose rate of inmates released from jail without any treatment?
• If we are still using Jails that were built in early 1800s, why do we use them in the same way?
• President Rutherford Hayes was the 1^st president of ACA, and I was the 103^rd president, if we sat down and discussed corrections, are we better today than we were in the 1800’s in dealing with prisoners with mental illnesses and substance problems?
• I have been known to say, “There are only two kinds of inmates in jail, those that are on drugs and those that need to be on them!” I used to think my saying was funny but now I think it is sad, people understand that mental illness and substance abuse are the cause of incarceration for the majority if not all inmates.  Why can’t we develop programs to keep people out of jail or treat them while they are in jail?

In graduate school, I lived in a substance abuse treatment center for 7 weeks.  When I was elected sheriff, I had never worked in jail.  I saw the opportunity to create a drug program in the Henrico Jail, it was very successful in educating the inmates on issues surrounding substance abuse.  Mentally ill were also put in the program and the structure of the program was beneficial to them managing the time they were serving.

Programs work if you allow the inmates to take personal involvement in them.  It is time we stopped looking for who to blame and start to attack substance abuse and mental illness at the earliest possible moment.

ABOUT THE AUTHOR: As sheriff of Henrico County, Mike Wade supervised four hundred employees, two jails with 1,400 inmates and fifteen courtrooms in two courthouses.  He launched two recovery programs. “R.I.S.E.” – Recovery in a Secure Environment – an 18 week in jail program with Henrico Mental Health.  Allowing inmates to help inmates with education surrounding Addiction, steps of Recovery and Relapse Prevention.  In Mike’s career as sheriff over 20,000 inmates attended R.I.S.E.  He also created “O.R.B.I.T.” Opiate Recovery by Intensive Tracking.  Mike was asked by Circuit Court Judge to do something about inmates returning to courts.  Simple program, sentence inmates to around two years, first attend R.I.S.E., then go to work crew followed by work release and home incarceration.  On work release and home incarceration they wore GPS. Simply, the longer they could stay under control the better chance they had of gaining self-control.  Both programs have numerous success stories and testimonials.

He has served as president of the American Corrections Association and twice as vice president. He is chair of one of its accreditation panels. He currently is the Vice Chair of the Henrico County Mental Health Board and appointed by the Bishop of Richmond to its Sexual Review Board.