'They're out of sight, out of mind'

CHAMPAIGN – In the six years Dan Walsh has been sheriff of Champaign County, he has noticed a marked increase in the number of jail inmates who are mentally ill.

Sheriffs in other area counties have, too.

This two-part series looks at how the county jails are caring for their mentally ill inmates and how mental illness has affected at least four families.

"The average citizen doesn't have to deal with it," Walsh said. "They're out of sight, out of mind.

* * *

Suzanne Edwards can't help but wonder if she should have alerted someone at the Champaign County Jail to what she saw the last time she visited her son – July 6, 2004.

"He was just depressed that Tuesday when I went to visit him," she said of her younger son, Marcus, who was a month shy of his 19th birthday.

Three days after she saw him, Marcus pleaded guilty to residential burglary. He was to be sentenced a month later. His public defender felt boot camp, not four to 15 years in prison, was a strong possibility given his young age.

About 36 hours after pleading guilty, Marcus Edwards tied one end of a bed sheet around his neck and the other to a toothbrush and a pencil. He then wedged the toothbrush and pencil into an air vent and knelt down, cutting off the blood flow to his brain.

Discovered shortly after 1 a.m. July 11, he died about eight hours later.

"No. No. No. No," his mother said, asked if she could have predicted her son's actions.

"I never thought Marcus would take his life. I didn't see the signs."

Apparently, neither did anyone at the county jail, where Edwards had been in custody for most of 2004 awaiting trial for criminal damage to property and residential burglary.

Edwards' death was the second of three suicides at the Champaign County Jail that year.

On June 26, 2004, Joseph Beavers, 37, of Urbana used a cord on a phone in a holding cell to cut off his airway. On Dec. 4, 2004, Terrell Layfield, 25, of Champaign used a bed sheet to hang himself.

Their deaths moved the Champaign County Board to open up its pocketbook for mental health services that are considered over and above what most counties offer for their inmates.

Sheriff Dan Walsh says that at a cost of about $234,000 a year, it's money well spent.

State's Attorney Julia Rietz confirmed the county settled out-of-court with the family of Layfield for an undisclosed amount. The Beavers family's lawsuit is unresolved. Suzanne Edwards never took legal action, Rietz said.

"All the money in the world wouldn't have brought Marcus back," Edwards said.

Still, Walsh and other area sheriffs feel the state is passing the buck – or perhaps more accurately, denying it – when it comes to mental health services for those accused of crimes.

"Does the average person care if a guy is in jail or a mental health facility?" Walsh asked.

Jail's mental health program

In the summer of 2005, the sheriff's office contracted with Health Professionals Ltd., a Peoria-based health-care group that specializes in inmate care, to provide medical and mental-health services to inmates.

"Every prisoner is screened for mental health by being asked a standard list of questions," said Greg Whicker, supervisor of the mental health program.

Whicker is one of four mental health professionals at the jail seven days a week. Three of them work full time; a fourth works half time. A psychiatrist visits twice a month and is on call.

Unless an inmate has been in the jail before, the screening officer has to rely on him to tell the truth about his or her needs and history. If the inmate displays erratic behavior, he is automatically placed on suicide watch.

Individuals on suicide watch are put in cells nearest the booking area for constant monitoring and are given only a blanket and mat for the floor and a green gown to wear. Referred to by the staff as a "turtle suit," the heavy, quilt-like gown is impossible to rip by hand.

"Hanging is the No. 1 mode of suicide in jails," Whicker said.

For their safety and staff safety, inmates on suicide watch or with violent behavior also don't get the plastic spoon to eat with that other inmates do. They get food that can be eaten with their hands, Whicker said.

For psychotic inmates who won't take their medication there is a restraint chair, which is kept out in the open near the booking desk so they can be watched constantly.

Waiting for trial

Inmates found unfit to stand trial – judges make that determination based on evaluations by court-appointed psychiatrists – may have to wait anywhere from two to eight weeks to get into a state mental health facility to get the help needed to attain fitness.

It's that lag time between unfitness and treatment that is such a burden on the county jails, the sheriffs said.

"We're not equipped to provide the services they need. We're just trying to prevent them from doing harm to themselves or others," said Kris Bolt, chief deputy for the Champaign County Sheriff's Office. "Jails cannot force medication."

Ford County Sheriff Mark Doran and Douglas County Sheriff Charlie McGrew echoed Bolt's concerns.

"We don't have the resources to care for them," Doran said. "The staff deals with the criminal elements of mental health. We're not trained in patient care but inmate care."

Said McGrew: "We have it backwards. We wait until the mental-health situation drives an individual to commit a crime and then treat it. They should be getting treatment before they commit the crime."

Douglas County also contracts with Health Professionals Ltd. for mental health services at the jail in Tuscola. Ford County uses the Ford-Iroquois Public Health Department to do inmate screenings and Paxton's Community Counseling and Resource Center for evaluations and referrals to proper services.

Doran said the Illinois Sheriffs' Association has alerted legislators about the need for care for mentally ill jail inmates.

In January 2007, Walsh wrote to local legislators complaining that the influx of mentally ill inmates had become a huge problem for sheriffs all over the state. Walsh said he received a polite political response from some legislators.

"It boils down to money and priorities," he said.

"The state has failed that most vulnerable part of our population," Whicker said. "They don't have lobbyists."

Institutional help coming

With the closing in 1995 of the Adolf Meyer Mental Health Center in Decatur and the closure in 2002 of the Zeller Center in Peoria, that left the McFarland Mental Health Center in Springfield as the nearest facility for inmates in East Central Illinois jails.

There are nine state hospitals in Illinois, only five of which have forensic units, which deal with the mentally ill who are accused or convicted of crimes.

Of the nearly 1,400 patients now in those state hospitals, there are beds available for 684 forensic patients.

Tom Green, spokesman for the Department of Human Services, said there were 573 forensic residents as of late April.

The state plans to add 22 forensic beds to the 41 now at the McFarland Mental Health Center by August, said Anderson Freeman, director of forensic services for DHS.

"The waiting list has improved," Freeman said.

In early 2007, there were as many as 30 unfit people waiting to get into treatment. A year later, that list had been whittled to nine, Freeman said.

Legislators know the problem

Local legislators are aware of the gaps in service to the mentally ill in general, not just those in jail. They're doing what they can, given the state of the Illinois economy.

"Sheriffs have written to me because they have people who are supposed to be moved from jails into mental health facilities and they linger there for weeks," said Rep. Naomi Jakobsson, D-Urbana. "I do know it's a problem. I've talked to the appropriate people who are supposed to pick them up. It's always some long delay."

Jakobsson admits that the state is not funding its mental-health care programs adequately.

Rep. Chapin Rose, R-Mahomet, said this year's state budget for mental health care has remained about the same compared with last year and the year before.

"The good news is, from having a huge developmentally disabled and mentally ill population in my district, we actually keep things going most of the time for most of the people," Rose said. "There are plenty of wonderful examples where people are living in the least restrictive environments and fulfilling wonderful lives. The state helps where the state can.

"The bad thing is there are always people who slip through the cracks."

Rose noted that $8 million intended to buttress community mental health providers was cut from last year's budget.

"There are plenty of existing obligations and promises that have not been fulfilled," Rose said. "(Free health care for all of Illinois) is a nice thing to propose, but first of all, it's not free. Look who we've promised free health care to and they can't get it. Folks who are waiting in line for (treatment for) mental health issues."

Sen. Mike Frerichs, D-Champaign, said he's a co-sponsor of legislation that would change Illinois Medicaid regulations to even out reimbursement rates for hospitals that offer in-house adult psychiatric services.

Frerichs said an "anomaly" in the rules allows hospitals with newer programs to receive higher reimbursement rates than hospitals like Provena Covenant Medical Center in Urbana, which has long offered psychiatric services.

A human response

A faith-filled woman, Suzanne Edwards misses her younger son terribly. As a single mother of two boys working as a presser at a local cleaner, Edwards said, she did her best to get through to Marcus, who loved music, summer time and being outdoors.

She concedes his "I don't care" attitude was a barrier between them. When she would visit him in jail, she would urge him to read or participate in support groups.

"He'd say, 'I don't want to read. It's boring,'" she said.

Still, she feels if more people, including his own family, had reached out to him, he might still be with them.

"Maybe counseling would have helped, to just draw out all the emotions of whatever was bothering him," she said.

Edwards has no desire to be a crusader for the mentally ill or jail reform.

"That's not going to bring Marcus back. I'm not going to wish it on anyone else. But they should be doing their job. He should have never been alone."–

Tomorrow: Local group pushing for rights for mentally ill and one mother's story.

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