Delays lower, but inmates needing mental health care may still wait

Delays lower, but inmates needing mental health care may still wait

URBANA — Two months after allegedly trying to kill a woman he didn't know, in what even an untrained observer would view as a psychotic episode, a man sits in the Champaign County Jail waiting to get help from state mental health officials.

On May 7, Champaign's Aaron Munds, 40, was found unfit to stand trial on charges of attempted murder and home invasion stemming from his March 17 arrest. The self-proclaimed "son of Satan" is waiting for a bed to open in a Department of Human Services mental health facility, where he will be treated with a goal of getting him to understand the charges against him.

It might be a few more weeks before that can even begin.

On the other hand, Sakin Demir, 44, of Urbana, earned a quicker trip to the McFarland Mental Health Center in Springfield last week by refusing to eat or drink for several days in jail — not out of protest but because he believed his food was being poisoned.

On Thursday, a judge found Demir unfit to stand trial on charges of criminal damage to property for slashing tires in Urbana in December and January. He has been in and out of jail over the last few months on the same charges but was brought back May 17 because of his refusal to attend an evaluation with a psychiatrist. He didn't eat for several days and drank very little, despite repeated efforts by the jail staff to get him to do both.

That's when Sheriff Dan Walsh sought help from county attorneys to be able to force-feed Demir.

"We spent three days on this," Assistant State's Attorney Barb Mann said Friday afternoon in Judge Heidi Ladd's courtroom.

Mann and fellow Assistant State's Attorney Joel Fletcher researched and prepared court documents and appeared before judges last Wednesday, Thursday and Friday to get an order allowing Walsh to force feed Demir while in the jail waiting to go to DHS. On Thursday, his attorney objected and Ladd asked for supporting case law before making a decision Friday.

Although Ladd was prepared to grant the sheriff's request, the order became moot when McFarland officials, acting on a plea from Walsh, found a space and picked Demir up Friday afternoon.

Demir's case illustrates what jail officials have been saying for a long time: We are not mental health clinicians. We are correctional officers.

But due to the lack of state money to beef up services at state mental health facilities, local jails often have to deal with people they aren't necessarily equipped to handle.

"Some of them are a tremendous amount of effort and work," Walsh said. "It's everything from somebody who is actively suicidal, to someone who hears voices and can't be around other people because they are paranoid schizophrenic, to people who think that all their food and water is being poisoned and the government is planting bugs in their head."

"Some of those people are ultimately pretty self-destructive. Sometimes, they realize it and sometimes they don't."

Wait list shorter

Of the approximately 159 bedded inmates last week, Walsh said five were waiting to get in a state mental institution.

The waiting time between a defendant being found unfit and being shipped to a DHS facility, the sheriff said, used to run two to three months. Recently, that has decreased to three to five weeks.

Don Henke, clinical director for a forensic unit (for those accused of or convicted of crimes) at McFarland, agreed that things have gotten a bit better.

"At the present time and for a couple of months, the waiting list for forensic patients has decreased significantly," Henke said.

About 50 beds for forensic patients have been added at McFarland in the last two years, he said, putting its capacity at 75 in that category.

There are also mental health centers at Chester, Elgin and Alton that deal with forensic clients.

"The statewide waiting list, which had been over 100 in months and years past, has been into the 20s in the last couple of weeks," Henke said, adding the average statewide length of waiting for admission is 35 days.

"If we could just hire 20 more people and build a brand new building, it would improve our speed of service, undoubtedly," he said, tongue-in-cheek. "It's difficult to weave gold from straw."

The assessment

Whoever said the wheels of justice grind slowly could have been referring to the mentally ill accused of crimes.

After Champaign County Assistant Public Defender Janie Miller-Jones is appointed to a case, she first reads all the police reports before making contact with the client, she said. It can be a few days before she receives those from the state's attorney's office.

The reports are usually her first clue that a client needs mental health services. Talking to the client is key.

"Five or 10 minutes, you don't always pick up on something," she said.

But if the client is saying something strange, she is duty-bound to seek a court-ordered evaluation for fitness to stand trial — that is, a psychiatric determination about whether the person can understand the charges against him and cooperate with counsel. A separate evaluation might be needed to determine if the person was criminally responsible at the time of the alleged act.

Champaign psychiatrists Dr. Larry Jeckel and Dr. Albert Lo do most of those court-ordered evaluations in Champaign County.

"We'll get them in within a week," Jeckel said. "But if they say they are very ill, we do expedite."

He estimates he does 85 to 100 evaluations each year for courts in 10 to 15 area counties.

Typically, inmates are driven to the doctors' offices, but both doctors will go to the jail if it's too risky to move the defendant.

They have to submit their written observations and opinions to the attorneys and the judge. A fitness hearing then must be held.

In Munds' case, Miller-Jones requested a psychiatrist be appointed on March 25. Dr. Lo submitted his report April 30. Ladd found Munds unfit on May 7.

In an ideal world, DHS would be able to take him immediately to begin treatment.

Frustrations mount

Once a finding of unfitness is entered, the clock stops on the 120 days within which the state must bring the person to trial. It starts again when the person is fit.

Waiting for the help can be a challenge.

"Sometimes it's months," Miller-Jones said. "I had one guy sit for three months and by the time DHS evaluated him, they determined he was fit."

"I literally believe my clients sit here two to three months before they go. It used to be a matter of weeks but it's not been that way for a really long time," she said.

Her clients can get some mental health services at the jail but not as much as DHS can offer.

"It's a funding issue and there aren't as many beds," she said, adding she wished that Presence Covenant Medical Center or The Pavilion could take accused clients until a DHS bed is ready so they could at least begin treatment.

In February, Miller-Jones, Walsh and State's Attorney Julia Rietz attended a conference in Bloomington, where the issue of what the DHS is doing was addressed.

"They gave us a lot of information about different facilities they have. Where a person goes depends on their needs," Rietz said.

"They (DHS) are advocating increasing the use of outpatient local sources. But that would be what one would call an unfunded mandate. They were not offering any way to pay for our use of local resources that may or may not exist."

In some parts of the state where the delays have gone on too long, Rietz said, counties have filed petitions to hold DHS in contempt of court, prompting the department to move more quickly.

Rietz said she's never done that. But she'd consider it.

Everyone playing nice seems to work better since all involved have the same goal of getting help for a mentally ill person.

"There have been, primarily in Cook County, a number of rules to show cause why we are not in contempt of court in trying to get people in more quickly," Henke said. "We've been able to work more cooperatively with the jails and the courts here in the central region (of the state).

"We're able to work with them pretty well. Certainly, there are days when they'd probably like to hang us just as much as put up with us."

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rsp wrote on May 27, 2014 at 10:05 am

They can get some help while they wait? If they were having a heart attack would they do some cpr? Federal law requires parity for mental health care, same as for physical care. Unless we require better care they won't provide it.