Joint Committee Studying Treatment Options for Offenders with Mental Illness or Substance Abuse Disorders
September 28 , 2001, Henrico County
During the fifth meeting of the joint subcommittee, the members heard presentations on juvenile detention and jail-based services in Henrico County as well as judicial, law-enforcement and consumer perspectives. The committee also held a work session on preliminary findings and recommendations.
Juvenile Detention. Every child who is admitted to Henrico Juvenile Detention is screened to determine the level of needed services. Approximately 50 percent of the juveniles are receiving prescription medication prior to admission. Thirty-three percent reported that they had been previously admitted to a psychiatric hospital. Despite the close working relationship and collaborative training between juvenile detention staff and the Henrico community services board staff, treatment gaps exist because of shortages of funding and qualified treatment personnel. An employee of the community services board provides 20 hours of mental health services per week, but more is needed, especially in light of the shortage of child and adolescent psychiatric beds in the Commonwealth. In addition, there is no formal substance abuse program, although the percentage of substance abuse among juveniles is high.
Jail-Based Services. Henrico houses approximately 1,037 inmates per day. All inmates are screened by nursing staff to identify people at risk of harm to self or others and those who will receive treatment while they are incarcerated. Reflecting the increasing level of mental illness among the inmates, there has been a steep increase in the number of psychiatric hospitalizations during the past year. Paid for mostly with local funds, Henrico operates a therapeutic community for substance abuse treatment, which can accommodate 36 inmates at its jail east site. The committee heard from a panel of inmates who are participating in the therapeutic community, Project Fresh Start, about their positive experiences. Other inmates completed a five-question written questionnaire about their experiences. One inmate wrote, It gives me a chance to do something positive for myself as well as society. I am not just doing time, then return to the streets to continue my actions. It lets me take a look a what Ive done, why Ive done it, and what can I do to keep from doing it again. Another inmate wrote, [The worst thing about being in Project Fresh Start is] I had to find it in jail.
Judicial Perspective. The Chief Judge for Henrico General District Court observed that, over two years, he had seen a slow increase in the use of cocaine and heroin. He also observed that alcohol and other drugs were the root causes of more than 50 percent of the cases in his court. Among the obstacles that he sees is an insufficient number of residential placements or acute psychiatric beds. The Chief Judge for Henrico Juvenile and Domestic Relations Court cited the need for more beds for children and adolescents with mental health needs. She also cited the need for a new disposition category, not guilty by reason of insanity, in order to ensure additional treatment options.
Law Enforcement. A representative of the Henrico County Division of Police said that police officers are frequently the first responders. He observed that law enforcement has experienced a steady increase in involvement with people with mental illness or substance abuse disorders since the 1980s. The community services board provides 30 hours of training and two days of practical experience in mental health issues to Henrico County officers. In contrast, a representative of the Waynesboro Police Department said that officers in that jurisdiction are afforded only the required five hours of basic training.
Consumer Perspective. A panel organized by NAMI Virginia included a family member of an individual who is dual-diagnosed with mental illness and a substance abuse disorder, and a defense attorney, both of whom related problems with obtaining needed services for persons involved with the criminal justice system. The executive director of NAMI Virginia cited the need for more community care, jail diversion programs, crisis intervention training, acute care beds, and standards for behavioral health care in jails, including criteria for formularies. Specifically, NAMI recommended:
The committee concluded with a discussion of preliminary findings and recommendations, which will be made available for public comment.