The sigh is universal. The despair and frustration evident. The inevitability of the time it will take for the judicial system to process, address the legal and medical needs before finalizing any case dealing with a brain disorder wears on the patience of all involved.
Recent cases demonstrate the situation.
During Circuit Court, the inmate came into the courtroom with three escorts. Two on each side and a third behind him holding his waist chain. The officer continued to hold the restraint through the entire proceeding which ended with the judge having to release the inmate. Around the courtroom, an undercurrent of comments and knowing looks said, “he will be back.”
A sad resignation followed the third time an elderly man stood with another inmate. The elderly man had tried to provide the young man with a place, care and basic watchfulness insuring medication would be taken. It turned out to be an impossibility. The elderly man could not control the younger man. The court released the older man from his commitment and did not lower the bond for the inmate. Sometimes the only control possible is within a locked facility.
A third man with a brain disorder wore only leg shackles as he entered the court with a tall uniformed escort. No sign of the waist chain shackled to the wrist handcuffs which many agitated inmates wear to court. He did not speak. He barely looked at the judge, let alone address him or answer the usual questions asked during first appearances. He stared vacantly.
When the judge asked, “Can you sign your name?” the man did not acknowledge him. His family and guardian stepped forward to speak for him. The charge was aggravated assault of a family member and yet the family, even the injured party, stood there with him. They had done what they could.
“Is he taking his medicine?”
“He has not missed a day, at least not with us. I do not know about now. We took the medicines to the jail.”
The judge, the deputy prosecutor and family puzzled over how to get a mental evaluation and sufficient mental treatment for the man. The state simply does not have the facilities to address the real needs of the severely mentally ill, especially the small fraction who act out in threatening or dangerous ways.
“We can order a mental evaluation at the state hospital, but it would be months before they have a bed,” the judge said. Until then, unless the the bond is met, the mentally ill family member will sit in a holding cell and jailers will provide whatever treatment he receives.
The family, the deputy prosecutor, the judge and even the man assigned to guard him all dealt gently with the situation and the inmate. The legal process of a first appearance continued. The legal details were addressed before the officer draped his arm around the man and slowly escorted him back to the holding cell. The tearful family followed them out of the courtroom.
That is how brain disorders fare in the Land of Opportunity, simply because the state government has failed to provide the funds.
It was not always this way.
According to reports from the Department of Human Services, in 1955, before the advent of most modern medicines, the state had 340 beds for every 100,000 people. Now it has 17 beds per 100,000. The state has one hospital. Inside it, the forensic beds stay occupied.
Far too often, a person in a mental crisis will enter the psyche unit of a hospital and leave within a few days with a prescription and admonition to check in with the local community mental health center. For those who become agitated and act out, instead of having their real needs addressed, the accused mentally ill often simply sit at the county jail at the taxpayers’ expense and taking the medications if prescribed.
And thus the dilemma continues. The accused waiting months for mental evaluation before they can go to court and hear the accusations against them. Nothing else can be done in the court until the individual is determined fit to proceed. The options beyond are few and far between.
The only way this will change is if individuals ask their Legislature to address this issue.This year let’s resolve to advocate to improve the provisions for those with brain disorders and move them out of holding cells and into evaluation and treatment in a timely fashion.
Joan Hershberger is a staff writer for the News-Times. She can be reached at joanh@everybody.org.