Health

What Happened When An Illinois County Rehabilitated Mentally Ill Offenders Through Treatment

CREDIT: COOK COUNTY SHERIFF'S OFFICE

The last 27 years of Luvell Pierre Gipson’s life have been peppered with stints in prison, bouts with bipolar disorder, and unsuccessful attempts to stop using narcotics. Desperate to support his family — and his drug habit — Gipson shoplifted from a Chicago-area Best Buy last summer.

That decision landed him in jail again. But his most recent stay in police custody was different than the other time he spent behind bars.

At the prodding of Cook County law enforcement officials, Gipson enrolled in a therapy program in the Cook County jail’s newly launched mental health transition center, located an hour outside of Chicago at the sheriff’s office. For six months, he maintained a steady bipolar treatment regimen, sifted through deep-seated depressive feelings with a psychotherapist, and sharpened his academic skills.

He counted among nearly 30 inmates who enrolled in the pilot program of the Cook County Mental Health Transition Center, which opened last August as part of an effort to provide holistic treatment to repeat offenders grappling with mental illness and drug addiction.

Shortly after completing the program, a drug-free and clear-thinking Gipson eagerly started classes at a local community college. Now sober for nearly a year, he balances a full-time academic schedule with a part-time job and still pays visits to the place that he credits with changing his life trajectory.

“The program gave me the opportunity to think about my behavior. In the past, I would shoplift and before I did so, my adrenaline and heart rate would increase,” Gipson, now an addictions studies major at Harold Washington College in Chicago, told ThinkProgress.

Since leaving the mental health transition center in February, Gipson has returned as an alumni adviser and guest speaker for inmates currently enrolled in the program. During those sessions, Gipson often touches on aspects of his transition to life without drugs, saying he left the facility with a toolkit of allows him to work on anger and self-esteem issues that trigger his desire to get high.

“These days, I constantly monitor my behavior and think about the repercussions of my decisions. I gained the tools of negotiation, anger management, and conflict resolution. I continue to use them so they’ve become a practical part of my life, whether I’m at home, school, or with my partner,” he said.

At Cook County jail, a team of mental health professionals determine a defendant’s eligibility for the program once they’re dropped off by the police. Once they go through processing, officers inquire about their insurance history and pull up their records. Practitioners also conduct an evaluation. If the individual is deemed in need of mental health treatment, officials prepare a packet to allow their lawyer to ask a judge for diversion from conventional incarceration.

Once admitted, inmates receive two-and-a-half hours of therapy for five days a week during which they evaluate their negative thinking and proclivity for criminal activity. They also receive job readiness training and the forms of enrichment that Gipson described. Once they complete the program, officials maintain contact with the enrollees, most of whom have newly acquired Medicaid coverage.

Tom Dart, sheriff of Cook County, said that the mental health treatment center goes beyond the conventional options that law enforcement officials typically have — and takes into account the bigger factors that influence an inmate’s entrance and subsequent returns to the prison system.

“Inmates with mental disorders are not criminals, but people with an illness. That’s why we developed a module that helps keep them home,” Dart told ThinkProgress. “It became our mission to distinguish who had an illness and put together a structured plan so they wouldn’t come back into our custody once they left. This is a program that we have developed and keep improving — a service here and a service there.”

Research highlights the benefits of connecting low-level offenders — particularly those struggling with substance abuse and mental health issues — with community health care programs, drug programs, and job training. The Seattle Law Enforcement Assisted Diversion program, for example, found that people who entered these programs cut their chances of getting arrested again by 60 percent. An Urban Institute report released earlier this year also found that mental health courts and in-house services have shown moderate success, in part because they’re better at addressing the root causes of inmates’ criminality.

Tom Dart, sheriff of Cook County, looks at computer screen in an office at his Chicago headquarters

Tom Dart, sheriff of Cook County, looks at computer screen in an office at his Chicago headquarters

CREDIT: AP Photo/Martha Irvine

Dart, who has been at the helm of the Cook County Sheriff’s Office for eight years, frequently advocates for holistic services for mentally ill inmates, penning an editorial in the Chicago Tribune last year and speaking to ThinkProgress about the issue in 2013. The launch of Cook County’s mental health treatment center follows Dart’s decision to hire a psychologist to run its jail system, as well as the launch of a family support hotline and mobile units designed to assist returning citizens during psychotic episodes.

Statewide, similar changes have been made amid concern about a growing mentally ill inmate population. Since the Reagan administration enacted policies that deinstitutionalized mental health services, prisons have become the new de-facto treatment centers, with the Cook County Jail counting as one of the largest in the nation. In the aggregate, more than half of inmates in jails and state prisons struggle with a mental illness, particularly depressive disorder, bipolar disorder, and schizophrenia. However, only one-third of state prisoners and one out of six jail inmates in that group reportedly receive mental health services during and upon their release.

In 2013, a monitor appointed by the U.S. District Court in Peoria recounted seeing segregated cells used in place of spaces deemed more suitable for inmates in need of mental health resources. His testimony led to a federal court order that obligated the Illinois Department of Corrections to improve prison services. Prison officials later drafted a plan that included the addition of four mental health treatment units, 1,200 beds, and more than 300 clinical staff workers. It also detailed the renovation of three correctional centers and the reopening of a juvenile mental health treatment facility.

But those adjustments haven’t come without difficulty. Illinois made the fourth largest cuts to mental health services of any state between 2009 and 2012, according to data from the National Alliance for the Mentally Ill. Funding cuts caused two state-run psychiatric facilities to close. Though Governor Pat Quinn (D) said such adjustments would bring in $2 million in cost savings for mental health care, the opposite happened. Costs for housing inmates with a mental illness have tripled that for average prisoners.

“With our budget crisis, Illinois hasn’t been very good at funding mental health services generally. The providers are struggling like you wouldn’t believe,” Dart said. “It’s a sad story for the mentally ill but the even worse for those leaving the jail. Before our work, inmates were getting churned right back out in the streets without getting treated. That’s why I opened up my own clinic. Now we’re putting together plans to diagnose them.”

Other states have taken a similar approach in screening inmates with mental health problems and connecting them with treatment. In March, lawmakers in South Carolina unanimously voted to expand the state’s mental health courts for nonviolent offenders. Last year, New York City Mayor Bill de Blasio unveiled a $130 million overhaul of the city’s criminal justice system. Strategies include the improvement of mental health screenings before arraignment, the restoration of Medicaid for inmates, and expansion of supervised pretrial programs and community services for more than 4,000 inmates.

There’s still some reluctance to rely on jail diversion programs as answer to the national problem of recidivism. Two-thirds of courts punish offenders who don’t follow through with treatment with jail time, a seemingly counterproductive remedy. Additionally, a 2011 review of offender-focused programs found that clinicians would find better success grouping returning citizens not by their offenses, but their needs, that if left unaddressed, could land them back in prison.

Even so, Gipson said he remains grateful to Cook County officials for taking an unconventional route in holding him accountable for his actions and helping him improve his life. He told ThinkProgress that the outcome would have been different had he been incarcerated again.

“It’s one thing to try to quit but when you realize why you’ve been using, you double down. It gives you another degree of sobriety,” he said. “It’s a process. People don’t know addiction is a disease and there’s a gray area in all of this. That’s why you need compassionate people in all of this.”