Sonoma County Jail officials acknowledge mental health shortcomings, defend care
While acknowledging some of the shortcomings in the mental health unit of the Sonoma County Jail highlighted this week by a statewide disability rights agency’s report, county mental health and jail officials insisted the level of care exceeds that at other California jails or across the country.
The most serious allegations in the 25-page report released by Disability Rights California included illegally medicating some inmates and using excessive solitary confinement and isolation with others.
Michael Kennedy, head of the county behavioral health department that provides the jail’s mental health services, said the problems cited in the report are not unique to Sonoma County. The real problem, he said, is the lack of secure inpatient psychiatric beds not only for jail inmates but also for the general population.
And county mental health and jail officials said while some of the report’s findings were valid, anecdotal accounts obtained during the DRC’s 2015 visit were exaggerated and “over-dramatized.”
But Anne Hadreas, an attorney for DRC, a nonprofit advocacy organization with state and federal authority to inspect and monitor government agencies affecting the disabled, said the people housed in the mental health unit were more acutely mentally ill than in other jails and often were cycled through the facility without ever being sent to an appropriate inpatient psychiatric hospital. Hadreas and other DRC attorneys, along with lawyers with the nonprofit Prison Law Office, toured the jail Aug. 25.
“What it is is a place that’s not set up to provide intensive mental health treatment,” Hadreas said Tuesday in an interview. “Which is a role that it’s taking on and a role that is not appropriate.”
In a planned all-day visit to the jail’s most secure mental health module, she and the attorneys went cell-to-cell and spoke, through door windows, to about a dozen inmates concerned about their treatment. The DRC reviewed the full health records of four inmates.
Of the Sonoma County Jail’s approximate 1,200 inmates, about one-third are taking medications for mental health conditions such as depression or anxiety, according to county statistics. Of those, just over a third were taking anti-psychotic drugs in 2015.
About 71 percent of inmates are accused or convicted of felony crimes, and the rest for less serious misdemeanor crimes, said Assistant Sheriff Randall Walker, who oversees the county jail system. For mental health inmates, about 67 percent are jailed for felony crimes and 33 percent for misdemeanors.
While the DRC report did recognize positive practices at the jail, particularly efforts to release people more quickly from custody, the majority of the report upbraided the jail for:
Treatment of mental health patients that focused on medication and cell-front interviews with staff through door food slots or between the door and the frame, interviews, the report said, that are ineffective in providing therapy;
The most acute patients receiving a visit from a psychiatrist only two or three times a week;
Illegally administering psychotropic drugs to mental health inmates not on involuntary psychiatric holds;
Illegally administering long-term psychotropic medications known as “decanoates” to unstable inmates who were on short-term psychiatric holds. State health officials, the report said, recommend such medications be used only after mental health patients are stabilized, and not on short-term holds; and