San Benito County officials can force medication on unwilling
inmates
San Benito County officials now have the authority to
involuntarily medicate severely mentally ill inmates.
San Benito County officials can force medication on unwilling inmates
San Benito County officials now have the authority to involuntarily medicate severely mentally ill inmates. New California legislation, SB-568, allows the county Board of Supervisors to authorize the involuntary medication of inmates under certain conditions.
Members of the Board of Supervisors approved the program at their board meeting Feb. 26, said Alan Yamamoto, director of San Benito County’s Department of Behavioral Health.
SB-568 was created as an interim fix to an insufficient number of beds at state mental hospitals, Yamamoto said.The ability to involuntarily medicate severely mentally ill patients gives sheriff’s another tool to deal with such inmates, said Curtis Hill, sheriff for the San Benito County sheriff’s department.
“It was a necessary piece of legislation,” Hill said. “The 800-pound gorilla is the lack of funding.”
For severely mentally ill inmates, the San Benito County Jail is equipped with two safety cells, Hill said.
They have rubberized walls and a hole in the floor for a toilet, Hill said. A switch outside the cells controls the flush, Hill said.
“That’s set up for temporary confinement,” Hill said. “Five, six, eight hours.”
One man has been housed in a safety cell for almost a year, Hill said. The man is 26 years old.
“I can’t even house him anywhere else in the jail, even a single cell,” Hill said. “All we give him in there, we give him a safety blanket, a roll of toilet paper in there and a bible. He sleeps on the floor.”
His clothing consists of a second safety blanket, Hill said.
The man was charged with assault with a deadly weapon, battery and murder, Hill said.
“This is a man that does not deserve to be there,” Hill said. “I don’t even care that he’s charged with murder. He’s innocent until proven guilty.”
Hill would like to transfer the inmate to Atascadero State Hospital, a facility intended for mentally ill people waiting trial, but there are no beds available.
“Atascadero is specifically set up to house people while they are waiting trial,” Hill said.
There are five state mental institutions in California, said Nancy Kincaid, a spokesperson for the California department of mental health. They are all at capacity except one institution intended for violent sexual predators.
There was a move among California officials away from institutionalization and towards treatment in the community, Kincaid said.
“That’s fine, but the county doesn’t have enough funds to drive the community treatment program,” Hill said. “Those are shrinking dollars.”
People who suffer from mental illness are ending up in jail, Hill said.
“It’s the trend in the state,” Hill said. “If you reduce the ability to get mental health, they end up in county jails. It’s an increasing population.”
At any given time, between 13 and 17 percent of the jail’s population suffer from mental illness, Hill said. The jail’s capacity is 145 people, Hill said.
Inmates may only be involuntarily medicated under a strict set of circumstances, Yamamoto said.
The inmate must have been declared by a judge incompetent to stand trial, Yamamoto said. They must also be incompetent to make their own medical decisions and be awaiting transfer to a state mental hospital, Yamamoto said.
“A court of law still has to render whether the medication is substantially likely to bring the inmate to competency,” Yamamoto said.
The medication must also be substantially unlikely to have side effects that would effect the outcome of the trial, Yamamoto said.
The effect of inmates that are incompetent to stand trial has been minimal in San Benito County, Yamamoto said.
“I think San Benito is really fortunate in some ways,” Yamamoto said. “When a law like this is passed, it means that it has been a big problem in other counties.”
Jailing people with severe mental illness without treatment can have tragic consequences, Hill said. “Maybe 10 years ago, we had an inmate who gouged his eyes out, with his finger nails,” Hill said. “If we had had the ability to give forced meds to the guy who gouged his eyes out, he would be seeing today. Probably.”
The situation was extreme, but the kind of case in which forced medication might be used, Hill said.
Treating mentally ill patients in jail is expensive, Hill said.
“It costs tens of millions of dollars to try and deal with this population,” Hill said. “We’re not treating the issue, we’re just treating the symptom.
Hill budgeted $35,000 for medication for the year, he said, and two mentally ill inmates used up 50 percent of the budget.
“The two people that blew the budget should be in Atascadero,” Hill said.
A large portion of mentally ill inmates are homeless, Hill said.
“We call them frequent fliers,” Hill said. “They’re constantly going in and out of the jail on low level crimes because of their mental illness.”
Substance abuse can compound the problem, Hill said.
“They have substance abuse issues on top of it,” Hill said. “Then they don’t take their medication. Then they get into trouble.”
Cindy Parr, shelter manager for the San Benito County Homeless Shelter, agreed.
Between 25 and 30 percent of the clients at the San Benito County Homeless Shelter suffer from some kind of mental illness, Parr said.
The county needs transitional housing for such people, Parr said.
“There’s got to be, some sort of a little community like a transitional housing, where they are monitored,” Parr said. “The county doesn’t offer anything really for these people, at all, as far as a living environment. There’s nothing for them.”
