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Swikar Patel | The Journal Gazette
Confinement officer Jake Hackett holds a “suicide suit,” which is put on inmates when they pose a threat to themselves.

Jail like a ‘mental institution’

High number of ill inmates challenges law officials

Swikar Patel | The Journal Gazette
Inmates with mental illness pass through this entrance to the padded confinement room at the Allen County Jail.

– Nearly catatonic, the inmate could neither bathe nor take care of himself.

It was Commander Charles Hart’s second week on the job heading the Allen County Jail nearly four years ago, and he faced his first severe case of inmate mental illness. The man’s situation was so dire that two correction officers would be assigned to brush his teeth twice daily.

Hart and officials with area treatment and advocacy groups say jailing the mentally ill is a complex problem with limited solutions. Although the jail can provide prescription medications and some care, it cannot substitute for a hospital.

But in some cases, that’s what it’s becoming for a segment of the mentally ill population that experiences a high recidivism rate in the criminal justice system, officials said. Still, it’s hard to determine how many crimes result from a mental illness or how many severe crimes are committed by the mentally ill.

A national study released last month by the National Sheriff’s Association and the non-profit Treatment Advocacy Center claims that a person suffering from a serious mental illness in the United States is three times more likely to end up in a correctional facility than a hospital.

Using government statistics, the study calculated the chance that a seriously mentally ill Hoosier would end up behind bars instead of in a hospital at 2.6 to 1, which ranks Indiana 27th among states.

Hart said it was impossible to know the exact number of mentally ill in the county jail at any time, but one official with the National Alliance on Mental Illness in Fort Wayne called the jail “the largest mental institution in the area.”

That has officials concerned.

“The bottom line is, we’re a jail, we do the best we can,” Hart said. “We’re not a hospital.”

The jail

Every inmate in the jail is screened upon entry and asked whether they have a mental illness or are taking medication, Hart said.

If the person is honest and lists a specific treatment center or doctor, jail staff members can procure medication for that inmate, Hart said. Unfortunately, that rarely happens.

“People come in and maybe they’re embarrassed, or maybe they can’t communicate with us,” Hart said.

Many times, jail employees do not detect mental illness until they begin to see erratic behavior, according to Hart.

Suicidal tendencies are the most common of those behaviors, Hart said, and there are a few steps the jail staff can take for such an inmate. They can be given a specialized suit, called the “suicide suit,” Hart said. It’s basically clothing designed to lessen the chance of the wearer using it to hurt himself or herself.

In other cases, an inmate acting erratically can be seen by a mental health counselor and a psychiatrist, both of whom are provided by Park Center, an area treatment facility that offers both inhouse and outpatient care.

The counselor and psychiatrist come to the jail every week, Park Center CEO Paul Wilson said.

If medication is prescribed for an inmate, the jail can provide it, but costs are steep. Jail officials have said in the past that the sheriff’s department is paying about $8,000 every two weeks for medications.

And although the jail does not have a separate area for the mentally ill, Hart said jail staff try to accommodate those suffering from mental illness by placing them in their own cells when possible.

Crisis intervention

One of the biggest improvements for all of law enforcement in the county has come in the form of specialized training for officers dealing with the mentally ill, according to area advocates.

A number of officers with the Fort Wayne Police Department and the Allen County Sheriff’s Department, including some who are based at the jail, are trained in “crisis intervention.”

These officers are usually called in, either on the street or to the jail, when someone is acting erratically and posing a threat to himself or others. They are trained not to make any diagnosis but to recognize possible signs of mental illness.

They also have the authority to take people to a hospital instead of the jail.

“It’s a powerful program, one of the best in the country,” said Kathleen Bayes, executive director for the National Alliance on Mental Illness in Fort Wayne, who called the jail the largest mental institution in the area.

“Before there was the (Crisis Intervention Team) in 2000, it was just like, ‘We pick up the mentals and take them to jail.’ ”

In 2009, crisis intervention officers for the Fort Wayne Police Department were called to 989 cases. Of those, 907 people were taken to hospitals on 24-hour commitments to be treated rather than to a jail.

Outside world

In recent years, officials in law enforcement, medicine and treatment advocacy have bolstered efforts to keep mentally ill people who have served their time from re-entering jail.

One of the biggest obstacles to that has been people’s access to – or willingness to take – medication. They might get treated at the jail and be given medicine that lessens their symptoms, but then they go without upon release. And on the outside, they commit another crime that lands them behind bars.

Many who suffer from disorders such as schizophrenia might not even realize they have a mental illness, according to Bayes.

“That’s the challenge,” said Wilson, the Park Center CEO, who said his organization is trying to reach out to people coming out of jail who are known to have mental illnesses, hoping they will accept help.

“People have civil liberties. People don’t have to take medications against their will.”

Likewise, Ruth Anne Sprunger, executive director of Mental Health America in Allen County and longtime advocate for the mentally ill, said her organization pores over all county police reports involving the mentally ill and does its best to follow up with those involved.

To combat a high recidivism rate for the mentally ill, Allen County Community Corrections, which oversees people on parole or probation, will soon reopen the Washington House for patients who have both an addiction and mental illness. Although the plan is to have roughly 48 people living in the home at a time, there will also be outpatient programs, according to Stan Pflueger, public affairs director for community corrections.

“We’ve known for years we’ve needed to have housing for people, that it’s not effective to house them in jails,” Pflueger said.

The Washington House program, Pflueger said, will offer residents an opportunity to play a part in making house rules and be responsible for its upkeep. It’s a form of treatment, he said, that will help residents stay clean of addiction and give those in the home skills to function in daily life.

Mental illness court

Still, other ideas have not flourished.

Nearly two years ago, Bayes approached an Allen County judge and prosecutor about a court devoted to misdemeanor crimes committed by the mentally ill. She said similar courts have popped up in Indianapolis and Terre Haute.

“One of the first issues for misdemeanors is that the recidivism rate is so high, we want to get them treatment so that the chances of committing a felony are much less,” Bayes said.

She said grant money is available to have such a citywide court, but the idea was shot down by the judge and prosecutor.

“There’s no need for it,” Allen County Prosecutor Karen Richards said. “Judges have a wide range of sentencing options, and they can take into account a mental illness. A mental health court would be duplicating what we already do.”

Such a court would not change things, Richards added, and how a mental illness could be defined as playing a role in a crime would have to be more thoroughly defined.

“And just because you take medication doesn’t mean you’re not responsible for your criminal actions,” she said.

The future

It’s hard for officials to say where things might be heading.

Some blame the lack of current facilities to house the mentally ill for the increase in the number of mentally ill people in jail.

Some officials in the sheriff’s department have said the 2007 closing of the Fort Wayne State Developmental Center, on the city’s north side near IPFW, led to more mentally ill people in jail.

“That was the worst thing they could have done for that segment of society,” said Cpt. Ron Rayl of the sheriff’s department, who heads internal affairs and regularly deals with mental illiness issues at the jail. “They need the strict rules to live in that structured society.”

Bayes said cuts to mental hospitals, such as the one in Richmond, are not helping, and even Wilson of Park Center said his organization is facing cuts, which will be formally announced this month.

Wilson said 19 people from Park Center have been given layoff notices, but he expects many will be hired back in different positions. He also said officials don’t expect cuts to affect how many people Park Center can treat.

Hart, the jail commander, said many mentally ill people who find themselves at group homes may begin to act out. These homes may not be ready to handle such problems, so the police are called and people wind up behind bars.

In some severe cases, Park Center can take jail inmates as patients, and others are sent to the Bowen Center in Warsaw or the hospital in Logansport.

There is an undeveloped wing at the jail that Hart would like to see made into a place specifically for mentally ill inmates, but nothing has materialized.

In the end, mentally ill people behind bars in Allen County have few options available to them.

“We are definitely not well equipped at all, as in no county jail is equipped to handle this,” Hart said.