LA County Wants To Tear Down A Jail To Help Its Mentally Ill Inmates

There's general agreement that the aging Men's Central Jail in downtown L.A. needs to be torn down. The plumbing often doesn't work, vermin infestations are not uncommon and the design with long rows of cells leaves deputies vulnerable to attack. The question is: what should replace the 1963 concrete fortress?

On Tuesday, the L.A. County Board of Supervisors is set to provide an answer. It's considering a few options:

• Replace the jail with a lockup tailored to provide better care to mentally ill inmates
• Build a mental health treatment center instead of a jail
• Put the whole thing off and study how to divert more people with mental health problems out of the criminal justice system

Until recently, many believed the project to build a new jail was a done deal. It was pitched to be a 3,885-bed facility "primarily designed for the treatment of different acuities of medical and/or mental illness or substance abuse disorders," according to a county website that explains the project.

Now, there's fierce debate over whether it's the right way to go, given that the county is in the middle of attempting to transform how it deals with mentally ill people who commit crimes - many of whom are homeless. About one-third of all jail inmates have some sort of mental illness and one-quarter need special housing - an estimated 5,100 in all.

ANOTHER OPTION:

Supervisors Janice Hahn and Mark Ridley-Thomas have introduced an amendment that calls the idea of building a new jail "obsolete." "The experts clearly tell us that we should be focused on exactly the opposite approach," according to the amendment.

Hahn and Ridley-Thomas's amendment would require county staff to develop a design for the facility that would "support a treatment-first approach, with appropriate security measures in place, with the ultimate goal of diversion to community-based mental health treatment wherever possible."

A THIRD OPTION:

Meanwhile, Supervisors Sheila Kuehl and Hilda Solis introduced a motion that would create a plan to demolish the old jail but would not give the go-ahead to build a new facility. Instead, it would direct county staff to seek out sources of additional funding to move more people out of jail and into treatment.

They cite the assessment of "several forensic mental health experts" that new jails, "even with improved treatment components, are unlikely to significantly improve the treatment of inmates with mental illness."

The motion points to state and local efforts to increase the diversion of people with mental health problems out of the criminal justice system, including the board's creation in 2015 of the Office of Diversion and Reentry.

"Before moving forward on a plan to build a new detention facility," Kuehl and Solis argue, "this Board is long overdue for a targeted and comprehensive study of who the people who are in our jails are, and what works to put them and their families on a path towards maintaining healthy, stable, and productive lives in their communities."

So with the supervisors set to consider the competing motions, here are five arguments for and against building a new jail, known as a Consolidated Correctional Treatment Facility.

FIVE ARGUMENTS IN FAVOR OF BUILDING A NEW JAIL

1. The facility would represent a "paradigm shift in the way the county cares for inmate-patients in the criminal justice system," according to the project's website. It would focus on treatment and rehabilitation rather than just incarceration.
2. The jail, which would house men and women, would provide more space for rehabilitation programs than the other downtown jail, Twin Towers, where mentally ill inmates are housed now. It would also provide a range of mental health services including medical detoxification for drug addicts, and psychiatric meds - as well as rehabilitation, educational and life skills programs, according to county planners. The facility also would have expanded visitation facilities and would promote family involvement.
3. Jails in L.A. County are operated by the L.A. County Sheriff's Department. But planners say the CCTF would be an integrated treatment facility in which the county Health Agency would partner with the sheriff to "seamlessly provide a safe and secure environment, in which licensed mental health care professionals can tend to inmate-patient needs." It's unclear exactly how the power relationship would work, but planners say clinicians would have greater say over how inmates are transferred to recreation areas and possibly be involved in discipline decisions.
4. The CCTF would include a new Inmate Reception Center, creating a single location for inmates entering and exiting the county's sprawling jail system, which currently houses more than 17,000 inmates. It would be designed to improve and expedite the assessment of medical and mental health needs by placing sheriff's deputies, medical and mental health clinicians in one location.
5. The facility would go a long way toward meeting the terms of a 2015 agreement with the U.S. Department of Justice that compels the county to improve care and reduce the use of force in the jails. The agreement grew out of a years-long FBI investigation that concluded the county was engaging in a pattern or practice of not only providing inadequate care to mentally ill inmates but of using excessive force against them.

FIVE ARGUMENTS AGAINST BUILDING A NEW JAIL

1. Most of the estimated 5,100 mentally ill jail inmates can be safely diverted to community-based treatment facilities with varying degrees of security, say advocates for the mentally ill. They agree with Kuehl and Solis that the board of supervisors should put the CCTF on hold while the county studies additional diversion options.
2. Diversion was once a boutique idea that didn't move a lot of mentally ill inmates out of the jails. It's different now. The Office of Diversion and Reentry, led by former Superior Court Judge Pete Espinoza, diverted about 3,000 inmates since the office was created two-and-a-half years ago. "The thinking has all changed," said Kristen Ochoa, Diverson and Reentry's medical director. "Nobody thought we could do this on this scale ... there's about to be a sea change" in terms of the numbers of people diverted.
3. Housing people with mental health problems in jail is inherently problematic. Sheriff's deputies have a fundamentally different agenda than clinicians. Mentally ill people often act out, and a deputy's natural reaction to someone breaking the rules is to punish them, said Dr. Terry Kupers, a psychiatrist who has studied L.A.'s jails for the ACLU. In a treatment setting operated by clinicians, the response is to talk someone down, he said. Likewise, mentally ill people behind bars prefer to be alone, which can make their condition worse. Clinicians would seek to coax them out, Kupers said.
4. The county should build on the state and local diversion initiatives. In addition to the efforts mentioned by Kuehl and Solis, L.A. County is looking at ending cash bail, meaning poor people -- some of whom have mental health issues -- wouldn't have to languish in jail awaiting disposition of their case. In addition, District Attorney Jackie Lacey has established a Mental Health Division to help frontline prosecutors identify mentally ill inmates who can be safely diverted from jail.
5. L.A. has a bad record running its jails and especially caring for the mentally ill. And new Sheriff Alex Villanueva has expressed misgivings about building a mental health jail where his deputies would be forced to deal with inmates who regularly act out. He's suggested a public hospital would be a better investment, an idea that seems to be reflected in the Hahn-Ridley-Thomas amendment calling for a Mental Health Treatment Center.