Reports show Erie County is improving mental health care for inmates

April 15--One of the inmates, a drug abuser, was diagnosed with schizophrenia. Another, a military veteran, was dealing with post-traumatic stress disorder. A third was self-medicating for schizophrenia and a traumatic brain injury.

All would need help after leaving the Erie County Holding Center, one of the few ''treatment facilities" they have ever known.

The transition of America's jails into mental health centers is unmistakable when reading a trove of just-released Erie County documents and seeing the needs of hundreds of inmates each month. The reports describe the county's court-ordered effort to reverse years of chronic shortcomings and offer robust mental health care behind bars.

For the most part, the county is succeeding with the sweeping overhaul devised to settle a U.S. Justice Department lawsuit seeking more humane conditions, according to reports by an outside consultant, Dr. Jeffrey Metzner of Denver.

In his latest summary, completed in November but made public only recently, Metzner finds the county substantially complying with a range of goals and falling short on a few.

For instance, some treatment plans are too generic, and a committee formed to foster guidelines on the use of psychotropic drugs meets too infrequently.

In collegial spirit, he credited the leaders of the county's Jail Management Division, the county Department of Mental Health and the University at Buffalo'sDepartment of Psychiatry with the march forward.

Metzner visits the Holding Center in Buffalo and Correctional Facility in Alden twice a year. He tracks, among other things, the county's ability to identify inmates at risk of suicide. Just a few years ago, the Holding Center's suicide rate was the state's worst.

But Metzner also reviews summaries about individual prisoners and those in a treatment unit, not simply those under suicide watch. He works to ensure treatment plans are written for inmates who are going to be around for a while, and that plans are devised to ease a mentally ill inmate back into society when the time comes -- measures that in an earlier era were associated more with psychiatric hospitals than jails.

Metzner says in one of his reports that a monthly average of 248 inmates at the Holding Center and 245 at the correctional facility received mental health treatment during the first five months of 2012.

The number at the Holding Center was then to drop as the Buffalo Police Department opened its own cell block for defendants awaiting arraignment. But the number of Holding Center arrivals referred to mental health workers actually increased.

It was a sign of the modern demands placed on local jails.

Citing years of abuses, the Justice Department'sCivil Rights Division sued Erie County in 2009 to force better treatment and to end abuses. Then-County Executive Chris Collins ended his opposition two years later by promising a better-trained staff and better practices, especially in preventing suicides.

To ensure compliance, the facilities would be regularly inspected by two professionals already helping the county bring its facilities up to present standards. One would assess the health care, the other the mental health care.

Their reports are seeing the light of day because the New York Civil Liberties Union lifted them from a cloak of secrecy. They were intended only for officials and lawyers, even though taxpayers cover the cost of the consultants and the cost of confinement.

In August, the 2nd Circuit Court of Appeals agreed with the Civil Liberties Union's arguments that the reports were of significant public interest and should be open for public review.

To the Civil Liberties Union, Metzner's reports show that Erie County should do something about the revolving door that leads some mentally ill offenders through the system time and again.

"After years of neglect and abuse in Erie County's jails, as well as costly litigation, the county has clearly adopted serious reforms to the way it handles the people it incarcerates who have mental illness," said Corey Stoughton, the Civil Liberties Union attorney who worked to release the reports.

She urged the county to look for ways to "divert people suffering from mental illness away from the criminal justice system and into effective treatment programs."

Erie County now has "mental health courts," where judges direct defendants into treatment to dispose of their case. The county also has a veterans court, for offenders haunted by their military service.

A growing number of police departments train officers in "crisis intervention" skills that help them get psychiatric help to people committing crimes or generating numerous calls because they are mentally ill. And in coming weeks, the County Legislature may vote to re-establish a local parole board, called a "conditional release commission," to free nonviolent convicts from the correctional facility early if they enter programs on the outside.

email: mspina@buffnews.com

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