Does anyone know how mental illness in jail is handled?

Nandina

Member
I have not posted in a long time. I have been living a sort of nightmare—the kind we all have experienced at various times with our wayward adult kids. I am still processing what has happened in the span of just a couple months.

Long story short— my son, age 20, who claimed to only smoke marijuana for the longest time, started using meth and other substances for a cheap high when pot wasn’t available. He didn’t last through two treatment facilities in two years. He gets kicked out for breaking rules or getting in altercations. He’s been homeless off and on for a couple years.

He was living in another state and committed a senseless crime of destruction that I feel was most likely a result of his meth use. He is currently in jail in that state and charged with two felonies, I will not bond him out. He still has several court appearances ahead of him and will eventually be sentenced. He has a lawyer in the other state to represent him in court.

After meth his whole personality changed. He became mean and confrontational. Also said some weird stuff that sounded like psychosis (sort of grandiose thoughts about his powers) but he was still coherent and could function. He had been in contact with us from jail and the relationship was ok even given all the chaos going on. He still loved us and expressed it often. And still does. That’s a good thing and I’m grateful for it.

Apparently he acted out in jail and they put him in solitary confinement for a couple weeks and we heard nothing. He’s been in touch after solitary but something is clearly different now. I feel like he lost his mind in solitary. He was already in a pretty fragile state after being homeless, using drugs and had some mental health issues for which he stopped taking medication when he turned 18 because he didn’t think he needed it (mood disorder-undiagnosed, ADHD, depression) and he has mild Asperger’s.

He has called here many times but we haven’t been able to carry on a conversation that really has any meaning. He babbles, thinks he is certain action figures, has been in contact with dead celebrities, is obsessed with a friend from high school, his crush, whom he thinks is meant to be with him. Most of the time he is pretty much incoherently mumbling. Seriously, he is not functioning in any normal sense. If he were here I would try to have him committed I am so concerned. He was not like this the day he first called me from jail.

It is scary knowing this is happening and he is behind bars. And probably will be for awhile.

I have never, ever seen him like this. He has had a psychotic break or something and I am many hours away and don’t know what I can do. He desperately needs help. He is not covered by insurance and apparently there is no free medical care for inmates in this state. We are willing to pay for treatment, if he can get it in jail or anywhere, actually, although a residential type placement might be cost prohibitive without insurance. We would pay for insurance if there is something like that for inmates.

I am just beginning to research things and try to understand his rights, if any. I know nothing about jail. So, if anyone does and could give me some advice for a situation like this, I’d really appreciate it. I just don’t know what’s out there or where to begin. Or if the jail even cares? But it’s very worrisome. Any advice or suggestions are welcome. Thank you.
 

MarCar

New Member
i don't know what state you are in but in California they have mental health court, and they force them to get help. That is one of the reasons i want my son to get arrested. It has helped other family members get the help they need.
 

Copabanana

Well-Known Member
I feel like he lost his mind in solitary. He was already in a pretty fragile state after being homeless, using drugs and had some mental health issues for which he stopped taking medication when he turned 18 because he didn’t think he needed it (mood disorder-undiagnosed, ADHD, depression) and he has mild Asperger’s.

We are willing to pay for treatment, if he can get it in jail or anywhere, actually, although a residential type placement might be cost prohibitive without insurance. We would pay for insurance if there is something like that for inmates.
Dear Nandina

I am only just now seeing your alarming and disturbing post. I haven't worked in jails but worked many years in prisons and almost all prisoners are first in jails. I will try my best to tell you what I know.

I agree with you. Your son seems clearly to be in the throes of a psychosis. The meth-psychosis may have been exacerbated by the isolation.

I will speak about how these things are handled in my state. I don't know about the state where he is incarcerated.

First of all, incarcerated people are dependents. What that means is that because they can't leave the County or State or in the case of Federal facilities, the nation, are responsible to provide for their needs to a level commensurate with what would be available if they were not incarcerated. This would not be "excellent" care. It is adequate care. This is constitutionally mandated. We as a society can't lock people up and then deny them what they need to live and to sustain baseline functioning.

It is not permitted that somebody have an untreated psychosis past a point. Inmates must consent to medication or other treatment. But they can be forcibly treated if they are dangerous to themselves, others or gravely disabled--which means, roughly, they are unable to meet their needs as far as eating, hygiene, functioning, health, etc. I have seen frequently, unfortunately, that prisoners who don't bother anybody are left psychotic and untreated. Sometimes, for years.

If your son is incoherent, it seems safe to say that he is unable to advocate for his needs. That means, you must. I will speak from experience in prison. A squeaky wheel does get attention. In prison there are people called "correctional counselors." I don't know what would be comparable in jail, but I would begin to call all day and every day. I would ask for the psychologist, I would ask for anybody that is in charge of his welfare, up to and including the person in charge, who in prison would be called the warden. I don't know what that is called in jail but in my state, sheriffs run jail.

In my experience it would be very difficult to get private medical people into see him. I have heard of it in prison but that was done through visiting and it is almost unheard of. But the thing is, there must be free treatment at the facility. If there isn't this would be constitutionally forbidden.

If there is no response I would call the governor's office, and the congresspeople of the city in which he is housed. I would even call senators. I would call anybody up the chain of authority. There are also advocates for incarcerated people. I would look for this kind of organization in the state where he is. I would be relentless. I have been called by at least one mother, when I was working. She was frantic. It was very similar to your situation.

I have a hard time imagining you can communicate with your son at all--in a way that he understands--and complies with. But in prison the best way to notify mental health staff is to put a note into a box, or give it to the custodial officer. Medical people are compelled to respond in a proscribed length of time, depending upon the severity of the crisis. But I don't see your son being able at this point to help himself in this way. But absent that, you can do it for him. I am certain of that.

His healthcare including mental health care is mandatory, not optional. They can't shirk it. But if he's incoherent and not making problems, this can be ignored a long time. You have to make sure that they can't ignore it. I would follow up my calls with letter writing, emails, and the like. This establishes a paper trail that can't be ignored, or your son or people that advocate for him would have a MAJOR lawsuit. Remember, this is the constitution we're talking about.

If there is anything I can do to help, please PM me. I mean that Nandina. I am so very sorry this has happened. Your son is such a good person at heart. I am suffering along with you for him. Any question you want to ask, please do, and I will try to answer. Please keep me in the loop. I am so very concerned.
 
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Copabanana

Well-Known Member
My impression of your son is that he is a sweet person without the kinds of experience that would prepare him for this environment. Boy. Did he get himself in a big, big mess, or what? I don't know if there is visiting there, but if there is I would try to go there and see him, if there is any possibility of doing so. The other possibility, is that he should have a court-appointed attorney if he is facing charges. These attorneys are overworked, but there is maybe some chance, that this person has met him. I don't know how you would find out what attorney is assigned to him, through the public defender's office, but there should be a way to find out.
 

Copabanana

Well-Known Member
apparently there is no free medical care for inmates in this state.
Nandina. I was re-reading your post and didn't pay enough attention to this. How could this be? In my state the federal government took over prison healthcare for more than 20 years because it was inadequate and made the state release a quarter of inmates, at least, so that they could adequately care for the remaining ones, health-wise. This doesn't make sense to me. There must be a way for incarcerated people to get treatment or it is in violation of the constitution. If you PM me the State I will see if I can find anything out.
 

Copabanana

Well-Known Member
coverage through the Marketplace.

Incarceration and Medicaid​

If you’re incarcerated you can use the Marketplace to apply for Medicaid coverage in your state. Medicaid won’t pay for your medical care while you’re in prison or jail. But if you enroll in Medicaid while you’re incarcerated you may be able to get needed care more quickly after you’re released.
There are 3 ways to apply for Medicaid:

State Medicaid policies and incarceration​

A number of state Medicaid policies may influence your decision to apply for Medicaid while in jail or prison. These include:


  • Whether your state has decided to expand Medicaid coverage to all adults with incomes up to 138% of the federal poverty level
  • Whether incarcerated people can stay enrolled while in prison or jail. Remember that enrolling in Medicaid while incarcerated doesn’t allow Medicaid to pay the cost of your care while in prison or jail. But it may help you get needed care more quickly after you’re released.

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Copabanana

Well-Known Member
Do prisoners have free health care?


Yes. Under T.C.A. § 41-4-115(a), all counties are required to provide medical care to prisoners incarcerated in the county jail. Also, the United States Supreme Court has held that prisoners have a constitutional right to receive necessary medical care while in custody.
 

Copabanana

Well-Known Member

What Happens To My Health Coverage If I Go To Prison?​

If you go to prison, your benefits change, including Medicaid and Medicare. The Constitution requires prisoners to be given health care while incarcerated under the Eighth Amendment.
Several factors play into how your coverage is affected, depending on your eligibility, whether or not you were enrolled before going to prison, how long you are in prison, and which state you live in. Medicaid and Medicare are affected in different ways if you become incarcerated.
If you know you will be incarcerated for any extended period of time, be prepared to potentially need to reapply for health insurance upon release

Medicaid Termination, Suspension, and Re-enrollment​

Will I keep Medicaid or Medicare in prison?
If you are enrolled in Medicaid before you went to jail, you may keep your coverage and remain enrolled, but the prison is responsible for any health care services you need, with the exception of inpatient treatment provided by a medical facility not associated with the prison. For example, you may have to go to a hospital while you are in prison. If you leave the prison to be admitted to a hospital for over 24 hours, the care you receive at the hospital can be paid by Medicaid.
This is called the inmate exclusion provision, and it has been improved since the Affordable Care Act passed in 2014. This provision only applies to federal funds like Medicaid, but does not prevent the states from using state funds for prisoner health services. This provision does not require inmates to be terminated from Medicaid upon incarceration.
Many states do terminate Medicaid upon incarceration, but some choose to suspend Medicaid benefits instead. It is better to have your benefits suspended rather than terminated. If your benefits are suspended, once you leave prison, it will be much easier and quicker for you to start receiving benefits once again. If your benefits are terminated, you will have to re-apply for Social Security benefits and Medicaid.

States That Suspend Rather Than Terminate​

  • California
  • Colorado
  • Florida
  • Iowa
  • Maryland
  • Massachusetts
  • Minnesota
  • New York
  • North Carolina
  • Ohio
  • Oregon
  • Texas, for 30 days. After 30 days, Medicaid benefits will be terminated in Texas.

What If I’m Not Already Enrolled?​

If you are eligible but not enrolled in Medicaid at the time of your incarceration, you can apply for Medicaid while you are in prison and you should be given the resources to do so. That way you can attempt to be covered as quickly as possible once you are no longer incarcerated.

Medicare Is Not Terminated, But SSDI Can Stop​

Medicare works a little differently. If you were already receiving Medicare before you went to jail, you will still be eligible for Medicare benefits while in jail. But if you are incarcerated longer than 30 days and are convicted of a crime, any Social Security Disability Insurance payments (usually linked with Medicare) will stop. This doesn’t mean you are no longer eligible. Your incarceration doesn’t affect your eligibility for Medicare.

Medicare for Disability​

If you are below retirement age and receive Medicare for disability, your care will be covered again once you leave prison and resume your SSDI benefits. To make this happen as soon as possible, you should contact the Social Security Administration to reinstate your Medicare coverage and SSDI benefits.
 

Copabanana

Well-Known Member

Even In Prison, Health Care Often Comes With A Copay​

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September 30, 201511:08 AM ET
MICHELLE ANDREWS
FROM Kaiser Health News
Budi Satria Kwan/ImageZoo/Corbis



Budi Satria Kwan/ImageZoo/Corbis
Correctional facilities have to provide health services to people who are incarcerated, but that doesn't mean the care is free of charge. In most states, inmates may be on the hook for copayments ranging from a few dollars to as much as $100 for medical care, a recent study finds.
At least 35 states authorize copayments and other fees for medical services at state prisons or county jails, according to the analysis by the Brennan Center for Criminal Justice at New York University School of Law.
The Federal Bureau of Prisons also permits inmates to be charged copayments for medical services. Some states and local governments require copayments for emergency treatment and hospitalizations in addition to routine care, says Lauren-Brooke Eisen, senior counsel at the Brennan Center's justice program who authored the study.
"It's understandable why jurisdictions need to increase their revenue," says Eisen. "From a public policy standpoint, however, the fees can serve as a deterrent to getting care."
The practice is part of a larger trend of charging inmates for prison services, says Eisen. In addition to medical copayments, more than half of states allow prisoners to be charged room and board while incarcerated. They generally also charge for incidentals like phone calls and Internet use.
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In addition to raising money, prison officials hope that by imposing fees they'll reduce demand for services, says Dr. Robert Greifinger, a former chief medical officer of the New York Department of Corrections who works as a correctional consultant.
But fees, even small ones, may not only deter prisoners from making requests for care that prison officials consider frivolous, they may also deter necessary care to keep chronic conditions in check or treat communicable diseases that could easily spread through crowded prisons.
An estimated 80 percent of prisoners are poor. Medical copayments typically come out of their commissary accounts, which are often funded by money provided by their families and earnings from prison jobs.
"Prisoners don't have money; they're getting $20 a month from their family," says Greifinger. "If they deplete that for medical care, they don't have money for underwear, soap or food."
In a landmark 1976 case, Estelle v. Gamble, the Supreme Court held that not providing adequate medical care to prisoners was a violation of the Constitution's Eighth Amendment against cruel and unusual punishment. But courts have generally allowed prisons to attempt to recoup some of the costs of treating inmates by charging them for their care.
At the Bernalillo County Metropolitan Detention Center in Albuquerque, inmates can see a nurse on a walk-in basis rather than having to put in a written request first. The process, implemented two years ago, is intended to give inmates better access to health care services, says Phillip Greer, chief of corrections at the center. Still, sometimes inmates misuse the system and copayments are one way to discourage that, Greer says. Prisoners generally pay $3 to see a nurse and $5 for a doctor visit. If they can't afford to pay, they're not charged, he said.
State spending on prison health care grew to $7.7 billion by 2011, with increases of more than 13 percent in half of states, according to an analysis by the Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation.
But inmates, many of whom are uninsured when they enter prison, often don't get the care they need. Among inmates with chronic medical problems, many didn't receive a medical exam while incarcerated, including 68 percent of local jail inmates, 20 percent of state prison inmates and 14 percent of federal prison inmates, a 2009 study published in the American Journal of Public Health found.
Dr. Josiah Rich, professor of medicine and epidemiology at Brown University, conducts a weekly clinic at the Rhode Island Department of Corrections in Cranston. Prisoners pay a few dollars if they make an appointment to see him. But if the doctor initiates the appointment rather than the prisoner, it's free of charge, says Rich, who is also co-director of the Center for Prisoner Health and Human Rights.
Recently the prison announced that if a doctor orders Tylenol, a topical cream or other over-the-counter treatment, those items will have to be purchased by the prisoner with commissary funds rather than provided through the prison's medical service at no charge, Rich says.
"Charging prisoners for health care is yet another way of kicking them when they're down," Rich says.
 

Nandina

Member
Thank you so much Copa for all your helpful information. I have pm’d you. As far as medical care or anything else for that matter, (even clothes and hygiene items other than 2 pr of underwear and prison suits) the inmates are charged for everything, even a daily incarceration fee and then given a bill upon their release.

It clearly states on the jail website what the fees are and that if they don’t make payment arrangements their wages can be garnished. Unbelievable that jail inmates, most of whom are indigent and will struggle to even find employment once released, are hit with a bill they probably can’t pay after they’ve served their time. Believe me, I want my son to pay the consequence for his crime, but it shouldn’t affect his income for the rest of his life!

I did a little digging though, and found out that in Sept. 2021 this practice among jails at least in this state has been temporarily struck down in court, finding that the courts, not jails, are responsible for assessing fees on inmates. But it will just be a matter of time before the state legislature finds a way to get around this.

And yes, you are right about my son. He is not prepared for anything like this, even if he weren’t in psychosis. He is very naive. He will be the one taken advantage of. It breaks my heart.

Sending love and thanks (through my tears)

And for anyone else reading this, if you are a praying person, please say some for my son and all the good incarcerated people who made a bad decision but shouldn’t be defined by it forever. Everyone deserves a second chance.
 

Nandina

Member
i don't know what state you are in but in California they have mental health court, and they force them to get help. That is one of the reasons i want my son to get arrested. It has helped other family members get the help they need.
Thank you MarCar, I will check into this. Something tells me this state isn’t as kind toward their inmates though, if you read my subsequent post. This situation has really been an eye opener for me. But thank you for responding.
 

Nandina

Member
My impression of your son is that he is a sweet person without the kinds of experience that would prepare him for this environment. Boy. Did he get himself in a big, big mess, or what? I don't know if there is visiting there, but if there is I would try to go there and see him, if there is any possibility of doing so. The other possibility, is that he should have a court-appointed attorney if he is facing charges. These attorneys are overworked, but there is maybe some chance, that this person has met him. I don't know how you would find out what attorney is assigned to him, through the public defender's office, but there should be a way to find out.
There is no in-person visitation right now at this jail, it’s all done through video chat which we will try to set up soon. He does have a paid-for lawyer who has been representing him in court. His last court date was before solitary, though, and he was probably coherent.
 

Copabanana

Well-Known Member
I would call the attorney and tell them about the psychosis. That's part of their job to represent him and advocate for his welfare. It's quite unfortunate they've been affected by this disaster.
 

lovemysons

Well-Known Member
Nandina…
I said a prayer for your precious son and you. I am so sorry he is suffering while in prison.
I hope you both get the help you are seeking very soon.
Love,
lms
 

Deni D

Well-Known Member
Nandina, I have no experience with how mental illness is handled with someone in jail, but have worried, many times, that I would have to deal with it. I just don't know. I loose my breath thinking about your situation, so without the words of comfort others can offer, here is what I have:
1. I think getting to the judge, most likely through his lawyer, as Copa has said, would be the way of getting him out of that jail and into a mental health facility is probably the best way to go. I mean when he has the next appearance.
2. I would search for his states and/or county mental health hotline and call them to see what they have to offer in the way of information for his particular situation. My experience with ours has been so helpful in the past.
3. As far as insurance goes, each state has their own rules, I think, but when my son was uninsured the hospital applied and received temporary emergency insurance for him. Hospitals want to be paid, they know how to get this temporary emergency insurance, whether it is because of a mental illness hospitalization or any other type.

I don't want to sound like I'm not relating so well here and just going to the facts of things but please know I am truly feeling your pain and praying for you, your son and your family, praying for healing and peace for you.
 

Copabanana

Well-Known Member
states and/or county mental health hotline
This is a good idea. There will be an ombudsman for the County and for the State. There should also be a hotline for Corrections.

Calling the attorney is essential. While it is a longshot it could be that his sentencing could be modified to deal with his emerging needs. For example, he could be diverted to a mental health facility.

The other reason that his attorney must be in the loop is because of competency issues and impairment of judgement beyond what just drugs would do. Nandina. We don't really know how long he has been suffering. The psychosis could have come first. This presents legal issues.

You are not a professional attorney or psychologist. (As far as I know.) All of us here are mothers, not professionals, dealing with our children. Give the experts the information they need to help your son.
 
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