Mental Health, Story Four: From the Streets to Jail and Back Again
By Kelley Weiss
Kansas City, MO –
VISIT THE SERIES PAGE
View an audio slideshow
In the fourth story in our ongoing series, KCUR's Kelley Weiss reports on how a broken system is making law enforcement take care of an increasing number of severely mentally ill on the streets, like Troost Avenue, and in the city jail.
- - - - -
In 1963 President Kennedy signed into law the Community Mental Health Centers Act that deinstitutionalized the mentally ill, moving them out of large state asylums and into the community. The problem is that not enough federal dollars followed to support those community programs. When patients flooded back into society, some of them found places to live like with their families or in private group homes where they got food, shelter and medication. Others were left on the street.
Driving through downtown Kansas City, Danny Davis, administrator of a midtown Kansas City group home, Campbell Care, says he frequently sees his former residents sleeping under bridges or huddling on park benches.
On a recent hot day, Davis finds Bobby walking down Troost Avenue. He's wearing a coat, carrying a pile of clothes and a 40 ounce can of beer. He says he's 60, he's missing teeth and has debris in his gray hair. He says life is rough.
Bobby: "Just, you know, like, being mentally ill. Praise the Lord, you know, keep your mind on Jesus."
Davis knew Bobby would have problems living on the streets with schizophrenia. He says it's frustrating to see people like this but he can't stop them from leaving and residents often seek out the unstructured lifestyle of homelessness.
Danny Davis: "We discouraged him from going, really didn't want him to go because we knew that he would not take his medicines and he would eventually be where it's at and I'm sure that he's been back in the hospital as he admitted."
Sgt. John Bryant, of the Kansas City Police Department, teaches officers Crisis Intervention Training so they can give better emergency response to people with mental illness. He slows down when a man wearing a three-piece suit, frantically waving his arms and yelling jumps in front of the police car.
SOUND OF SGT. BRYANT AND MAN ON THE STREET
Barut has paranoid schizophrenia and is an Ethiopian immigrant in his late 20s. Bryant says Barut ended up on the street that day after threatening to kill the administrator and residents of the group home where he lived. Barut says he recently was in jail. He asked to go back but Bryant handcuffed him and transported him instead to a nearby hospital emergency room.
John Bryant: "Evidently, he's just so miserable staying at the group home and his medications are so out of whack that I don't think he really understands what he wants to do or where he wants to go."
Barut's situation is increasingly common says Dr. Stuart Munro, a psychiatrist at Kansas City's Western Missouri Mental Health Center, a state hospital for the mentally ill. He says there is a shortage of community treatment and psychiatric beds. Since 1950, he says, state hospital beds in the northwest region have gone down from more than 2,000 to about 300. Without treatment centers, he says, people end up homeless. For example, one third of all homeless people are schizophrenic and he says the homeless are more likely to break the law by trespassing, urinating in public or petty theft.
Stuart Munro: "We know that today in each facility there are far more people with mental illness locked away than there are here at Western Missouri Mental Health Center."
In 2001 Jackson County started a program to reverse this trend - it's called the mental health court. It's designed to connect the mentally ill with treatment instead of punishing them. Judge John Williams says if a defendant is mentally ill and can complete a comprehensive program, including taking proper medications, the court will drop the charges for non-violent crimes. He says mental health court reduces costs and deters crime.
John Williams: "Instead of just everybody just saying, 'Well you did this again, you're guilty you're going to have to go do thirty days in jail.' And, then when they come out there's no better solution to what the problem was when they went in."
Just half will finish the program. But, studies show, of those who graduate, only 11 percent commit another crime.
John Wickizer: "Now we get people that walk in the door that we've never seen before and they are just howling-at-the-moon crazy."
John Wickizer is a captain at the Municipal Corrections Institute, or MCI. He says he's seeing an alarming increase in the number of inmates with mental illness since his 20 years at the city jail. Inmates in orange jump suits lie idly on cots, head to foot, in long rows. It's loud and feels cramped. Wickizer says many of these inmate can't handle the rowdy, shared living quarters and there are always six inmates in isolation because the jail cannot give them enough medical treatment and they could hurt themselves or others. They're locked in 8 by 10 foot cells with no windows, a steel cot and toilet.
SOUND OF ISOLATION CELLS
Inmates can stay here up to a month or in a bigger unit that looks like a large cage with four cots. Wickizer says isolation cells for the mentally ill are inhumane and make their symptoms worse.
John Wickizer: "Screaming, cussing at people that aren't there, not knowing where they are or what day of the week it is. I don't like seeing them in jail. I think they're here because they're crazy. I don't think jail is the place for them."
It seems like no one has figured out where that place is. From her office at the front of MCI the jail superintendent, Nancy Leazer, says it's disturbing that in her jail three-quarters of the 200 inmates have mental illness. Like others around the country she says her jail has become a makeshift hospital a poor substitute for proper treatment.
Nancy Leazer: "They deteriorate while they are here and we can see them deteriorate and it's no secret that we're way beyond our useful life out here and we need some more investment."
The question is what kind of investment that will be? It's been decades since policy changes threw the mentally ill out of asylums. Now, the talk is about privatizing the system and making changes to keep the mentally ill off the streets and out of jail.
Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.
Download recent health stories or subscribe to the KCUR Health Podcast