Clark County Sheriff Garry Lucas pledged to county commissioners last week that he will take a new approach with mentally ill inmates at the Clark County Jail.
Lucas and top jail administrators met Aug. 15 for a work session requested by commissioners in light of inmate suicide attempts and deaths.
Lucas said the county will, among other things, step up efforts to identify at-risk inmates, increase training for custody officers on how to best handle mentally ill inmates and make sure inmates who leave jail have a discharge plan to ease their transition back into the community.
"People have to have a future vision," said Ric Bishop, administrative commander at the jail tasked by Lucas to lead the new health and safety plan.
Lucas and Bishop outlined how the plan will be implemented over the next three years.
Bishop said the Sheriff's office will also seek input from community advocacy groups.
"The recent tragedies in our jail are not acceptable," Bishop said. "We're going to welcome (the volunteer groups)."
Bishop said he hopes to partner with a local provider that would accept special-needs inmates. Currently, there are no beds for mentally ill inmates except at Western State Hospital near Tacoma. Bishop said that because of budget cuts, fewer inmates will be transferred to Western State for competency evaluations. Instead, Western State will send a doctor to the jail to interview inmates whose competency or sanity has been questioned by a judge.
The jail's new health and safety plan also applies to elderly inmates and chronically ill inmates, all of whom are a growing segment of the inmate population.
Nationwide, there are three times more seriously mentally ill people in jails and prisons than in hospitals, according to a 2010 study by the National Sheriff's Association and the Treatment Advocacy Center. The study also found that in 1955 there was one psychiatric bed for every 300 Americans, and by 2005 there was one psychiatric bed for every 3,000 Americans.
"Historically, we have viewed our jail as a warehouse," Lucas said. But jails have to accommodate the needs of the changing population, he said.
Many of the alleged crimes that land a person in jail may be a result of mental illness, Lucas said, but once a person gets arrested on suspicion of committing a crime, he's in the criminal justice system. And the system can't meet the inmate's needs.
"It's not an easy question to answer," Lucas said. "We have pledged ourselves to doing whatever we can to reduce the risk … we're working to resolve the problem."
Of the 15,639 people booked into the Clark County Jail last year, 33 percent were considered "special needs" inmates, based either on information they provided when they were booked or, for repeat visitors, on information on file at the jail. "Special needs" includes mentally or chronically ill and elderly inmates.
Inmates are routinely double-bunked in the jail's six-room medical unit, and other special-needs inmates have to be isolated.
An average of 56 inmates are on suicide watch every month. The jail has modified cells to reduce suicide risk -- by removing sprinkler heads and vent covers with slats, for example -- and has increased the use of suicide smocks.
Inmates on suicide watch are checked every 15 minutes.
Bishop said studies show inmates are less likely to commit suicide if put in a cell with another inmate, but the jail isolates at-risk inmates in accordance with federal guidelines such as the Prison Rape Elimination Act.
Lucas and Dr. Stephen Goldberg, executive vice president of clinical affairs for Conmed Healthcare Management, which contracts with the county to provide medical services in the jail, told county commissioners the jail isn't an adequate facility. Not holding out hope for a new jail, they will continue with the expansion of modified cells.
Commissioners Marc Boldt, Steve Stuart and Tom Mielke have not discussed the possibility of building a new jail.
The jail opened in 1984 with 306 beds; it has been retrofitted and modified to add beds. It has an average daily population of 623.
When it was built, national standards weren't followed, in order to keep costs down, said Lucas, who took office in 1991.
Suicide attempts at the jail have more than doubled since 2007, according to a June report by Auditor Greg Kimsey.
Medical costs have increased from $2.7 million in 2007 to $3.2 million last year.
In 2009, a mentally ill inmate died from an overdose of generic Prozac and his family sued the county and Wexford Health Sources Inc., the county's former medical contractor for the jail. The county and Wexford settled by each paying the family $175,000.
Last year, 18 inmates attempted suicide and one inmate died. Two inmates have committed suicide this year and a third inmate died in February. In July, Clark County Medical Examiner Dr. Dennis Wickham ruled the death was a homicide from asphyxia while being restrained by custody officers. The inmate, Marius Asanachescu, had bipolar disorder and had been awaiting transfer to Western State for a competency evaluation.
Clark County Prosecutor Tony Golik said last week he received reports from the Vancouver Police Department on Asanachescu's death but ordered detectives to collect more information.
"We just want to be extremely thorough," Golik said.
The names of the custody officers involved have not been released, but Sgt. Fred Neiman said last month the officers were trying to restrain Asanachescu to keep him from harming himself.
Stephanie Rice: 360-735-4508 or firstname.lastname@example.org.