Monday, March 12, 2012

Forcing Dignity, a Sheriff draws a line!

     Recently, the Sheriff in Summit County, Drew Alexander, made the startling declaration that he would refuse to accept inmates with severe, untreated mental illness. On the surface, people wondered if this law enforcement officer had lost his mind in his own right, amid the fear that he would allow all the crazy people to wonder the streets. I had a couple of friends insist that this was a discriminatory practice that was once again, adding to the stigma of having one of these disorders.  
     After the initial shock, those comments do not stand up to scrutiny. In fact, after a recent interview I had with him, it is evident that Sheriff Alexander is becoming a champion to end the barbaric “treat them and street them” mentality that permeates the medical profession with their dismissal of those with mental illness. In essence, most medical providers would rather exclude the mentally ill from appropriate treatment, and send them back to the streets without adequate care, which in many cases, leads them to be dumped on the prison system. To more clear, his announcement could be the most merciful actions that the law enforcement community has ever done for this invisible and widely misunderstood group of people!
     This directive stipulates clearly that before the individual is to be placed in the jail system, he or she must first be stabilized. In simple terms, they must be given proper therapeutics, such as diagnosis and medication. After the person is stable, this regiment can continue under the controlled environment of the medical personal of the jail. This is a much safer environment for both the prison guards and the inmate themselves. This could also lead to some court ordered and monitored programs once they leave the prison system. Long term, we would see a decrease in the recidivism rates of these same individuals.
     If you want better understanding as how we are at this stage of a law enforcement official forcing treatment, you just need to understand recent history. Many of us old enough to remember, can find humor in old movies, with their portrayal of those in psychotic crisis, then known as the infamous, nervous breakdown! With that breakdown, two individuals would show up driving the ambulance, and carrying the straightjacket, which was used to restrain the person in question. Add to all the old classic cult song, “The funny Farm” and it would be scenes that would provoke laughter.
     In twenty first century America, those hospitals that people were taken too do not exist, and neither do the individuals arriving with the straightjackets. They have long since been replaced with police officers and with that; the medical community finds virtue in excluding those seeking help. After all, they then become the problem of the jails, not theirs! Thus began the process of the revolving door of those in crisis entering the emergency room and being sent out through those same doors, with instructions to obtain treatment elsewhere. After that, the ping ponging between these same ER’s and jails became commonplace.
     There is ample evidence that a directive such as this should have occurred many years ago. A common misconception is where people are taken when are in need of mental health treatment. Many would be shocked to learn that the number one facility for dispensing care to people in need is the Las Angeles County jail. In the Summit County Jail, it is estimated that about 40% of its prisoners have mental health issues, and along with it, a chemical dependency. Would it not have been much more prudent to treat these people outside of the prison system before they become a financial burden on society? Sheriff Alexander has agreed and decided it is time for action!
     If there is one situation that still amazes me, is the sheer arrogance and ignorance of the medical community with regards to people with mood disorders. I use this example on many occasions of two people being brought in to an ER. One has a broken leg, and the other is in a suicidal psychosis. Which one will be treated? Which one has a more life threatening condition?
     In that scenario, the one with the broken leg will be treated, and will be given after care instructions to make a full recovery. The one with life threatening illness may be held for observation, or may just be sent back to the streets to fend for themselves. Even if kept, that person most likely will eventually be disposed of by the medical community, with instructions to seek help. It is as if seeking help becomes a scandal in the eyes of the medical establishment as a reason to enter the hospital in the first place.
     Unlike the medical community at large, Sheriff Alexander recognized something that has been ignored for many years, and that is mental illness is a real illness. He was quoted in a local paper as saying “If a person had an injury he would be sent to a hospital; this is the same thing.” He is calling out people for practicing this inhumane practice of ignoring those in need and forcing them to put the brakes on this disgusting ritual.
     This is not a cure all for what ails the mental health system, but it is another element to the puzzle. Giving people without hope some hope, those without dignity, some stability, will go a long way to restoring faith into a broken system. I am hoping that law enforcement officers across the country follow Sheriff Alexander’s lead and influence the medical community, and of course our political leaders to begin to restore the system. It will be a mammoth task. However, as the old Buddhist saying goes, “A journey of ten thousand miles begins with a single step”. Sheriff Alexander just forced people to take the first one!


  1. This is powerful and wonderful news and I can only hope that Sheriff's follow his lead.
    DJ Jaffe
    Exec. Dir
    Mental Illness Policy Org
    Twitter @MentalillPolicy

  2. It's a shame that this attitude towards people with mental illiness isn't nation wide already...My best friend's son, Casey gave his life to his mental illiness two and a half years ago when he jumped in front of a train in Plattsburg,NY, just a couple hours after meeting with his case workers. He was only 24 yrs old.
    Of course, his doctor's and case management staff are denying that he showed any signs of being troubled and let him leave the facility. Well I personally pray, that they each live with that decision every minute of the rest of their lives.
    I knew Casey, watched him grow up with my son. They spent alot of time together, they were friends and his Mother and I are still best friends to this day. It's heartbreaking to hear her heart and soul still mourn the loss of her youngest child. He has an older sister and a brother that was very clost to him, who still mourns the loss of his little brother. He has a family, he was someones son, brother, and friend.
    No we can't bring him back, but we can't take away the loss of him either...and to this day those who are responsible, those who were trained to help their lives as if nothing happened to this young man who had a life and was a life! Let's get it together people, the mentally ill need help from all of us and they needed it yesterday!!

    1. I am so sorry to read about Casey. I find that story so familiar to many others that I have encountered as an advocate. The treat them and street them mentality must end and end now! If you read my posting about a hospital in Lorain that I put up this morning, you will understand why situations such as yours occur.

  3. I wish all sherrifs stood up like this against the mental health departments, and made them do their jobs with assisted out patient treatment.

    1. I agree with you. However, hospitals are the biggest culprit, especially in the emergency room setting. They feel it is ok to just dump people in jail so it becomes their problem. Thank you for your comment.