“There is an interesting alignment of different political stripes” between politicians who see providing more accessible mental healthcare as a means to reduce crime and those who are discovering that a get-tough-on-criminals approach is not very effective when it comes to addressing mental illness, said Dr. Jay Shannon, CEO of the Cook County Health and Hospitals System.
The insurance expansion under the Affordable Care Act has also played a role by providing financing for alternative approaches to treating people with behavioral health issues who are caught up in the criminal justice system. Illinois has expanded Medicaid eligibility to many of the previously uninsured, and more than 12,300 people have been enrolled while in custody.
Jennie Sutcliffe, director of the Sargent Shriver National Center on Poverty Law's juvenile justice initiative, said this has made it easier for people to continue the treatment and medication they started in jail after they're released. “It's one of the best things that's happened for both the public health system and the criminal justice system,” she said.
Scheribel has been enrolled in a Medicaid managed-care plan since before his last arrest. He chose the plan because it didn't require copays. But it was a major shift in his court handling that made the biggest change in his life.
For most of the previous decade, he had bounced in and out of the regular court system. But after his latest run-in with the law, the ex-Marine's case was handled by the Veterans Treatment Court division of Cook County's specialty court system. “I've never experienced anything like this before,” Scheribel said. “The judge talks to me like a friend.”
Dart's strategy for overhauling the county corrections department began with bringing in professionals skilled at handling people with behavioral health issues. Dr. Nneka Jones Tapia, who now heads the jail, was the former chief psychologist at Cermak Health Services, a branch of the Cook County Health and Hospitals System that serves as the jail's medical provider.
Jail employees begin screening pre-bond detainees at the jail immediately after they are brought through an underground labyrinth to a basement holding area. Elli Petacque Montgomery or one of her staff members will ask each of the detainees whether they have been diagnosed with anxiety, bipolar disorder, post-traumatic stress disorder or schizophrenia, and whether they used alcohol or drugs.
Petacque Montgomery, the facility's director of mental health advocacy, said most inmates are astonishingly frank about their conditions. “When we say, 'We're here to help,' they open up,” she said. “Most people want to get help—you'd be surprised.”
Stephvon “Bo” Cook is doing his part to reduce recidivism among behavioral health patients at Cook County Jail. A counselor with the WestCare Foundation, Cook runs group sessions in a 48-man dormitory in the jail where inmates are serving 120-day sentences and participating in a court-ordered substance-abuse treatment program.
Cook leads talks on anger management, drug issues, forgiveness, grief, relationship skills and self-control. While these topics may not be topics hardened inmates typically discuss, Cook's animated and charismatic delivery plus his football lineman's build help make it work.
Last month, his clients gave him a homemade birthday card expressing gratitude for helping them turn their lives around. Former inmates are also invited to keep the conversations going free of charge at Cook's One More Chance Clinic, which he operates on the University of Illinois at Chicago campus.