Behavioral health behind bars

Tom Dart, who has served as sheriff of Cook County, Ill., since 2006, is pushing to end what he calls the criminalization of mental illness. Nationwide, about 20% of jail inmates and 15% of state prison inmates have a serious mental illness—10 times the number of people with serious mental illness in state hospitals.Behavioral health behind bars and beyondQ&A: Meet the sheriff who runs the nation's largest psych facility

Dart blames the large number of mentally ill inmates in part on decades of budget cuts for mental health services. “The people who traditionally would go to community locations for treatment are ending up in jails and prisons in outrageous numbers.” Behavioral health behind bars and beyondQ&A: Meet the sheriff who runs the nation's largest psych facility

Dart named Dr. Nneka Jones Tapia executive director of the jail in May. Jones Tapia was formerly chief psychologist at Cermak Health Services, a branch of Cook County Health and Hospitals System, which provides healthcare services to the jail. “When you have a correctional facility turning into a quasi-mental health hospital, you sure as heck better have upper leadership with a background in mental health issues,” Dart said.Behavioral health behind bars and beyondQ&A: Meet the sheriff who runs the nation's largest psych facility

It's not the healing environment most healthcare facilities seek. But even with its barred windows, guard towers, and razor wire-topped fences, the 96-acre Cook County Jail is becoming a leading provider of behavioral healthcare services in the region.“I talk to the detainees on a regular basis and they say it's the best treatment they've ever gotten," Dart said. "Is that not a horrific indictment of our society that people go to jails for the best treatment?”Behavioral health behind bars and beyondQ&A: Meet the sheriff who runs the nation's largest psych facility

Jail employees screen pre-bond detainees as soon as they're brought in. Mental health advocacy director Elli Petacque Montgomery and her staff ask inmates if they've been diagnosed for conditions such as bipolar disorder, post-traumatic stress disorder or schizophrenia and whether they use alcohol or drugs. Petacque Montgomery said most inmates are frank about their conditions. “When we say 'We're here to help,' they open up.”Petacque Montgomery said she sees firsthand how untreated behavioral health issues can create a cycle of involvement with the criminal justice system. She worked 25 years ago for an agency that collaborated with Illinois Department of Children and Family Services, and now sees people she worked with as children showing up in the jail as adults.Behavioral health behind bars and beyondQ&A: Meet the sheriff who runs the nation's largest psych facility

Stephvon “Bo” Cook is a counselor with the WestCare Foundation. Cook runs group sessions on emotional and drug issues for inmates participating in a court-ordered substance abuse treatment program. “They don't think they're redeemable, but I teach from a spiritual philosophy that all are redeemable.”Behavioral health behind bars and beyondQ&A: Meet the sheriff who runs the nation's largest psych facility

Dirk Scheribel, a 54-year-old ex-Marine who lives with anxiety, depression and alcoholism, was arrested last November after shoplifting a bottle of liquor. He was taken to Cook County Jail and was assigned to a mental health dormitory, where he received treatment and counseling. Scheribel now lives in a recovery house with other men with similar histories. “A lot of good things are happening for me,” he said.Behavioral health behind bars and beyondQ&A: Meet the sheriff who runs the nation's largest psych facility