As Congress embarks on a rethinking of the criminal-justice system, jails and prisons are confronting myriad problems in dealing with the mentally ill.
CHICAGO — Nneka Jones Tapia, who runs Chicago’s sprawling Cook County Jail, has an indelible childhood memory of police officers pounding on the aluminum walls of the family’s double-wide trailer home in North Carolina, rifling through cupboards and drawers, and arresting her father on charges of selling marijuana.
Jones Tapia, then 8, had to call her mother home from work.
In the next several years, other relatives, including two brothers, and a number of friends also spent time in jail. She says she might have ended up there, too.
Instead, she became captivated by psychology and earned a doctorate. She began working at Cook County Jail in 2006, and this spring became its unlikely warden when she was promoted to executive director, one of the first clinical psychologists to run a jail, underscoring how much the country’s prisons have become holding centers for the mentally ill.
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“It’s a national disgrace how we deal with this,” said Sheriff Thomas Dart, who appointed Jones Tapia, 37, to the post and who refers to the jail as the largest mental institution in the country. He said that up to one-third of the jail’s 8,600 inmates were mentally ill.
As Congress embarks on a rethinking of the criminal- justice system, jails and prisons are confronting myriad problems in dealing with the mentally ill. There are 10 times as many mentally ill people in the nation’s 5,000 jails and prisons as there are in state mental institutions, according to a study last year by the National Sheriffs’ Association and the Treatment Advocacy Center, a nonprofit group that supports expanded access to treatment. Such inmates are far more likely to be kept in solitary confinement and to be beaten by guards and other inmates, corrections officials say.
Three of the nation’s largest jails — Rikers Island in New York, the county jail in Los Angeles and Cook County Jail — have been under federal scrutiny, in part because of the mistreatment of the mentally ill. In Los Angeles and Cook County, the jails are operating under federal oversight, and Cook County has become a model of sorts for other troubled institutions in how to deal with the mentally ill.
Before becoming warden, Jones Tapia oversaw health care at the jail, and under her guidance, Cook County began offering services that would have been unthinkable a few years ago. All inmates upon arrival now see a clinician who collects a mental-health history to ensure that anyone who is mentally ill is properly diagnosed and receives medication. The jail then forwards that information to judges in time for arraignments in the hope of convincing them that in certain cases, mental-health care may be more appropriate than jail.
The jail also enrolls arriving inmates in health-insurance plans and helps arrange basic case management upon their release.
“We’ve started to focus on the entirety of the system, from the point of arrest through discharge, and really forcing the whole system to take a look at the people that we’re incarcerating,” Jones Tapia said.
Officials have also discussed using a Sheriff’s Department van staffed with a therapist to perform house checks on former inmates, and if necessary, drive them to medical appointments to ensure that prescriptions are refilled on time.
Dart, who has led the push for change, says the jail has become a dumping ground for people who should not be locked up. “The person isn’t choosing to be schizophrenic,” he said.
“The vast majority of mentally ill people are here for nonviolent crimes, like stealing food to survive or breaking into places, usually looking for somewhere to sleep, or getting caught with drugs because they are self-medicating. How is it different than us locking up diabetics? Jails were never meant to be mental-health hospitals.”
To press ahead with the jail’s overhaul, Dart promoted Jones Tapia in May.
Jones Tapia said that while she worked at the jail as a psychologist, she made a point of hanging out with corrections officers, and that had eased the transition to her new post. “I think they welcomed the opportunity to share their world, and many of them, when they see me today, say, ‘I know you’re going to be all right because we taught you well,’ ” she said.
She also married a corrections officer, Angel Tapia, a 12-year veteran of the jail.
The program she is most proud of — and the centerpiece of efforts to overhaul the jail — is the mental-health transition center, which started last August and was run by Jones Tapia before she became warden.
Five days a week, a group of about 15 inmates with mental illnesses such as depression, bipolar disorder and schizophrenia receive cognitive behavioral therapy, job-readiness skills and extra recreation.
The warden said such inmates who were released without such services were often back within weeks. “If somebody doesn’t have access to the basic tools to survive, they’re more likely to recommit a crime and come back,” Jones Tapia said.
None of the 43 former inmates who attended the program before being released have been re-arrested, said Ben Breit, a jail spokesman.