There are approximately 2.3 million inmates in the federal, state and local detention facilities in the United States (Bureau of Justice Statistics). Of the 2.3 million total inmates in the United States, approximately 1.2 million of them have some type mental health illness or substance abuse related problem. When it is broken down even further, 480,000 of those mentally ill inmates were confined in local jails and detention facilities (National Institute of Corrections).
This has become a very real problem for our community as well as other communities across our state and nation. So much so, that Governor Pat McCrory issued Executive Order No.76 on July 14, 2015, which tasked our local and state leaders to come up with viable solutions in hopes to “provide treatment for people with mental illness and substance abuse disorders to significantly benefit individuals, families, communities, and taxpayers”. This Executive Order specifically addresses the issue of “reducing the number of individuals with mental illness and substance abuse disorders in our jails and prisons”.
The Moore County Detention Facility is forced to face these very difficult problems on a daily basis. We are funded by local taxpayer dollars. We are not allocated any monies from federal or state agencies to specifically address mental health problems. There is no funding from local mental health entities in our community to help us with this problem.
Inmates with mental health illnesses and substance abuse problems are difficult to manage and create challenges for our staff. Every inmate that is brought into our facility is screened medically utilizing a questionnaire with a specific series of questions. The questionnaire, along with a waiver for the release of their medical history, is forwarded to our medical staff, a registered nurse supported by Southern Health Partners, a provider for inmate medical services. The nurse uses the medical questionnaire and the inmate’s prior medical history as a tool to identify inmates that may be in need of medical, physical, or mental health care. Inmates that have been identified as substance abusers, and are currently under the influence at the time of entry, may be detoxified for a period of time in our facility at the direction of the nurse. The detoxification process requires temporary segregation from other inmates and requires additional supervision of the inmate by a detention officer until the inmate is cleared by the nurse.
Inmates who have been identified with mental health problems who display erratic behavior may also be segregated from other inmates until they are able to successfully maneuver through their crisis. Sometimes, just the mere fact of being incarcerated causes erratic behavior. If the inmate is unable to make it through their crisis in a reasonable amount of time, we have to acquire services outside of our facility. This requires additional resources and supervision. One major challenge we face upon inmate entry to our facility is the honesty and accuracy of the information provided by the inmate. Inmates often fail to disclose certain illnesses or prescribed medications which would enable us to better serve them. It usually takes some type of physical or mental breakdown for us to be able to identify a specific problem that could have been avoided if the inmate had told us the truth about the problem at the point of entry. Once we get to this point with the inmate, the next step usually involves a visit to the emergency room and follow up care with psychiatric care. Again, this requires additional personnel for us to be able to manage the crisis and stabilize the inmate so they can return to the facility.
Unfortunately, there are many reasons why some inmates fail to disclose their illness or addiction. It may be for fear of embarrassment of their particular affliction or they may be afraid to be separated from the general population. Even though inmates may fail to disclose some or all information, we still attempt to identify that a problem may exist, and take that into consideration for inmate classification. We utilize an inmate classification system in order to house the inmate in the appropriate housing unit. Unfortunately, this may not always be the case because some inmates are able to function well enough to hide their issues. In cases such as the aforementioned, it would be beneficial for family members of inmates to help convince them to cooperate with our medical and detention staff. A simple phone call to the detention facility nurse disclosing the specific illness, doctor’s name, and prescribed medications would be most helpful.
The Moore County Detention Facility contracts with psychiatric professionals whose services are offered to the inmates. Most visits are accomplished utilizing electronic video visitation. If the psychiatrist identifies a specific need of medication for the inmate, then that information is forwarded to the nurse for the medication to be administered. The psychiatrist sees an average of about thirty-five patients each month in our facility for various mental health related problems. It should be noted that these are inmates who are seeking help or who have been referred by the nurse. Not all inmates who are in need of mental health care seek it out. If the inmate does not feel comfortable speaking with our medical staff, they can simply waive their medical information to the nurse so the nurse can follow up with the inmate’s doctor and confirm their medications that need to be administered without delay. We can accept an inmate’s medications from home, but we have to confirm the prescription with the prescribing physician before the medications can be administered.
Mental health and substance abuse by inmates in our detention facility poses a very unique problem, and one that can be very complex. A detention facility tends to be a melting pot for these problems, and I dare say that most officers are only minimally prepared. Detention and corrections officers lack the training and general education to be able to work with these problems, yet they are asked to deal with them anyway. Inmates with mental illnesses and substance abuse problems require added supervision, increased medical attention, and are an added cost to a facility.
If you have a family member or friend who is mentally ill or a substance abuser and they become incarcerated for some reason, I encourage you to encourage the inmate to ask for help. Usually when a person is incarcerated, that becomes one of the lowest points in their life. This becomes an excellent time for the inmate to face their problems and work their way back to wellness and functionality. I urge you to support your local elected officials in order that they may provide us additional resources, personnel, and proper education to better serve all individuals who may pass through the doors of our detention facility. I ask you to support the furtherance of these issues, and pray for a resolution to this often ignored problem.
Captain J. A. (Andy) Conway
Moore County Sheriff’s Office