Mental health & the jail
December 19, 2016
The young Hispanic male would stand in his jail cell shooting invisible bows and arrows at the walls before squaring up into fight poses against an imaginary opponent.
When the deputies would walk by his cell, he would salute them and say, "I'm ready for battle Captain, let's go, I'm ready for war." Five minutes later, he would be rearranging a "couch" in his cell.
These are the types of people the deputies working in the Carson City Jail: inmates with mental health issues who tax manpower, time and resources.
"It's tough and it's different," said Deputy Ron Kennison. "It is tough when you have a guy that comes in and just has a bad attitude because that is just his personality, but when you have people that legitimately have mental health issues, you are dealing with a whole different set of rules there."
For the deputies working in the Carson City Jail, though they are not trained psychologists, they experience many with mental health issues on a daily basis.
"In here we are doctors, psychologists, counselors you know we wear many hats that we aren't trained to do but we have to because it is what it is," said Kennison. "We do so many more jobs than what you learn in the academy, but we just have to deal with it and do the best we can."
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Many of the inmates with mental health issues need psychiatric help, however, most of the time the deputies can't provide the necessary levels of care for these inmates.
"It makes our job difficult because we aren't psychiatrists, so to take care of their needs is difficult," said Deputy Justin Whitehead. "So we just try to comprehend their need but when they are acting up, there isn't much we can do but tolerate it and make sure they are safe."
So the deputies have adapted and tried to master the art of — talking — which many of them say is usually exceptionally helpful in most situations.
"It's one thing you acquire with this job, your voice is kind of like your saving grace it can really de-escalate the situation just based on how you talk to the person," said Deputy Arik Sitton. "You try to get on their level. I don't try to talk to them like I am this big authority guy unless I have to be… and I don't come in at a full 10 either; I try to come in calm because when they see you calm they tend to stay calm."
"The de-escalation is important because you've got someone that is coming in throwing fists at everyone and their adrenaline is pumping. You try to talk them down and try to talk to them in a calm voice because going at them screaming isn't going to help, you know?"
Many of the deputies agree that keeping calm while dealing with a subject with mental health issues is key to a smoother interaction.
"If you yell at them to shut up and all this, they aren't comprehending that, they are probably just going to yell more and keep going," said Kennison. "That's the big thing: try not to aggravate them. Sometimes it can't be avoided, but just try not to, because you want to try to keep them calm."
Kennison, who has been working in law enforcement for nearly 25 years, said that a lot has changed in the way officers are asked to handle inmates with mental health issues, which in turn has required him to adjust his tactics.
"Back then you didn't really even deal with it. It kind of just wasn't talked about and now it is so much more prevalent it just seems like everybody, I would say like 80 percent of the people that come in have a mental health issue whether it is anxiety, depression, PTSD," Kennison said. "…I have had to become more understanding and more tolerant because it is not something they do on purpose, it is something they can't help."
But, it isn't always that easy.
Often, the deputies will get inmates who spend days with no sleep, screaming, yelling, kicking the doors or throwing things in their cells.
"They call you any name in the book and some of these people say some gnarly stuff, but you get used to it," Sitton said. "… but at a certain point, you're like 'I can't wait to go home.' It is very draining."
Sitton recalls one inmate they had several years ago, a 6-foot 9-inch, 300-pound man, who smear his feces all over the cell and himself on a daily basis and make weapons with his bed sheets. Nearly every day the deputies would have to gear up in riot and Hazmat suits to go into his cell to get him cleaned up.
"When we would all gear up, we would gear up in Hazmat suits and he called us spacemen, he called us spacemen trying to take him away," Sitton said.
Housing these kinds of inmates creates a host of difficulties for the deputies.
Because inmates with severe mental health issues need to be housed in single cells, hosting a multitude of them can create problems for the deputies who may need those cells for inmates who need to be separated from others.
"It is a scary system," Whitehead said. "They take up real estate for people that need to be put by themselves for high priority crimes, threatening inmates and such. There is a need for those single cells but we can't fill them because of the mental health inmates."
At times, trying to focus on those with mental health issues can disrupt the deputies other duties.
"That is where a lot of the problem comes in, is the time management," Kennison said. "I have so much to do, I really don't have the time to sit and talk to them for 20 minutes, which is probably what they need. We need to learn to condense and compress it, sometimes it is helpful, sometimes it's not."
To help the deputies, inside and outside the jail, the officers go through Crisis Intervention Training, a 40-hour training that helps deputies identify, handle and provide resources for mentally ill subjects.
"The evolution of responsibility to mental health has been moving over the last five years and that is what caused us to recognize that we needed more training for our officers," said Sheriff Ken Furlong. "That spurred department-wide training certifications for crisis intervention."
In addition to the CIT training, the department created the Mobile Outreach Team and FAST programs that bring certified doctors and counselors with patrol deputies and inside the jail to help treat mentally ill subjects. However, the problem is that the FAST team is only in the jail for a few hours weekday mornings to try and help inmates.
"(FAST and MOST are great) when they are here," Kennison said. "But take swing shift for example, we don't have Dr. Joe, we don't have FAST or MOST. If they bring them in, we have to deal with it. We do the best we can on top of what the deputies have to do."
However, the CIT training helps teach the deputies ways to better handle these inmates.
"It has been knowing more and having more tools to help people in crisis," said Deputy Michael Huynh. Huynh just recently completed his CIT training with the Sheriff's Office. "It is about knowing the process for how to get them help to get them into mental health court or to see Dr. Joe and then have that continuous knowledge for different resources and outlets."
The CIT training is meant to help provide the deputies with tools to talk with mentally ill subjects in order to defuse a situation.
"The uniform can cause outbursts and this training helps them de-escalate the situation," Furlong said. "De-escalation is the focus on everything we do."
Though many of the deputies have gone through this training, there reaches a point where it just isn't enough.
"I have been through CIT like a lot of the deputies but it's just when you get so many that you aren't equipped to it, it just makes it tough," Kennison said. "We just need more places and people who are more equipped to deal with it than the deputies are that would be most helpful. Realistically with money and budget how they are, probably not, but that would be the ultimate to have more people here qualified to talk to these people. That would be the most helpful unfortunately it would be the most unrealistic."
Furlong acknowledges these concerns with the mental health inmates, but agrees there isn't much more that can be done at the moment.
"It is unfortunate that we don't have a 24/7 medical staff, because a person in crisis can be a danger, but that just isn't feasible," Furlong said.
Often, the FAST and MOST counselors try to get the inmates help in institutions specifically for mental health in Reno, however, due to the demand beds aren't always available and an inmate could be in jail for weeks or months before they can be treated.
"They need to be somewhere where they get the proper treatment, the proper medication," Sitton said. "Unfortunately, jail is a holding spot for them until the courts can figure out what they have to do to get this person help, which is unfortunate because it can take a while to get some help."
The prevalence of mental health inmates has been increasing to the point where most of the deputies find the screams, the imaginary people, the kicking and more to be just another day on the job.
"It shouldn't be that way but it's common now and you just have to deal with it," Sitton said. "I have no control over it so you just figure out what you can do to help them and move on."