Two friends’ run, two others’s collaboration and a desire to help underserved populations helped bring psychiatric service to the Ingham County Jail.
Neighbors Judge Thomas Boyd and Jed Magen, now the MSU Department of Psychiatry chairperson, collaborated to create the Ingham County Mental Health Court. This partnership between the court and the MSU Department of Psychiatry inspired Chief Probation Officer Da’Neese Wells and her friend while they were brainstorming ways to bring psychiatric services back to the Ingham County Jail.
Since May 27, the jail has had no psychiatric services. The Community Mental Health Authority of Clinton, Eaton, and Ingham Counties had provided a psychiatrist to the jail. However, after the psychiatrist’s retirement and in the face of budget cuts, the organization did not replace him. The funding was reallocated to other services, Wells said.
To address this, the 55th District Judicial Court, the Sheriff’s Department and the Health Department collaborated.
“There’s a population at the jail that needs this service,” Deputy Controller Jared Cypher said. “This is really an innovative, multi-departmental kind of cooperative effort to get these needed services into the jail.”
On Oct. 25, the Ingham County Board of Commissioners approved a resolution to partner with the MSU Department of Psychiatry to provide psychiatric services to inmates. The board authorized contracting a “senior-level resident psychiatrist,” meaning they are a licensed physician in their residency training to be a psychiatrist, and a supervisor to provide care for up to eight hours weekly.
“This is a small, small impact on the overall operations of the jail. Eight hours a day, one day a week for a selected number of individuals does not have, overall, a substantial impact on the jail, but it has a significant one,” said Corrections Maj. Sam Davis.
Psychiatric care is especially important for inmates. They have limited opportunities to pursue care on their own, there are restrictions on medications entering the jail, adjustment to jail setting is difficult, and they are separated from community support systems, Davis said.
“We can’t replace 100 percent of what they get in the community, but we do, by our offering those services, effectively close that gap a little bit,” Davis said. “I don’t want to say we’re putting a Band-Aid on it, because I think it’s more significant than that.”
This partnership between the Sheriff’s Department and the Department of Psychiatry is based on a template, taken from the 55th District Mental Health Court’s partnership with the Department of Psychiatry.
Boyd identified a need for a mental health court, because defendants had significant mental health problems going unaddressed, Magen said.
“The court has always struggled with providing appropriate supervision and services for mentally ill defendants,” Wells said. “That’s really what this all goes back to: the 55th District Court is dedicated to providing the services that our citizens need, that court users need.”
Magen said the partnership with the court met an educational and a clinical need. Psychiatric residents are exposed to low-income populations with mental disorders. They serve individuals who may have multiple disorders, collaborating with employees, officers and other medical practitioners to provide care.
“We’ve been involved for a long time in community work, and providing psychiatry services, so this is another extension of that,” Magen said. “It’s really helping provide, locally, psychiatry services in an area where there really aren’t a whole lot.”
The 55th District Court was awarded a $261,000 grant from the State Court Administration Office, and the Mental Health Court became operational Oct. 1, 2013.
“When people in mental health court see the MSU resident, the goal is that they see them to address their immediate needs and then we link them to community providers, so that they set up long-term, ideally lifelong, relationships,” Wells said. “You can’t just address their mental health needs for the brief period of time they’re involved with the court.”
In jail settings, Magen said, there are higher percentages of individuals with mental health challenges. These problems can be amplified by the adjustment to jail and often withdrawal.
“Then, you’ve got a variety of psychiatric disorders that can make it really difficult for them to function in the population,” Magen said, “and can make it really difficult for the Sheriff Department to deal with them in the jail setting.”
The need for continuing service is another reason psychiatric service is so important for inmates, Wells said.
“Obviously, inmates are some of the people that are most at risk and most in need of psychiatric services. Typically, correctional institutions are already providing mental health services to a disproportionate number of their population, when compared with the general population,” Wells said. “It’s unfortunate, then, when you have a correctional setting that has no psychiatric services available.”
Davis, Magen and Wells said they expect the model of the partnership between the MSU Department of Psychiatry and the court to translate well into a partnership with the Sheriff’s Department and the jail.
“What it comes down to every time is we are in a service profession, and when organizations start making decisions based on what works for them, rather than the people that they serve, that’s when I think they start running into trouble,” Wells said. “We’ve consistently worked with the sheriff’s office to figure out what’s going to serve the population better. We have always worked successfully with the Ingham County Sheriff Office.”
Davis said the partnership’s success will be determined, in part, by feedback from the psychiatric resident, input from inmates, an improved mental health environment and an enhanced plan for inmates’ transition from jail to the community.
Magen said he hopes to see better care, better coordination of services and good training for psychiatry residents come out of this partnership.
“What we’re trying to do is take a plan that works well, shift it to another area and then improve upon it. We’re taking something that we already know works, that we already know is a good thing, that we already know is mutually beneficial for everyone and then move it to an underserved population,” Wells said. “We’re not starting from scratch, we’re not doing something we don’t know if it will work or not, and we’re not doing something we’re not sure if it’s even needed.
“We know they need psychiatric services in the jail. We know there are none available right now. We know we can work with MSU because we have before, and because we know no one else is going to do. It’s about recognizing a need and being determined to address it.”