Berkeley County launches mental health pilot program for inmates

MONCKS CORNER — Berkeley County is taking steps to prioritize mental health by launching a new pilot program at the county detention center covering inmates with mental illnesses.

The program is a partnership between the Hill-Finklea Detention Center and the Berkeley Community Mental Health Center and made possible by a $373,000 appropriation from the state legislature.

It is the first program in South Carolina to receive state funds specifically designated to follow inmates with mental illnesses from their entry into the detention center until their release, while encouraging them to visit the mental health center after their release, the center’s executive director Matt Dorman said.

According to Dorman, 40% of people incarcerated in Berkeley County suffer from a mental illness, and about half of them suffer from a serious persistent mental illness, such as schizophrenia, bipolar disorder with psychotic features or a major depressive disorder.

Sheriff Duane Lewis hopes the effort will encourage other counties to follow Berkeley’s lead.

“I think that’s the first step in really trying to recognize that we have a mental health crisis in Berkeley County and in this state, not just inside the detention center or the correctional facility. “, Lewis said.

What is the pilot program?

Before the program, the detention center had only one psychiatrist who worked two hours a week and a clinician with a bachelor’s degree who worked three months a year.

At the same time, the detention center faces overcrowding. Lewis said the prison’s capacity is supposed to be 291 inmates but it houses an average of 450. At one point, there were 500 inmates in the detention center.

Lewis attributes some of the overcrowding to people with mental illnesses who are constantly incarcerated.

Randy Demory, the director of the detention center, said inmates with mental illnesses require more attention from staff than other inmates because they cause more conduct problems: not taking care of themselves- even when taking showers or using the toilet, inciting violence with words and being hungry. strikes.

“They’re mismanaged and mismanaged in the community, obviously, and then they go to jail, and we’re just not equipped to give them the care they deserve,” Demory said.

State Rep. Sylleste Davis, R-Moncks Corner, said when Lewis and Demory asked for a special assignment, they told her recidivism was high among people with mental illness.

Lewis compiled the information he, Demory and Dorman had gathered — the program proposal, the cost breakdown, the data on mental illness among the prison population — to give to Davis. Davis in turn wrote a letter to Governor Henry McMaster asking him to consider giving state funds to the proposed program.

Davis said the effort had several goals: to reduce the number of people with mental illness going to jail and to help them get the help they need; improve the recidivism rate; and improve public safety.

Dorman said they began work almost immediately after the county received the funds in October.

With the funds, the Berkeley Community Mental Health Center provides two master’s-trained clinicians working 40 hours a week and one clinician working four hours each on Saturday and Sunday. The center also provides a psychiatrist working 12 hours a week to prescribe psychiatric medication.

As of November 29, clinicians had seen between 175 and 200 inmates.

Inside the detention center

Inside what was once a holding cell – the doors have been removed and the walls painted baby blue to add a friendlier vibe to this newly transformed office – two clinicians consult computer systems to see which inmates they are going to talk.

Clinicians receive an average of 10 referrals per day.

Stacy Keller, director of emergency and forensic services, said there are several ways for clinicians to receive referrals: through a database where inmates themselves can request to see a counsellor, a referral the medical team and the references of the detention officers.

Clinicians put all the information they need on a whiteboard: who they need to see, who’s on suicide watch, who’s in the hospital, and who’s going home. This way, it is easier for clinicians who come to the detention center the next day to pick up where previous clinicians left off.

Clinicians conduct a mental health assessment of every inmate they see.

They ask questions such as how the inmates feel, if they have had suicidal thoughts, what medications they take and if they have ever had counseling or therapy. Based on the responses, clinicians then determine whether the feelings are due to environmental issues they can help address or a mental illness that requires further involvement.

They had to work through the backlog of about 90 inmates who already needed attention before moving on to new inmates. Erica Shaw, one of the clinicians who works at the prison, said she was flipping through several pages of inmates waiting to see a clinician when she started.

Clinicians went through the backlog of inmates in 30 days.

When clinicians talk to inmates, it’s friendly and comfortable. It’s more like a conversation between friends than a clinician assessing their mental health. Between questions about suicidal thoughts and the drugs the inmates are taking, jokes and stories are exchanged between the two.

Demory said having such care for the inmates was unlike anything he had ever seen inside the detention center.

“Apart from the only two hours of psychiatrist time, we’ve never had nearly 80 hours a week of master’s-level clinicians working with these inmates,” Demory said. “We’ve never had a master’s level mental health clinician in the prison, working with the prison population for a certain number of hours a week.”

Keller said she has already seen a positive impact.

“There was this tendency for residents to say, ‘I don’t feel safe’ and stuff to get put in a solitary cell so they could have a break and their own bed,” Keller said. “In the first month (of the pilot program), it was reduced easily. We were able to ask questions such as “Is this a security issue? or ‘Do you need a break?’ because if so, let’s help each other in another way. (Being put in solitary confinement) is for emergencies. This is not a vacation spot. »

Part of the pilot program includes follow-ups when people are released from prison. Prior to the program, Dorman said the mental health center never knew who was in jail and who had been released, and in turn acknowledged that inmates were unaware that the mental health center was still a resource that they could use after their incarceration.

Now clinicians keep a list of those who have been discharged, as well as who they remain in contact with and who they have recommended to come to the mental health center for follow-up.

Dorman gave an example: A newly incarcerated detainee was held in the detention center under a court order and began receiving mental health services. The prison mental health center team then coordinated and facilitated discussions with the court, the inmate and the lawyer to develop a follow-up treatment plan after his release.

“The inmate was released and immediately assigned to a BCMHC therapist and psychiatrist,” Dorman said. “I’m confident that will happen more in the future.”

Dorman said the mental health center will soon provide transportation to drive newly released people to the center from their homes.

Follow-up also includes helping newly released inmates find jobs, Dorman said. The Mental Health Center has three employment specialists who find employers who do not withhold people from incarceration, as long as the Department of Mental Health is involved in the process.

Looking forward

Although there are only two months left in this program, Lewis said they will reapply for the funds for next year and hopes lawmakers see it as something worth pursuing. .

Dorman said a year might not be enough time to gather enough data to see the difference in recidivism. It could take up to five years to come to a conclusion. In other respects, the program looks promising.

Those involved believe it will be successful. Davis, Lewis and Demory all hope the program will be replicated statewide.

“I have great confidence in our ability to make a difference,” Davis said.

Keller said she was also hopeful about the work clinicians do in the detention center and believes the compassion they show to inmates while they work has a positive impact on the mental health of prisoners. detained.

“There is a lot of judgment about why people are in jail. For these people, they carry that here with them,” Keller said. “When they have this opportunity to get – sometimes for the first time in many years – regular medical care, mental health care, and they are treated like a human being when they arrive, it makes a huge difference. I hope this will help in their rehabilitation.