Kadner: Cook sheriff runs mental institution
By Phil Kadner firstname.lastname@example.org July 18, 2013 10:24PM
Updated: August 20, 2013 6:36AM
Cook County Sheriff Tom Dart is the keeper of the largest mental health facility in Illinois — Cook County Jail.
“We are all horrified by stories of state institutions for the mentally ill in the 17th and 18th centuries,” Dart tells me before a tour of the jail Thursday. “It seems so barbaric now.
“Well, today we put people in jail, 50 to a room, and have them watch TV all day. Is that progress? Most of these people shouldn’t be here.”
Last year, the state closed the Tinley Park Mental Health Center for financial reasons, and more cuts have been made to funding for social service agencies that provide treatment programs and support for mentally ill individuals.
So more of them end up on the street. They commit crimes, often of a petty nature.
And they end up in the county jail.
Of the 10,000 people incarcerated at the jail, the sheriff’s department estimates that at any time between 25 and 35 percent (about 3,000) are suffering from a mental illness.
“And when we send them back onto the streets, there’s no program to get them help,” Dart said. “We wave goodbye, shout ‘Good luck! Have a nice day. And don’t forget to put on your clothes.’”
Frustrated by the inhumanity of a system that he’s certain “people will someday look back at in horror,” Dart has instituted a number of programs at the jail to get mentally ill people the help they need.
One of the first things he did was hire Elli Petacque Montgomery, who had been a director at two large psychiatric hospitals, creating the position of deputy director for her in his office.
Each day, Montgomery, with the assistance of a part-time employee and an intern, screens about 200 people who arrive at Cook County Jail and are placed in holding pens awaiting a bond hearing.
Dart and his staff allowed me to observe the process Thursday morning.
One by one, Montgomery calls out numbers assigned to each person, and they step forward to the fence of the holding pen.
She asks them what crime they are charged with, if they have a history of mental illness, where they have been treated and by whom.
A detainee tells her he was arrested “for possession.”
“Of heroin?” she said.
He nodded in the affirmative.
Montgomery later tells me that’s a key indicator of mental illness.
This detainee is pretty typical, she said. He lost his job, his Medicaid coverage and could no longer obtain his medication.
The man tells me heroin is the only thing that will “keep me from hearing my voices.”
“It’s very common for mental patients to self-medicate when they can’t get their prescription drugs,” Montgomery said. “Heroin is often the drug of choice for schizophrenics.”
She does her best to keep the interviews private in a raucous setting by telling the detainees to step closer to the fence and to her when she asks them about their mental health.
“When we find someone who has a history of mental illness, we notify the public defender’s office,” Dart said.
“If they’re here for some petty offense, and many of them are, we want to get them into a treatment program and out of the jail as quickly as possible. Unfortunately, not all the judges are cooperative.”
Montgomery tells me that on this day she identified nine of 13 new women detainees as suffering from a mental illness.
“A lot of times, I know the doctors who have treated them or the facilities they have been in, so I immediately know they’re telling the truth about their history,” she said. “After you’ve done this for awhile, you can often identify the people with mental illness just by looking at their behavior (in the pen).”
After the holding pen evaluation, Dart escorts me to Division 2 of the jail, a cell block where many of the mentally ill detainees are housed awaiting trial. They are also assigned to Divisions 4 and 10, and some in Division 9 and at Cermak Hospital, the jail’s medical facility.
Some of them are sleeping in bunk beds, wrapped up in blankets as if in cocoons. More are sitting at long tables watching the TV, with soap operas seemingly the choice of the day.
Each slowly walks up to Dart to tell his story, often asking for some small favor (“I need underwear” or “I can’t get through by phone to my wife in Alabama”).
One 27-year-old man calmly relates his story to Dart and myself.
The father of five said he was working two jobs, had traveled to the Southwest Side one day to donate blood and suddenly found himself in a strange home.
“I thought it was my auntie’s home,” he said. “It looked just like it.”
He broke a window, crawled through the broken glass into the house and went to a bedroom, where he got in the bed and started watching television. That’s where he was found when the homeowner returned.
“I didn’t know where I was or how I got there,” the man said, adding that he suffers from bipolar disorder and schizophrenia.
“I just want to go back to work,” he said. “I go to work every day and take care of my kids. That’s what a man’s supposed to do. I need to get into a (mental health) program.”
I asked Dart what it cost taxpayers to keep mentally ill people in the jail and he shakes his head.
“That’s one of my frustrations,” he said. “I can’t get an answer to that question because Cermak Hospital is run by the (Cook County Health and Hospital System). I’m one of two sheriffs in the country, as far as I can determine, that does not hire the provider of health care services in his jail.”
Dart said the doctors are “terrific,” but the bureaucracy is “awful.”
He would like money to create a separate unit at the jail for the mentally ill, to establish case histories to track their progress after they are released and for more support for his reform efforts.
But that’s not likely to happen.
“The Legislature certainly isn’t going to do anything,” Dart said.
So we put the mentally ill in jails and prisons and forget about them.
We’re willing to pay the price for that. Heck, we don’t even ask what it costs.