Questions are being raised over a plan to add hundreds more mental health beds at an Orange County jail.
“By default, the Orange County jail has become the de facto mental hospital of Orange County,” Sheriff Don Barnes said just before supervisors unanimously approved the overall strategy plan, known as “integrated services.”
“If we’re going to be the mental hospital of Orange County, we’re going to be a good one,” the sheriff said, adding that one in three people jailed in Orange County have a “daily nexus” to mental health treatment.
Last year, the county’s jails had about 2,200 inmates with severe mental illnesses and 7,000 inmates with mild to moderate mental illness, “who have cycled through the jail like a revolving door on a continual basis,” Barnes said.
“When we look at our criminal [justice] system and our jail, we have to see it beyond… incarceration. We have to see it as opportunities for treatment,” said Supervisor Andrew Do.
Yet there was no discussion of how much money would be devoted to the plan or how many doctors or nurses would be treating inmates. Answers weren’t provided after the meeting either in response to questions from Voice of OC.
The full county plan for the jail mental health changes is 69 pages long and does not include the words doctor, nurse, psychiatrist, or psychologist. It mentions deputy sheriffs 28 times, largely in reference to providing deputies with additional training about mental health and substance use disorder.
Critics said the plan will further exacerbate the use of jails as mental institutions, and called on supervisors to instead invest in community-based mental health treatment.
“There is no question that Orange County continues to face a severe shortage of mental health treatment beds in the community. If the goal is to keep people out of jail, money must be invested in community-based alternatives and solutions, rather than in building 896 new jail beds,” said Daisy Ramirez, a jail reform advocate with the American Civil Liberties Union of Southern California.
Referring to public comments last week by Supervisor Andrew Do that people with mental illnesses are “languishing in our jails,” Ramirez added: “Employing the language of advocates and activists does not mean anything if it is not followed by action and financial investments in prevention and diversion options.”
“Expanding the [jail] system does not do away with the problem of jails becoming de facto mental health institutions. It makes it worse.”
Ramirez called on supervisors to halt the jail expansion until they’ve studied alternatives.
Huntington Beach resident Gianni Castellanos also criticized county supervisors for dressing up more jail beds as an effort to provide treatment.
“On Aug. 13, the Board of Supervisors approved a $300,000 settlement to a former jail nurse who alleged that a sheriff’s deputy prevented her from treating an inmate, and then warned her not to tell anyone,” Castellanos said, referring to a settlement with former nurse Jennifer Westfield.
The county plan does not say how much money will be devoted to it, and officials listed its “financial impact” as “N/A.”
Officials do not plan on releasing information about costs and the physical environment of the mental health beds until a later, unspecified date.
The plan calls for adding 177 health workers at jails at some point in the next five or six years, but officials didn’t have answers Tuesday about when they would be added and what types of health workers they would be.
Much of the jail mental health plan involves adding 800-plus jail beds, which officials term as mental health and substance use disorder treatment beds, at the Musick jail between Irvine and Lake Forest. The expansion is a major part of a $167 million expansion of the facility that will add 896 beds.
The integrated services plan also calls for training all sheriff’s deputies in mental health crisis intervention.
Do pushed back against the critics, saying it’s not supervisors who decide who goes to jail and for how long, but the courts.
“Maybe a little bit of Constitutional Law 101 is necessary. The court is an independent arm of the government,” Do said of the public speakers.
“All we can do is – when they are in custody, that we provide the best services we can. So don’t come here and preach to us about, somehow incarceration is not the right model of care,” Do said.
“We have no control over it. And if one comes here to purports to try to tell us how to do a better job – well, try to understand the system a little bit better before you make recommendations.”
What Do did not mention is that county supervisors decide what types of mental health infrastructure and services to build with tax money.
And Orange County has courts specifically focused on diverting people with mental illnesses into treatment outside of jails, though OC faces a severe shortage of community-based mental health beds.
“Based on the current population of Orange County we should have about 1,500 psych beds. And we have less than 100,” the supervisors’ chairwoman, Lisa Bartlett, said three years ago.
As of last year, Orange County was short by 1,586 psychiatric beds, according to the California Hospital Association.
Nick Gerda covers county government and Santa Ana for Voice of OC. You can contact him at ngerda@voiceofoc.org.