TOMMY: I was hallucinating while I was in a jail cell. The worst thing they could have done to me, is keep away from medicine. It made me worse off than I was before. NEWS ANCHOR: Many of the country’s 3,300 jails have seen a rise in the number of inmates with serious mental illness. OHIO ANCHOR: Jails and prisons have become the last resort for those in need of treatment. KANSAS REPORTER: I think that jails and prisons are filling in the gap for services that people can’t get other places. REPORTER: Chicago’s Cook County Jail, the nation’s largest mental health care provider. BENJAMIN: Nobody cares about these people. They don’t have a voice. SEATTLE REPORTER: The King County Jail has become the largest facility housing people [with mental illness] in the entire state. KING COUNTY SHERIFF: Law enforcement’s being placed in a very, very difficult position when it comes to trying to deal with a what is really a health care issue. KIM: Jails don’t want to be psychiatric facilities and they shouldn’t have to be psychiatric facilities. They’re not meant to be psychiatric facilities, they’re meant to be correctional settings, and there’s all kinds of reasons why jails are not good environments, settings for people with mental illness AVID stands for Amplifying Voices of Inmates with Disabilities, and the AVID Jail Project goes into several jails here in King County [Washington] to monitor, do outreach, perform investigations and work more largely on the systemic issues that we see to try to make circumstances and treatment better for inmates with mental illness. KIM: At the AVID Jail Project we go into the jails roughly twice per week. Sometimes we go into group settings and speak with inmates in a dormitory setting. Sometimes more frequently we go cell front to cell front to speak with inmates who are in a segregated housing status. They are generally on 23 hour lockdown, very limited interaction with other human beings and limited ability to reach people. So, we will do rounds in those units pretty frequently. In doing our monitoring work in the jail, we’ve thus far identified bigger, broader, general issues, that we’re looking at more closely. The first of those is timely and effective access to psychiatric medications. RUBEN: I was brought into King County Jail May 6, 2015. My symptoms… hallucinations, nightmares, dreams, also hearing voices. When I got here, I let them know about my situation that I couldn’t, that I needed my medication, my psych [medication]. When I first met with them they told me straight out, blank, that they were not going to give me my medication for my voices, which is Seroquel. KIM: It wasn’t that they didn’t believe that he was prescribed this. They just disagreed with the dosage, and therefore refused to give it to him. RUBEN: The voices were coming back, a lot stronger. The more I fight that it’s a hallucination, that it’s not real… the more reality they become. It took them at least five days to… get me my Seroquel, my medication, that I needed for the voices. KAYLEY: Another serious concern that we have about the treatment of inmates with mental illness in jails is the overuse of segregation We’re seeing a lot of inmates with serious mental health conditions being confined in their cell, by themselves, for up to 23 hours a day. Often losing their hour out, so being confined for 24 hours a day. LYDIA: It was really hard. It was, you know, to be in your room all day. Not being able to have, you know, privileges, you know, and etc., knowing that other people in the facility are having those privileges like going to church, going outside, or going to NA [Narcotics Anonymous] meetings. I, you know, have bipolar, depression. Being locked down your cell, like, for 23 hours a day is like hard, you know. It’s just… it caused me like, to be emotional and stuff. RUBEN: I just ask people that don’t hallucinate, that don’t do that, just to think of themselves, about being in a room 23 hours a day. Like if your fantasy is a real world. Like… a production of a movie how real it looks, real… But in this case, it’s not a movie. It’s a reality of my life… that I have to deal with. KIM: One of the problems that we see pretty frequently is that there isn’t significant, or even sort of, minimal planning, release planning, for inmates who have mental illness. What does that mean? That means: Making appointments for them with outside providers. Connecting them to maybe resources and services that they already had in place. Working with their friends and family. Ensuring that they have some place to live. Ensuring that they are at least minimally covered by medical insurance. Ensuring that they have medication when they leave the jail, psychiatric medication that will bridge that gap until they can get to an outside provider. Things like that. In the course of doing regular monitoring at one of the jails, I met a young woman who was incarcerated at the jail for in the end, it ended up being two months. Um, it was difficult to engage with her given her symptoms of mental illness, but her mother contacted us and we worked pretty closely with her mother to try to help her mother contact the jail and advocate for her daughter. To just give her a sense of what the jail is like on the inside, since her mother couldn’t go where we were going to see her daughter. VIRGINIA: My name is Virginia Owens and I have a daughter living with mental illness. She was originally diagnosed with bipolar, and manic. She was locked up from March 22 to May 22. I just was concerned for her safety, number one and then, you know, her health. I know what she’s gone through. I know, you know what, just how she react, how she reacted, just prior to her coming into jail. MADISEN: I was really surprised when she first left the jail and she came out because like I’ve never seen her like that before. It was really scary like to see her, and it was sad because she was shaking, and she didn’t seem normal at all. Like, she seemed like worse. She was on her knees and she was crying. And she was just sitting in the same place just um, asking God why is this happening to her, over and over again. VIRGINIA: No one made a not one phone call to me about what they were going to do, how she was going to be released, what process needed to occur before releasing her. KIM: …and if those inmates have significant mental illness, very frequently, you seem them re-arrested shortly thereafter. We’ve continued to the monitoring work. We’ve started doing some more intense investigations at the jail, and looking into inmate records, and trying to get a better sense of these systemic issues, and with that information we are meeting with the jail officials and jail administration pretty frequently, I’d say every four or so months. Sitting down, bringing our concerns hearing their concerns, and those lines of communication are open all the time, but we try to meet with them on a more formal basis, I’d say, every four months or so. KIM: The hope is that we can bring these issues to their attention, and that they will recognize that there are some significant problems, and that we have common ground, and that that common ground is that a jail is not really an appropriate place for someone with significant mental illness, and if that person has to be in jail there need to be some protections, and care provided to those inmates, um and I think if we can come together on those basic tenets, we can go pretty far.