Broken lives, broken system - behind bars

There's a mental health crisis in this country that's been developing over decades. With treatment centers closing, more and more mentally ill people end up in jail, prison, or in the local hospital emergency room.

Jails and prisons don't just cost the public a lot more money, they actually tend to exacerbate the problem with the mentally ill.

They have no windows. There is no therapy. And they are filled with criminals. Jails make the situation worse.

By some measures the problem in Minnesota is actually worse than it is nationally. According to the latest information from the Minnesota Psychiatric Society there are 28 'mental health' beds across this country for every 100,000 people. In Minnesota, we have little better than half that - 17.

Fewer mental health beds means more people on the street and ultimately in our jails and prisons.

Watch Part One of this report about Police and the Mentally Ill.

At the Ramsey County Jail last month, we witnessed scenes you don't see every day.

We spent several hours over two days with 36-year-old Kelly Sauer - an inmate and a patient.

He doesn't remember much about the theft that put him here. But when he tells you 'the voices made him do it,' he is credible.

"When I'm off my meds," he told us, "I don't remember a lot of things. I go through blackouts, I hear voices. I see people that aren't there. After hearing the voices over and over and over and over, you just do what they say. You don't even think about it."

Kelly is schizophrenic. The voices, he says, have told him to kill himself since about the age of 13. He's tried repeatedly. When the voices tell him to leave - he does that too.

"I've woken up and been in Nebraska. I've been in Las Vegas," he says. "I just wake up and I'm there. I don't know how I got there, I don't remember."

When asked if he's ever hurt anyone, he tells us, "No, I've always hurt myself."

By his own count this is his 20th incarceration. He'll face commitment to a mental hospital this time - at least for a few weeks. He's hopeful he'll get more help. But Kelly knows the system for dealing with people like him is broken.

In our week inside the Ramsey County Jail we watched person after person come in, identifying themselves as mentally ill. Jailors are now required to ask "Do you have any mental illness?"

As jailers explain it, there's been an evolution of law on this subject requiring them to know if a person is mentally ill. And it's not enough to go with what they're told. They have to figure it out.

They hire psychiatrists to help them. As a matter of policy, the jails have to determine if the inmate should be medicated, and if so, what medicines would be best. They have to provide those drugs at no cost to the inmate and make sure they take the medication.

They don't always need a doctor to know they have a problem. While we were with them they put one man, Derrick Hutchinson, in a Kevlar suit. He's been here many times and jailers say they are often worried that he will hurt himself.

Hutchinson told us the voices he hears seem very real.

"I get all swooped like where the hell them voices coming from?!... What the hell?!... you know what I'm saying?" Hutchinson told us.

He says they don't tell him much they just "bug me to death."

Ramsey County Sheriff Bob Fletcher says he's stunned by the level of mental illness he sees in the jail. It's often said today, that the largest facility for dealing with people who are mentally ill in this country is the Los Angeles County Jail.

Jails, Fletcher maintains, are a lousy place for the mentally ill.

"It's not designed to treat persons who are mentally ill," he says. "Many in law enforcement resent the fact that the policy makers continue to expect us to be the final safety net."

The breakdowns here are almost overwhelming. Fletcher says we're clearly not taking care of this population to begin with.

We ask the mentally ill to take their medications when their mental illness often keeps that from happening. When they fail and they get in trouble, we put them in jail. Jailers say they're more likely to be victimized there. They sure don't get treatment.

In fact, the way it works in Minnesota, as soon as we put them in jail - while the jail will take over their medications - we terminate their healthcare altogether. So when they get out there's no access to medication, treatment or anything else.

Sue Abderholden, with the National Alliance for Mental Illness says, "If you were on Social Security Disability, that's been stopped. You have to get everything re-started. And you have to reapply for your healthcare. And that is a 36-page form."

Abderholden says it's more work for those least likely to manage it.

One way police have been trained to minimize this problem is to start taking these people directly to the hospital instead of the jail. That way, at least, their healthcare isn't canceled. This has led to hospitals being jammed with the mentally ill as well.

Dr. Beth Johnson is a psychiatrist at Hennepin County Medical Center. She says emergency departments are stuffed full of psychiatric and chemically dependent patients who "need to be seen and there's no place to put them."

At the new Acute Psychiatric Services Center at HCMC, where she works, they took 2,000 patients last year. The place only has eight beds.

On the day we arrived they were housing some in interview rooms, and more were waiting on gurneys in the general emergency room as well.

"It clogs up the system," Johnson says, "so we end up having a lot of patients on the street."

On the street and then often back in the jail, where the average hold is just four days.

Not only does this system not work, she maintains, experts say it's extraordinarily expensive.

Hard numbers can be impossible to obtain because they involve "patient" records. But a recent study of just two chronic recidivists at HCMC found taxpayers paid $2 million for the care of just two people over two years.

And in the end their mental illness didn't get better, it got worse.

By Rick Kupchella, KARE 11 News

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