Katie Alderson, the mental health alternative coordinator at Cascade Mental Health, left, and Ann Harrie, a deputy prosecutor in Lewis County, pose for a portrait at the Lewis County Law and Justice Center in Chehalis on Friday afternoon.
A Lewis County program designed to keep non-violent, mentally-ill offenders out of jail is getting rave reviews from criminal justice and mental health agencies.
It has now attracted the attention of researchers from the social work program at the Tacoma campus of the University of Washington.
“There’s at least four different names, specific people who have been cycling through the jail for the past 18 months,” said Kevin Hanson, chief of the Lewis County Jail. “At least three of them are living in our community now. They’re out of jail and they’re productive members of our community. It is absolutely amazing when you see someone who has turned their life around.”
Assistant professors Jerry Flores and Janelle Eliasson-Nannini, of UW-Tacoma, plan to begin studying the program in detail beginning next month.
“Personally, I’m hoping to assess the effectiveness and the cost and benefits of doing this mental health alternative because it’s unique to other programs that are out there,” Eliasson-Nannini said. “By doing that we can be able to create an example or kind of a template for other communities to implement.”
The Mental Health Alternatives program has existed in test stages since 2013, but officially began accepting clients in a full capacity two months ago, said program coordinator Katie Alderson, of Cascade Mental Health Care. The program’s annual budget is about $96,000, funded from Lewis County’s one tenth of 1 percent mental health and substance abuse sales tax.
The agencies involved — including the Lewis County Sheriff’s Office and Jail, Prosecutor’s Office, Superior Court administration and Cascade Mental Health Care — work to identify inmates at the jail with mental health issues. The program is one-of-a-kind, and was developed by the agencies involved, said Lewis County Prosecutor Jonathan Meyer.
If an inmate qualifies for the program, he or she is offered a chance to participate. Participation is voluntary. If the inmate agrees, he or she receives a suspended jail sentence after his or her conviction.
Case managers from Cascade Mental Health Care then help the person get access to a variety of services including health care, public transportation, food stamps and others.
The participant is required to check in regularly with case managers and follow other conditions of their release. Care from case managers and the conditions vary from person to person.
“It’s a one of a kind program,” Flores said. “By providing people with mental health and drug addictions more individual attention … you’re going to help them spend less time behind bars.”
If a participant does not meet the conditions of the program, they face sanctions, such as jail time.
On average, mentally-ill offenders spend two-thirds more time in jail than their peers, Hanson said. Up to 43 percent of Lewis County Jail inmates self-report an unmet need for mental health services.
“It just seems for the last 10 years it’s getting worse and worse and worse,” he said.
When Hanson started working at the jail in 1991, seeing an untreated mentally-ill inmate was a rarity, he said. Now, it’s a daily occurrence.
Meyer said he and other stakeholders started discussing the problem soon after he was elected.
“It grew out of this frustration,” he said. “It started with a guy who was in custody for 18 months and we hadn’t even gone to trial.”
County staff spent the majority of that time working with mental health professionals to stabilize the inmate so he would legally be competent to stand trial. Meyer said the man likely spent more time in jail waiting for trial than he would have been sentenced to for his alleged crime.
The challenge is not unique to Lewis County.
“That’s where the untreated mentally ill end up,” said J.P. Anderson, a mental health counselor at Cascade Mental Health Care and one of the founding members of the program. “Our county looks like a lot of Washington, especially east of the mountains.”
Anderson noted that the issue was recently addressed in the Trueblood v. Washington State Department of Social and Health Services case heard in the U.S. District Court in Seattle.
In the case, plaintiffs argued that defendants in criminal cases were spending too much time in city and county jails awaiting mental health services.
“Our jails are not suitable places for the mentally ill to be warehoused while they wait for services,” wrote U.S. District Court Judge Marsha J. Pechman in her findings of fact on April 2. “The state of Washington is violating the constitutional rights of some of its most vulnerable citizens. The State has consistently failed to provide timely competency evaluation and restoration services, services needed to determine whether individuals understand the charges against them and can aid in their own defenses, which is required in order for them to stand trial.”
Pechman ordered the DSHS to provide in-jail competency evaluations within seven days of a court order.
Lewis County officials first contacted the University of Washington while applying for a $200,000 U.S. Department of Justice Grant for mental health programs. The grant would require detailed statistical analysis of the Mental Health Alternatives program, Hanson said.
“The pieces of it all kind of fell together at the same time,” he said.
Agencies involved in the Mental Health Alternatives program hope the UW researchers will both validate and improve the program.
“I want to know from an outsider what we’re doing is working,” Meyer said. “We want to make sure we have the best program.”
In the long term, the program could become a model for other agencies.
“If this program works, I want to see other counties do it,” Meyer said. “If others can benefit from what we’re trying to do here, great … There’s no personal pride at stake, there’s no egos.”
Eliasson-Nannini and Flores said this attitude is partly what attracted them to the program.
“We are more or less going to get unfettered access to our participants,” Flores said. “Lewis County — they sort of sought us out, they wanted to work together. The access we’re getting is really unheard of.”
Flores said he became interested in researching mental health in jails after writing a dissertation on young, incarcerated women. Eliasson-Nannini teaches a course on mental illness in the criminal justice system.
“We do a lot of talking on what can we improve, what are the challenges, but it’s so rare to actually be able to make a change,” she said. “You don’t see that, and we can really learn a lot in addition to benefiting Lewis County. In terms of research you really want to be able to get this early access.”
The researchers have slightly different techniques. Flores said he prefers observing his subjects firsthand and collecting qualitative data, while Eliasson-Nannini described herself as more methodical and focused on quantitative, or numerical, data.
“It’s exciting to think about the recommendations they can make,” Anderson said.
The data they collect could help improve Lewis County’s program, but it could also reveal information about mental health and criminal justice in rural communities throughout the country, Flores said.
“In the United States, we forget the most people live in rural areas. The big cities get a lot of attention,” he said. “Most people still live in rural areas. I think the findings we create are going to be able to speak to a large part of the population.”
Flores said he hopes their findings can impact national policies over time.
“At the very least we can start with creating findings that are relevant to the county we’re working,” he said.
The researchers will begin their work in September, and plan to spend at least a year studying the program.
“Janelle and I are sort of hashing out all of the measurement tools we’re going to use,” Flores said. “We’re going to produce high-caliber, rigorous research the follows the scientific method — that is our goal. It’s also going to give us all a sense of legitimacy.”
Even without the results of the study, stakeholders in the program say it’s working, and has brought together a diverse group of people to attempt to influence the criminal justice system for the better.
“This issue has most people on the defensive,” J.P. Anderson said. “We kind of put each other on the defensive for a while, but now we’re on the same side playing offense.”
