Why Mental Health Matters

More than 40% of inmates at the Orange County Jail in Orlando, Florida, have some sort of mental health diagnosis. It’s not a statistic the department takes lightly. And it’s not a figure unique to Orange County.

According to the National Association of Counties (NACO), an estimated 2 million people with serious mental health disorders are booked into county jails each year. NACO says the pervasiveness of serious mental conditions in jails is three to six times higher than the outside community.

All across the country, corrections professionals struggle with the challenges of running jails, which are complicated operations even without the difficulties associated with managing mentally ill inmates. Our populations show up at all hours. Many offenders lead extremely disorganized lives—but the moment they enter the jail, we become responsible for their well-being. Suddenly we are confronted on the spot with determining how securely to house them and whether they need medical or psychological care.

Jails now shoulder the brunt of the nation’s mental health crisis. According to the Mental Health and Justice Partnership at the Pew Research Center, people with mental health conditions—including bipolar disorder, schizophrenia, and severe depression—are jailed more than 2 million times each year across the nation, often for misdemeanor crimes.

A 2014 State Survey by the National Institute of Corrections reported that the number of individuals with serious mental illness in jails and prisons now exceeds the number in state psychiatric hospitals tenfold. Surely today, nearly 10 years later, that number has grown exponentially.

With the mental health crisis continuing to escalate, Orange County Mayor Jerry L. Demings commissioned a Mental & Behavioral Health System of Care Community Analysis. Not surprisingly, the findings showed jail is the last place these individuals should be housed. Instead, providing treatment in a therapeutic environment is a more effective intervention.

While there is no shortage of challenges, the Orange County Corrections Department (OCCD) has worked diligently to make improvements on the mental health front. OCCD launched its “New Start” mental health program at its Main facility in February 2022. The New Start program curriculum covers cognitive behavioral change, communication, and anger management, among other topics. The unit is committed to rehabilitative programming, increased socialization opportunities, and blunting some of the harsher conditions of restrictive housing. New Start works to stabilize inmates while in custody and connect them with tools and resources to succeed upon release.

The Treatment Advocacy Center, a national nonprofit dedicated to making treatment possible for severe mental illness, says approximately one-third of individuals with severe mental illness have their first contact with mental health treatment through a law enforcement encounter. That is a sad fact. Also sad is that the Orange County Jail is Central Florida’s largest mental health provider.

Given this reality, OCCD is dedicated to ensuring correctional officers working in mental health units receive specialized mental health and suicide prevention training. Roughly a third of OCCD staff have completed the Crisis Intervention Training, a 40-hour curriculum that covers techniques to calm, contain, control, and de-escalate individuals experiencing a mental health crisis.

In June of last year, OCCD hosted a Community Resource Fair to assist recently released inmates, offenders on community supervision, and the homeless. More than 40 community resources participated in the fair, including the National Alliance on Mental Illness (NAMI), the Urban League, United Against Poverty, and the Florida Restoration Rights Coalition. The fair’s intent was to assist people who are down on their luck or who need a little boost and to provide them with help for a more stable environment, including mental health counseling, employment, educational resources, and affordable housing.

Matt Wiskow, a Security Administration Sergeant at the Lane County Sheriff’s Department in Eugene, Oregon, says that the agency has had to adapt to dealing with more inmates with mental illness and more severe mental illness. “Five years ago, we developed a sergeant position that we call the Mental Health Sergeant. The sergeant works with our mental health staff, the state hospital, the courts, the public defender’s office, and various community partners,” he said.

Sergeant Wiskow said Lane County had to adjust its approach and started the program based on a need. “We were seeing the trend toward a higher population of folks in custody with Severe and Persistent Mental Illness (SPMI) and a lack of resources for us to manage this population,” he said.

In speaking with corrections professionals from agencies across the country, Sergeant Wiskow said the prevalence of inmates with SPMI is becoming more common. “It has been a great benefit in cultivating relationships with community organizations and developing our inmate wellness program.”

Lisa Graham, Health Services Program Administrator with Corrections Health Services in Orange County, can relate and says jails lack the capacity to satisfy the current demand for mental health services. “We currently do not have enough crisis stabilization beds for our acute mental health inmates,” she said.

Graham said county jails are often ill-equipped to handle the treatment needs of people with severe mental health issues, and incarceration can actually exacerbate these conditions. She said the community also plays into the equation since there are not enough inpatient and residential homes for acutely ill patients with criminal histories. On top of that, Orange County—like so many jails—is dealing with staffing shortages, as many licensed clinicians prefer to telework from home.

The Orange County Jail is the fourth largest jail in Florida, with an average daily population of 2,357 in 2022. It’s also a frequent landing place for many people in the midst of a mental health crisis, and we often see the same familiar faces cycle through repeatedly.

Most states are dealing with burgeoning numbers of people with mental illness in jails, and this is precisely why the American Jail Association (AJA) is making mental health a top priority. Legislators have the power to convene the necessary stakeholders to advance new approaches for handling individuals with mental illness. AJA will continue to support and champion legislation to change the way we think about and use jails in America. Louis A. Quiñones, Jr., CJM, CCE President American Jail Association