The reality is that most jails across the country now hold more mentally ill people than hospitals.
According to Mental Health and Justice Partnerships 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.
The National Alliance for Mental Illness (NAMI) believes all people with mental health conditions who are incarcerated deserve access to quality mental health treatment. NAMI supports public policies and laws that expand and improve access to mental health care within prison and jail settings.
“The unfortunate truth is that despite improvements over the past 30 years, the correctional system continues to struggle to meet the vast needs of the increasing number of inmates with mental health conditions,” says Thomas Fagan, PhD, professor emeritus at Nova Southeastern University in Florida and a former administrator for the Federal Bureau of Prisons.
In the Orange County Jail (the fourth largest jail in Florida with an average daily population of 2,377 in 2021), more than 40% of inmates have a mental health diagnosis. In other words, 4 out of 10 inmates in the jail are suffering from a mental illness. “This is a significant amount of inmates in our custody,” said Orange County Corrections Chief Louis A. Quiñones, Jr. who is a longtime advocate for mental health.
Fortunately, a new effort is underway to get this underserved population the help it needs. Called “New Start,” this mental health program began operating in the main facility at the Orange County Jail at the end of February 2022.
Delivering a New Program Working with the local chapter of NAMI and other groups to provide a strong base of support for recently released inmates, the New Start program is designed to lead inmates down a pathway from hardship to healing. “Our goal is to return inmates to the community in a better state than when they came to jail,” says Chief Quiñones. He believes New Start is a step in that direction.
Senior Community Corrections Officer Rosanna Fajardo, who plays a lead role in the program, couldn’t agree more. “By providing a well-structured and safe environment for this group, they are able to establish positive behaviors, communication skills, and beneficial ways of thinking in order to succeed upon their release,” she said.
The New Start program and unit are managed by qualified program staff in collaboration with Corrections Health Services, mental health specialists, and peer-support specialists. Their mission is to provide medication management, education, support, and guidance to Max II and High Medium male inmates who are cleared from sub-acute mental health units. This unit is managed by correctional staff who have received Crisis Intervention Training, which improves communication, identifies mental health resources for those in crisis, and ensures officer and inmate safety.
Addressing Behavior Issues Because of their impaired thinking, many inmates with serious mental illnesses present behavioral management problems. Providing them with sufficient structure and consistency is key to their success. And removing them from the general population lessens the chance of them being bullied by other inmates. Furthermore, the New Start unit is located in close proximity to the jail’s onsite Medication-Assisted Treatment (MAT) clinic. Many of these inmates struggle with substance abuse as well as mental illness.
Support From the Mayor
Unlike most county jails, the Orange County Jail does not fall under the sheriff’s office and is governed by the Board of County Commissioners. “Here in Orange County, we are fortunate to have a mayor who is a strong advocate for improving mental and behavioral health care,” said Chief Quiñones.
According to Orange County Mayor Jerry L. Demings, who served in the past as the Orlando Police Chief and Orange County Sheriff, incarcerating mentally ill people is costly and increases the likelihood they will be back. The goal is to get them to treatment instead. He says, “Providing treatment in a therapeutic environment is more effective in reducing recidivism and the rate of incarceration.”
Mayor Demings recently spearheaded an eight-month-long effort that culminated with a comprehensive report titled Orange County Mental and Behavioral Health System of Care Community Analysis. Five committees—looking specifically at the continuum of care; advocacy; business and philanthropy; criminal justice; and homelessness and housing respectively—received stakeholder input on the allocation and adequacy of behavioral health services and programs, and provided recommendations to increase and enhance service delivery. The committees also focused on funding needs and the prioritization of funding.
New Start is part of an overall emphasis on mental health. To learn about the comprehensive report, visit ocfl.net.
The New Start program curriculum covers cognitive-behavioral change, communication, and anger management among other topics. Up to 24 inmates can participate in the program at a time.
In addition to traditional medical, psychiatric, and addiction treatment, creative arts therapy is also offered. This consists of a booklet with activities for the inmates to monitor their habits, moods, and thoughts, and to write journal entries to spark creativity. To encourage mindfulness, the jail is currently looking to add yoga and meditation training to the curriculum.
Another notable statistic of the Orange County Jail is that approximately 66% of use-of-force incidents at the Orange County Jail involved mental health inmates. It is anticipated that with the New Start program in place the jail will see a decrease in the amount of use-of-force incidents.
Providing Connections A critical component of the program is that it provides inmates with individualized case management and connections to services within the community once they are released. “We definitely don’t want these inmates returning to jail, and linking them with resources for success is one more way to assist them in making a new start,” Officer Fajardo said.
With being connected to helpful community resources, former inmates have an increased chance for successful reentry into the community along with a possible decrease in hospitalizations and homelessness. New Start endeavors to create a life plan for inmates that enables them to exist in the community without posing a threat to public safety, others, or themselves.
Partnerships are a critical component of the program and the Orange County Jail works with the local chapter of NAMI and other groups to provide a strong base of support for recently released inmates. Program staff also work to reunite the newly released inmates with family members and other loved ones.
Chief Quiñones says the program works to stabilize inmates while in custody and connect them with tools and resources to succeed upon release. New Start also offers hope and promise for current and soon-to-be-released inmates so they can become productive contributors to society.
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Tracy Zampaglione, APR, is the Public Information Officer for the Orange County Corrections Department in Orlando, Florida. She can be reached at Tracy.Zampaglione@ocfl.net.