Crowded hospitals leave mentally ill inmates in jail

State hospitals lack space, budget to meet demands

Jerry Kimble should be in a mental hospital.

The doctors who examined him say it. The attorney representing him and the assistant district attorney assigned to prosecute Kimble believe it. So does the judge who signed the order committing him.

But Kimble, who suffers from paranoid schizophrenia and bipolar disorder, remains in a Richmond County jail cell, despite the order signed a month ago today by Judge Carl C. Brown Jr., committing him to a mental hospital.

Kimble is not alone. Across Georgia, 184 men and women who have been deemed mentally incapable of standing trial are locked in jails for weeks and months because there isn't enough room in the state's seven mental hospitals.

"That's what jails have turned into -- mental hospitals," said Richmond County sheriff's Maj. Gene Johnson, who oversees the county's overcrowded jail.

Kimble is one of a dozen men in the jail who shouldn't be there because a judge has ordered their commitment. In fact, once a doctor determined in the spring that Kimble was incompetent to stand trial, he should have remained in the hospital instead of being shipped back to the jail, said Susan Jamieson, of Atlanta Legal Aid. Jamieson is an attorney who works for indigent mentally ill people to help them with treatment issues.

"It's totally illegal and contrary to the Americans With Disabilities Act and state law," Jamieson said of the practice of leaving mentally incompetent people in jail cells.

The state is required by law to treat Kimble and every other person in Georgia in the same circumstances, Jamieson said.

The state is responsible, but the state's Department of Behavioral Health and Developmental Disabilities, which controls Georgia's mental hospitals and treatment options, has a limited budget, said Tom Wilson, the department's spokesman.

Across the state, there are only 600 spaces for people such as Kimble, who needs to be in a forensic ward, Wilson said.

"They stay pretty much full," and there's a waiting list, he said.

The department could expand the number of spaces in the forensic wards, but that means more money, Wilson said. Georgia's lawmakers have slashed the state budget repeatedly in the past two years, sparing only Wilson's department the last time, he said.

The department has been focused this past year on improving conditions inside the state's mental hospitals in an attempt to stay ahead of a federal lawsuit the U.S. Justice Department filed against the state, the governor, the commissioner of the Department of Behavioral Health and Developmental Disabilities, and the commissioner of the state's Department of Community Health.

The lawsuit alleges that the treatment and safety of patients is so poor that it violates the U.S. Constitution's protective clauses meant to keep all Americans safe.

Federal and state attorneys announced in January 2009 that they had negotiated a settlement agreement, but mental health advocates opposed such a quick settlement without more investigation. The Justice Department continued to track the state's treatment of mentally ill and disabled people and on Jan. 28 asked the judge for permission to amend its complaint. On July 1, Georgia's attorneys fired back, claiming the Justice Department was trying to change the terms of the negotiated settlement and ignoring the three-year window the state had to make the necessary improvements.

Kimble and other inmates like him have been left out of all those discussions and legal maneuvering, said Jamieson, whose clients are most often trying to get out of the hospitals because they believe they no longer meet the requirements for hospitalization.

Poor, incarcerated, mentally ill people fall to the bottom of the barrel, she said.

Off their meds

Kimble's mother, Linda Curry, has been beside herself with worry and frustration.

His symptoms first developed around the age of 15. He ended up in a hospital in such bad condition that doctors told her he would never be well enough to leave. But she and her husband worked constantly with Kimble, and his doctors finally agreed to let him return home with two medications, one if which cost $1,500 a month, Curry said.

Her son was like many young adults with schizophrenia. He didn't want to take the medicine because of the side effects, she said. He was off his medication on Sept. 20 just after midnight when he was nabbed outside a burglarized home on Woodlake Road. The deputy at the scene caught his brother, Izale Kimble, coming through a broken rear window. Both were arrested.

Curry said her son went without his medication for three months while in jail. In a paranoid state, he attacked another jail inmate in December because he believed the man was making sexual advances, Curry said. Kimble now faces an additional charge of aggravated assault. He was sent to the hospital, where he was stabilized with the proper medication, Curry said. But once stable, he was shipped back to the Richmond County jail.

When asked about the incident, Johnson said federal law prohibits any release of inmate medical information.

It's like a revolving door with mentally ill inmates, he said. If an inmate has an extreme episode, the person can be taken to a hospital emergency room. But the inmate will be medicated and sent right back as soon as he's stable, Johnson said. "It's a never-ending battle for us."

Waiting list

Todd Snyder, 50, has been in the county jail for nearly a year. He was accused of burglary and arrested after an officer on routine patrol was flagged down. Someone was in the closed Ming Wah Restaurant on Baker Avenue just before 1 a.m. July 27. The deputy saw Snyder, who was homeless, step out of the front door, according to the incident report.

On Jan. 6, Judge Sheryl B. Jolly signed an order that should have meant Snyder's immediate hospitalization. But Snyder was still in jail this weekend.

Johnson said he would like to get mentally incompetent people out of the jails, but once a judge signs the commitment orders, he cannot release them to anyone but the mental hospitals, he said.

It costs Richmond County taxpayers $47 a day to house an inmate, Johnson said. Right now, he has 12 inmates deemed mentally incompetent waiting on beds in the mental hospitals. Thirteen other inmates have been evaluated and are awaiting reports from doctors. Six others are at hospitals.

Wilson said lack of space isn't a new problem in the state. There have been waiting lists for a number of years.

There are some proactive steps the behavior health department wants to take, he said -- working with those in the criminal justice system to speed up legal proceedings that would help move patients through the hospitals faster, and establishing diversion programs such as mental health courts.

Judge James G. Blanchard Jr., who presides over the Augusta Circuit's drug court, hopes to start a mental health court. He was impressed with a recent visit to the Savannah mental health court, he said.

"The jails are not intended to be hospitals," Blanchard said.

The great thing about drug court is the ability to get these people through the system faster, get them stabilized on medications and established on a monitoring system, he said.

Georgia mental hospitals

- East Central Regional Hospital (Augusta)

- Southwestern State Hospital (Thomasville)

- West Central Georgia Regional Hospital (Columbus)

- Central State Hospital (Milledgeville)

- Georgia Regional Hospital (Atlanta)

- Northwest Georgia Regional Hospital (Rome)

- Georgia Regional Hospital (Savannah)

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