A California measure to reduce prison overcrowding reveals how America is, once again, failing some of its most vulnerable.
I am impregnating myself with the faith required to see Second Chance Alliance, The business God has given my wife and I visions of to come alive for the reason of this article. So many people who are not affected by veterans who are denied mental health and felons who are in need of housing and health care they don’t find compassion for these people. But my wife and I having had to suffer on both ends of this spectrum find it necessary to open a place that will empower disenfranchised people and homeless vets. We find it most imperative to help society help these people.
Please pray for us to get the funding and people who have skills to help us encourage, empower, develop and guide to hope that is everlasting and not just shubbing a pill down their throat without a support system of professionals and recovered individuals who have beaten the odds. That’s what we want Second Chance Alliance for.
When Lockinvar Jacobs stepped off the bus at L.A.’s Union Station last summer, he wasn’t quite sure where to go. The 49-year-old schizophrenic had just been released from state prison, where he’d done a five-year bid for felony drug sales. It wasn’t his first time getting out of the big house; he told me, when we spoke recently, that he’s spent between 16 and 20 years of his life behind bars for drugs and other nonviolent felonies, such as burglary. He couldn’t be sure of the exact number, he said, because the Haldol and other meds have clouded his memory. What he was sure about was that this last time, he was released without his medication.
Jacobs had less than 48 hours to report to a county probation officer; if he failed to appear, he could face “flash incarceration,” meaning he’d get tossed into L.A. County Jail for a week or two. California prisons provide up to $200 gate money for release-es, but Jacobs needed clothes before he left the prison, for which the state had charged him $43. With $157 left over, his first stop would be a Skid Row shelter he knew well. There, he was told the probation office was several miles and city bus rides away. His cash didn’t last long. “I wasn’t very smart at handling my money,” he told me, a coy smile lighting up an otherwise hangdog expression. But he was able to report on time.
At the probation office, an on-site Department of Mental Health worker gave him a referral to a doctor but no medication. Like approximately half of those who get a mental health referral from DMH, Jacobs didn’t make it to his appointment. Without his meds, he had one of the “nervous breakdowns” he’s been experiencing since the 10th grade, some of which have required long-term hospitalization. Wandering Skid Row for hours in a speechless stupor, taunted by voices in his head, dehydrated by Southern California’s hot autumn sun, Jacobs collapsed to the sidewalk and sat against a wall, nearly catatonic, until someone finally called the cops.
California holds the distinction of having more prisoners than any other state and is sixth per capita (Louisiana tops the list). Even that is no small feat when you consider that the U.S. has the highest per capita incarceration rate of any country in the world, with more than 1.5 million inside state or federal prison walls at any given time. The Golden State, as people like Jacobs have learned, is more like the Gulag State.
Most of California’s prisoners, on whom it spends at least four times as much as it does on its K–12 students, are caged near outposts like Lompoc or Fresno or facilities far enough away from population and media centers that it’s easy to forget they exist. The number of prisoners reached such levels that by 2006, California was embroiled in two class action suits alleging that the overcrowded conditions in which the state was housing its convicts prevented the Department of Corrections from providing adequate health care. This, the suits alleged, violated the ban on cruel and unusual punishment in the Eighth Amendment of the U.S. Constitution. Brown v. Plata, the case consolidated from the two class actions, went to the U.S. Supreme Court, which ordered the state to thin the ranks of its prisoners to a still-crowded but barely acceptable 137.5 percent of total capacity.
That was in the summer of 2011. In October of the same year, Gov. Jerry Brown signed Assembly Bill 109, the intent of which was to reduce the state’s burden by shifting responsibility for many prisoners to California’s 58 counties. Contrary to popular belief, A.B. 109 did not call for the early release of prisoners. Rather, state prisoners whose most recent crimes—the ones for which they were doing time—were nonviolent, nonsexual, and nonserious felonies (called N3 crimes) are now turned over to the counties that prosecuted them. (To be sure, this includes N3s who have committed past crimes that were more serious. This glitch in the law has been widely criticized, especially in light of a murder committed by a homeless man on the streets of Hollywood not long after his release.)
Some 18,000 ex-cons have come back to Los Angeles County since the passage of A.B. 109. Of those 18,000, an astonishing 8,300 are in the county’s Department of Mental Health database because of some history of mental illness, be it garden-variety depression or anxiety, PTSD, personality disorders, or schizophrenia.
As A.B. 109ers have surged into L.A. County in the last couple of years, the law has revealed a dirty secret that most in the United States, including its elected officials, would rather not confront: The prison system has become the mental health system. Funding for rehabilitation programs was cut in recent decades amid a frenzy of law-and-order vindictiveness and with little regard for how it might affect recidivism, crime rates, or costs. Meanwhile, mental health treatment is valued less by the health care system than treatment for maladies occurring below the neck. So it should be no surprise that mentally ill criminal offenders, sometimes referred to by the acronym “MICOs,” aren’t getting very good treatment either in prison or after they’ve done their time.
Former Rhode Island congressman Patrick Kennedy is the author of 2008’s Mental Health Parity and Addiction Equity Act, which sought to force health insurance companies to offer better coverage of mental health. “While the old model of warehousing the mentally ill [in psych wards] might seem like ancient history,” he says, “history has in fact repeated itself in the context of prison.”
Had someone like Lockinvar Jacobs committed a crime in certain other countries, things would have been different. In England, for example, he’d have been sent to one of many new “diversion sites,” where proper treatment is available. In a country such as Finland or Denmark, a mentally ill offender would have received a different sentence in the first place, or no sentence at all, and been sent to a treatment center.
Jacobs was lucky enough to be taken to a hospital after he collapsed on Skid Row, where he got his prescription filled and received IV nutrition during a 15-day stay for observation. On release, he could have wound up in any number of scenarios: the street, a shelter, a halfway house with full services for the mentally ill (called a step-down facility), or, if things had really spiraled, a lockdown psychiatric ward. The Department of Mental Health referred him to the Amity Foundation, which houses and feeds some 50 A.B. 109ers among its clientele of 200 other destitute individuals.
Four days a week, Jacobs makes the hour-long round-trip bus-and-foot journey to Project 180, a treatment center that receives funding through A.B. 109 and provides programs in basic life skills such as hygiene and use of public transportation, as well as individual and group therapy.
Janet, who’s spent half her life in prison, hears voices in her head when she’s off her medication. How could she be expected to show up for appointments, stick to her meds, and stay out of trouble without regular therapy and guidance?
While Amity can be lenient with time limits, other providers have to send clients away after six months. Jacobs could soon be on the street, where he’s less likely to get his meds, more prone to schizophrenic episodes, and more likely to re-offend. If he slips up, he’ll be sent to L.A. County Jail. There, he’d get his meds, but on release he’d be out on the streets again, this time with nothing but the clothes on his back and a paper prescription, which he’d then need to have filled.
Amity Foundation’s California vice president, Mark Faucette, arranged for me to interview half a dozen mentally ill A.B. 109ers. Gathered around a boardroom table, they told me their criminal and mental health histories. There was Janet, a 45-year-old Latina who’d spent half her life in prison, serving six terms for drug possession or sales charges. She told me she hears voices in her head when she’s off her medication, and by her vacant stare, I didn’t doubt it. We spoke about her many transgressions, which had earned her a term in prison, followed by a recent stint in L.A. County Jail for selling dope to feed her habit. (She certainly wasn’t feeding herself; Janet looked life-threateningly thin.) “When I got out of jail this time I still didn’t have no medication,” she said. “I [couldn’t] see a psych doctor until a month later. I don’t think that shouldn’t be like that.”
It may be easy to dismiss the claims of a mentally ill drug addict who’s spent so much time in prison, but even if Janet was bending the truth, it was clear that the odds were against her. Getting out of prison can be a challenge for the most able-minded among us. Marginalized or locked up long ago, many have no family, no resources, and no home.
Troy Vaughn, chief program officer at Lamp Community, a homeless-services provider, explained it to me this way: “If I’ve been incarcerated for a period of time, even if it was a year, I come out and society looks different,” he said. “That’s one barrier that I have to address.” Making things more difficult, A.B. 109ers must now navigate county red tape, rather than state agencies they’ve grown accustomed to while cycling through the system. Mental illness compounds these challenges, says Vaughn, a former Marine who was homeless and addicted to drugs and spent nearly a year in L.A. County Jail in the early 1990s. Anyone whose sanity has been challenged by a trip to the DMV can relate to that idea.
Hearing Janet talk underscored what Vaughn had told me. She seemed to barely understand the difference between state parole and county probation, and without help from Faucette, her explanation of how she’d navigated various state bureaucracies would have been incomprehensible. How, I wondered, could someone like Janet be expected to show up for appointments, stick to a regimen of meds, and stay out of trouble without regular, maybe even daily, therapy and guidance?
Antoinette had a slightly easier time. As instructed, she went straight to the probation office after her release; she told me she was put on a two-week waiting list to get an appointment to re-up her meds. With nowhere to go, she managed to find housing through a friend until she was referred to Amity.
Troy Vaughn, himself an ex-con with mental health and substance abuse disorders, now directs programs at a community advocacy organization. He says he’s “living proof” that rehabilitation and treatment are preferable to incarceration for the mentally ill.
I also met Anthony, a schizophrenic with a history of crack addiction who had a hard time remembering the most basic recent events of his life.
So old and co-occurring were George’s disorders that he wasn’t sure if the meth caused the voices in his head or if he used the drug to quiet them.
As recently as the early 1960s, MICOs like the ones Amity is trying to help would have been involuntarily committed to a psychiatric ward, the type of place that was famously, and accurately, portrayed in the book and film, One Flew Over the Cuckoo’s Nest. That began to change in 1963, when John F. Kennedy signed the Community Mental Health Act, the intent of which was to fund local services so those in need could avoid such a fate. The mentally ill, JFK memorably said, had for too long been “alien to our affections.”
Similar congressional measures followed, but funding didn’t, leaving few resources for the mentally ill. With the best intentions, California in the late 1960s passed the Lanterman-Petris-Short Act, which practically did away with involuntary commitment in the state. Trouble was, it left many vulnerable Californians to depend on a disintegrating mental health care system. Suddenly, the streets became a de facto mental hospital—with no staff. What happened next is no surprise. As the psychiatrist Marc Abramson wrote, law enforcement began to “regard arrest and booking into jail as a more reliable way of securing involuntary detention of mentally disordered persons.”
Under President Reagan, federal funding for mental hospitals dwindled and the cycle continued. With fewer community services in place, mentally ill criminal offenders began finding themselves on the street and then behind bars, where a culture of chaos, stigmatization, and abuse by prisoners and guards would exacerbate their afflictions.