jail, shelter the new mental hospitals? [Phoenix, AZ] FWD

Tom Boland (wgcp@earthlink.net)
Thu, 23 Apr 1998 12:56:47 -0700 (PDT)

FWD http://www.azcentral.com:80/news/0420comside.shtml


  By Christina Leonard
  The Arizona Republic
  April 20, 1998

One way to gauge the state of the county's mental-health system, officials
say, is to note two places where many mentally ill people are routinely
housed and treated:

One is the Maricopa County Jail system.

The other is the downtown Phoenix homeless shelter.

Jail officials say it's an all too common scenario: mentally ill people are
arrested for petty crimes - shoplifting, trespassing, indecent exposure.

They're sick, and need help; one jail counselor estimated that 10 percent
of jail inmates are mentally ill.

But most get only locked up. Then, instead of heading to a health-care
facility upon release, some are sent directly to the downtown homeless

It's not because either facility is suitable, everyone agrees, but because
cheap housing is rare and the system offers few alternatives.

"Our jail is a revolving door for the mentally ill," said Carol Woodhall, a
psychiatric counselor at the Madison Street Jail. "I'm not comfortable with
it, but then again, I just wish there was a place for them to go and get

Central Arizona Shelter Services on West Madison Street absorbs many of the
county's homeless mentally ill population.

"We are the agency people look to to access any type of homeless issue -
with behavioral health being one of them," said David Hammond of CASS. "We
do receive prisoners with mental illnesses more often than we would like."

Many are patients of ComCare, an agency now run by the state to provide
mental-health services. ComCare caseworkers themselves concede that a
homeless shelter is hardly an ideal place for the mentally disturbed, but
say their hands are tied.

Eric Raider, a ComCare administrator at the jail, said some patients are
homeless before they get to jail or choose to go to a homeless shelter
instead of a care facility.

"At least we know where they are if they go to CASS," he said. "It's better
than them going out on the street."

Linda Glenn, a court-appointed monitor of the state's mental-health system,
said this is not how the system is supposed to work.

"We're trying to put in checks and balances to make sure if that happens (a
patient is sent to CASS), it's in a very temporary situation," Glenn said.

Rhonda Baldwin, who oversees ComCare for the state Department of Health
Services, said case managers might send inmates to CASS, but "my issue is
to the extent to which it is happening and trying to isolate it."

Baldwin confirmed that patients "kind of cycle through jail and the
homeless shelter," but asked: "Is it a small group of people, or are we
dealing with a systemic problem of not getting people hooked up fast

Many say the problem is much larger than just finding placement for
mentally ill jail inmates - it's a problem finding placement for all
mentally ill patients.

Ron Smith, who runs ComCare for the state, said there are two reasons for
the shortages: There are not enough group homes and there's not much
low-cost housing.

Even when someone is discharged from the hospital, it's not easy to find
them a spot, he said.

One of the restrictions that has drawn the most criticism is the
court-ordered settlement that limits the Arizona State Hospital to housing
only 55 patients from Maricopa County. It's based on a 1981 agreement in a
class-action lawsuit, Arnold vs. Sarn, that requires the state to continue
to move patients out of institutions and into society's mainstream.

The lawsuit, however, doesn't stipulate how much housing should be
available in the community to meet the needs of patients being released
from institutions, Smith said.

Glenn said the Valley "probably has one-third of the specialized-type
housing we need."

Kitia, who asked her last name not be used, said she's a victim of the
housing shortage. The 37-year-old, diagnosed with manic-depressive illness,
said she lives at CASS because she has no other place to go.

She's been mentally ill since she was 15, she said, and was treated at two
Valley hospitals about two months ago. But when she was released, she found
herself homeless.

Since she's in her manic stage, she's not suicidal, Kitia said. But she has
tried to commit suicide before.

Her fiance, Lee, said CASS is not the right place for mentally ill patients.

"There ain't much they can do, they've got nowhere else to go," the
40-year-old said. "But this is the wrong place - there's too many drugs and
too much violence here."


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