Jail poses danger to mentally ill
Lack of staff training puts disturbed inmates at greater
by Shawn D. Lewis, the Detroit News, January 12, 2003
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Ariel Perez Jr., 19, took a drastic step just 28 days into a
90-day Oakland County Jail term.
The Auburn Hills teen twisted a sheet around his neck and
ended his brief life, becoming the jail's first suicide in a
decade. He was in jail for violating probation on a
home-invasion case. Perez had stolen a used punching bag and
phone card from a friend.
A psychiatric patient being treated for schizophrenia, Perez
posed the type of challenges local and state corrections
officials expect to grapple with increasingly.
"I tried so many times to get help for my boy and asked his
most recent psychiatrist to try to help him get his medication
(Lithium) in the jail," said Ariel Perez Sr. after losing his
son Nov. 25. "But nobody paid attention."
County sheriffs and jail administrators in Michigan and around
the country acknowledge they are not trained or staffed to
evaluate severely disturbed inmates. The patients already are
stressed, experts say, and being jailed can add to their
agitation or despair.
At issue is how to deal with the medication and counseling
needs of patients who need specialized care.
"We weren't designed to deal with mental health issues. We
weren't intended to deal with the mentally ill," said Terrence
Jungel, executive director of the Michigan Sheriffs
Nationwide, a greater number of lawbreakers with mental
disturbances also are being incarcerated as a side effect of
psychiatric hospital closings and the trend of community-based
care, according to corrections officials and health
Michigan shut 10 state mental hospitals in the last decade,
and the number of new state prison inmates reporting past
mental health care rose from 6,169 (19 percent) a year in 1990
to 11,598 (23 percent) last year.
The number of mentally ill behind bars today is almost five
times the number in state mental hospitals, according to
federal figures. While serious mental illness afflicts 5.4
percent of U.S. adults, the mentally ill account for almost 16
percent of inmates, or more than 284,000 people, the U.S.
Justice Department says.
"It's cheaper to treat the mentally ill in a jail or prison
than in a mental hospital," said Dr. Elliot Luby, clinical
professor of psychiatry and law at Wayne State University. "It
is a cold calculation on the part of the budgeting people in
Gov. Jennifer Granholm tends to agree, but sees no easy
answers as she confronts a $1.8-million budget shortfall. "The
governor feels jails are not the place for us to keep the
mentally ill," said Mary Dettloff, her spokeswoman. "We've
received a lot of information from mental health advocacy
groups who want us to take a look at this."
But the ability to make suggested changes is limited, Dettloff
added, explaining that the state would have to find no-cost or
Suicides and attempts by mentally ill inmates across Michigan
leave devastated families in their wake.
Patricia House, 38, of Clinton Township, diagnosed as bipolar
and on the drug Depakote, now is paralyzed from the neck down
after jumping from a second-floor balcony of the Macomb County
Jail in 2001. Lawrence Hull, 41, of Flint, a schizophrenic who
was taking Prozac, Depakote and other mood-stabilizers,
committed suicide by hanging himself with his shirtsleeve
inside a Flint police lockup that same year.
Suicide leads jail deaths
Suicide is the third-leading cause of death in prisons and the
leading cause of death in jails. From 1984-93, according to
the most recent U.S. Justice Department study, the national
prison suicide rate was 20 per 100,000 -- 150 percent higher
than that of the general population.
The suicides prompt lawsuits that cost Michigan taxpayers
millions of dollars, said Mark Reinstein, president of the
Mental Health Association in Michigan, an advocacy group in
Southfield. More than 95 percent of those who take their lives
behind bars have a treatable mental illness, according to the
On a more positive note, suicides are uncommon in Michigan's
state prisons, which currently house nearly 50,000 inmates.
The Department of Corrections recorded 45 suicides since 1995.
Similar figures for county jails are not compiled in a central
In Wayne County, eight inmates killed themselves since 1999,
including two with previous mental health care. In Macomb
County, there were six suicides between July 2000 and last
April. Perez's recent hanging at Oakland's jail was the first
in a decade.
Advocates seek answers
Gathering information on jail suicides has been challenging
for prisoner advocates.
The Michigan Protection and Advocacy Service sued Wayne
County's sheriff in December for refusing access to records of
three inmates who committed suicide between 2000-2001 at the
county jail. The group also cites problems getting suicide
records from Macomb County.
"After months of negotiations, they finally released the
medical records for the people who died and policies and
procedures at the jail. But we really need to ... ask them
questions about what we've found and what changes they've
made," said Yvonne Fleener of the Lansing-based group.
The group suggests Macomb officials follow jail procedures in
neighboring Oakland County, which "had zero suicides in their
jail during the time Macomb had their rash of suicides,"
Medical personnel at Macomb's jail in Mt. Clemens work for a
private contractor. "Macomb is the only county to use (that
arrangement) -- there's got to be something to that," Fleener
Each of the county jails employs psychiatrists: one in Macomb,
four full-time psychiatrists and one part-timer at the Wayne
County jail, and two part-timers covering 40 hours a week
combined at Oakland's facility. Screening for suicide risks is
part of each facility's intake procedures, and mental health
professionals are on 24-hour call for emergencies.
"We have a failing mental health system," said Luby of Wayne
State, who has a private practice in Farmington Hills. "The
effects are felt at county jails. They don't have the funds,
hospitals here have been closing and there are very few acute
"So the hospital settings then become the prisons."
Toll is six in Macomb
In Macomb, five inmates hung themselves and a sixth died after
jumping from a second-story balcony at the Macomb County Jail
between July 2000 and April 2002. The jail houses 1,400
"I told the police that she was supposed to be on her meds,"
said Miller, 65. A lawsuit against the county has been filed
on behalf of House's 12-year-old son.
"I'm a fighter, and I'm not going to give up on my daughter,"
Miller said. "To be honest, we've been through hell, and it's
Macomb County Sheriff Mark Hackel acknowledged suicidal
inmates aren't always easy to spot or treat.
"Sometimes a corrections officer can see somebody who looks
despondent, or upset. But unfortunately, you get people that
get upset and jump off a two-story balcony because of a phone
call," Hackel said. "We've had that happen. How do you prevent
The Macomb County Jail has undergone changes since the
suicides. Previously, Macomb prisoners on suicide watch were
placed in cells with around-the-clock monitoring. They
returned to the general population once the medical staff
determined they were no longer threats to themselves.
"They weren't followed or monitored as closely or as often as
they should have been," acknowledged Michelle Sanborn, who has
run the jail in Mt. Clemens for nine years.
Now, a prisoner who leaves suicide watch goes to a unit with
close supervision and mental health monitoring before he or
she is sent back to the main cellblocks.
In Oakland County, Ariel Perez was the first suicide in a
"This was an unfortunate incident," said Capt. Michael McCabe
of the Oakland County Sheriff's Department shortly after the
hanging. "This is the first suicide in over 10 years, so I
think our record speaks for itself. Other than that, I can't
But the Perez family remains inconsolable.
On Thanksgiving morning, Perez's parents and two sisters
accompanied his casket back to Villalba, Puerto Rico.
His mother, Gladys Perez, has been so shaken that she returned
to the island again after a brief stay in Auburn Hills
following her son's burial.
His father, Ariel Perez Sr., a cook, and sisters Jennifer, 25,
and Elda, 20, remain in Auburn Hills.
"Arielito" was diagnosed with attention deficit disorder as a
child, his family says. Passed through the Pontiac School
system without learning to read and write, he spent a troubled
youth, eventually committing the crime leading to his fatal
12 percent on drugs
The Oakland jail holds up to 1,800 inmates, with about 12
percent on psychotropic drugs.
Officials declined to say whether personnel knew of Perez's
mental condition or whether he received correct medication.
"We can't divulge confidential information," said George
Miller, health division manager at the county jail.
The Auburn Hills teen was jailed last Oct. 28 for violating
probation in the earlier home invasion case.
"He came from a good family," said attorney Frederick Toca of
Pontiac, who represented Perez at the time. "He had severe
learning disabilities. He had a deficit as far as his ability
to understand. He was convicted in circuit court.
"One of the things we hoped was that he wouldn't do jail time
because of his profound inability to understand. The calling
card was worth about $6, and the punching bag was used. It was
nothing major at all."
Case in Flint
In the Flint police lockup on Jan. 11, 2001, 41-year-old
Lawrence Hull was "yelling, screaming and kicking the door,
demanding his phone call and his medication," according to a
Arrested hours earlier on a charge of hitting his sister,
Lawanda Hull, the detainee was told by jail guard Ricardo
Clemons that "there are people trying to sleep and you are
making all this noise," the report says. "Hull would not calm
down and continued to yell and scream and waving his arms.
Clemons then went back to the intake area and continued to
process the inmates."
Shortly thereafter, Hull was discovered hanging in his cell by
a shirt sleeve.
The police report said Hull had been acting strangely for
days. He was being treated for depression and schizophrenia at
a Genesee County mental health facility, according to his
sister, Patricia Jones.
"Police went to his house and took a bag filled with his
medications after he committed suicide," said Jones. "It was
too late then."
She reflected a moment and added, crying: "I feel so badly
because I promised my mother before she died that I would be
responsible for him. I feel like I failed."
Toca, the Pontiac lawyer who defended Perez as a youth now
represents Lawrence Hull's family in a wrongful death lawsuit.
Experts familiar with these types of cases are pessimistic
about improvements in the way jails handle the mentally ill.
"The situation is getting worse because society looks at
(mental patients) like they shouldn't have gotten in trouble
and gone to jail in the first place, " said Dan Manville of
Ferndale, a civil rights attorney who has represented
prisoners for more than 15 years. "And with all the cutbacks
in jails and prisons because of the economy, and since the
mentally ill are considered on the bottom anyway, they get the
worse treatment inside the jails."
But the Michigan Sheriffs Association is working to help
county jailers deal more effectively and safely with mentally
ill inmates. Two training sessions will be held May 29-30,
said executive director Terrence Jungel.
He acknowledged that mentally disturbed or emotionally
unstable inmates are a tough problem for sheriff's
"We're looking for better ways of diverting the mentally ill
from county jails to treatment programs," Jungel said. "One of
the problems is that there is really limited availability of
regional treatment programs. It's a community problem that
needs to be dealt with on a community-wide basis."
Detroit News staff writers Gary Heinlein, Tony Manolatos,
Santiago Esparza and Mike Martindale contributed to this