EVANSVILLE - The role of the Vanderburgh County sheriff in mental health assistance has been a constant topic during public forums and candidate nights as the November election gets closer.
It's also a topic the candidates do not agree on.
Democrat Noah Robinson has been vocal since the start of his campaign about being in favor of jail expansion, but with specific focuses on mental health and substance abuse assistance, as well as vocational job training.
Republican Jeff Hales, meanwhile, has been vocal since the start of his campaign that he does not believe mental health is part of a sheriff's job.
Robinson talked over his positions with the Courier & Press. Hales did not respond to requests for an interview for the second story in a row. His comments come from public forums held last month by local organizations.
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'Defunding the police'
During the Fraternal Order of Police candidate night on Sept. 21, Hales said the sheriff's office has the job of housing and helping those incarcerated. He said that includes helping with issues of substance abuse and partnering with organizations like Southwestern Behavioral Healthcare and Deaconess to provide them space to offer services.
But he followed that up by saying the focus on mental health in jail was "an essence of defunding the police."
He claimed it would move funding from policing into mental health, an area for which the sheriff is not responsible.
"Do I have compassion? Do I want to help? Absolutely, I do," Hales said. "But I also see this is just another way of the social system taking money from policing and from doing our job."
Since Hales did not return requests for an interview, the C&P did not have the opportunity to ask him to expand on his belief in partnering with organizations like Southwestern while simultaneously thinking social services were defunding law enforcement.
Robinson said "defund the police" makes for a shocking bumper sticker for people on the far left of the political spectrum. But that's not where he falls, he said.
"I certainly wouldn't be in law enforcement if I wanted to defund the police," he said. "I certainly wouldn't be running for sheriff if I wanted to defund the police."
Robinson said that would be a completely inaccurate depiction of how he intends to operate if elected.
"I would hope my opponent would stop levying that comment to me, because he knows it's inaccurate," Robinson said.
Regarding funding for the mental health and substance abuse assistance, Robinson said he will advocate to put it into programming and staffing. That will include chasing a lot of grant dollars.
Expanding the Vanderburgh County jail
Robinson said an internal study completed by the sheriff's office in conjunction with the University of Southern Indiana showed at least 70% of people incarcerated at the Vanderburgh County jail reported having some type of mental illness.
With those percentages, it's not uncommon for a person to experience a mental health episode while in the jail. Right now the facility, with its concrete block walls and in some cases padded cells, is not conducive to improving mental health, Robinson said.
Inmates who are considered at risk are often placed in the medical area as a means of removing them from the jail's general population.
Robinson said it's not fair to ask the six-to-eight people in a cell to watch over a cellmate who is having a mental health crisis. It also could open the individual up to potential violence.
But right now, there isn't a designated space in the jail to properly house those dealing with mental health needs.
During a tour of the jail earlier this year, Courier & Press reporters witnessed a man in a holding cell having an episode that included screaming "please help me" and banging on the door. A corrections officer responded by pulling a screen over the window on the door. The man's episode continued.
"I am, at a fundamentally core level, deeply uncomfortable with how we handle mental health in the jail overall," Robinson said when asked about the incident, for which he wasn't present. "The line, 'we're doing the best we can' is honest. We are doing the best we can. But we can do better."
Robinson said a broader question for society as a whole is where does a mentally ill person who has committed a serious crime go?
"It would be inappropriate to take that individual to a non-secure location when they have a crime to answer for. So we need an intermediary solution that we don't presently have," Robinson said.
He said the solution is a jail built to both safely house the mentally ill and hold them criminally responsible.
The county has approved $13.5 million for a 120-bed expansion. The current plan includes adding 15 beds for male segregation - giving the confinement officers space to remove an inmate from the general population - as well as 36 more beds for male adults and 36 more beds for female adults, in dorm style.
There are slated to be six beds for male juveniles and four beds for female juveniles, with 15 beds for male behavioral health and six beds for female behavioral health, also dorm style.
If the design plan follows its proposed timeline, the project could be put out for bid as soon as this month.
During the Sept. 20 Evansville Rotary Club forum, Hales called the $13.5 million a "drop in the bucket."
"We absolutely need a jail expansion," he said. "But at what cost?"
Hales said he has always pledged he will be fiscally responsible with constituents' money. He also said any jail expansion project should include updates to improve the booking process.
Diverting people from the Vanderburgh County jail
When asked if he believed there were currently, or had been previously, people in jail who should not be there, Robinson said he'd heard anecdotes of individuals who would have been better served in other places.
But options like that haven't always been available. Robinson said the county is just now seeing options pop up with the United Caring Services Diversion Center and Southwestern Behavioral Healthcare's Crisis Center.
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Diversion should always be a part of the conversation, Robinson said. He plans to create a protocol for when deputies are dealing with victimless misdemeanors such as public urination or public intoxication. Often those situations would be suitable for a diversion from the jail.
"Our deputies, they don't want to take people to jail. We don't go out there saying 'let me find someone to take to jail,'" he said. "Jail is necessary when it's an individual that's not following our society's rules. But I'm all about problem solving."
To Robinson, jail is one option. Not the only option.
"One of my favorite expressions is, 'when all you have is a hammer, all your problems start to look like nails,'" he said. "The jail is a very big hammer."
Continuity of care
When a person is booked into the Vanderburgh County jail, part of the intake process includes a survey that asks about health needs such as history of substance abuse and current medications.
Robinson said the questions are "methodical and evidence-based" to help identify risk factors. The answers are reviewed by medical staff, at which point the person would be seen by a nurse on staff who would assess if intake into the jail is the right decision.
If there are too many risk factors, Robinson said the individual would be seen by an emergency room doctor who would either admit them or clear them to return to the jail.
At the jail, through a contract with Quality Correctional Care, there is a staff doctor who visits and a nurse manger who is there at all times during the day. There are also nurses and licensed practical nurses who provide service after hours.
"The last thing any sheriff wants to have is an inmate that suffers a severe health emergency inside the jail," he said. "I think the public is very unforgiving, and rightly so, when an inmate dies in our custody because it's our job to maintain the safety of the facility."
Robinson said he thinks the sheriff's office is "pretty good" about assuring those medications are continued while a person is incarcerated. But he wants the office to be very good. Identifying medications quickly and confirming the individual was actively taking them before entering the jail are both priorities for him, he said.
For people who may be dealing with a substance withdrawal, Robinson said he wants to make sure proper medications are given. The same goes for incarcerated individuals who were working with a particular doctor or mental health professional before entering the jail.
Robinson said it would likely be a professional with Southwestern who would work with them during their time in the Vanderburgh County jail, but someone like a doctor or therapist wouldn't be turned away from visiting an inmate.
If Robinson were elected, he said he would want to tailor treatment plans based on individual needs. A part of his duty as sheriff would be to maintain the health and safety of the jail.
"You can't do that by turning a blind eye to people's medical needs," he said.
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The sheriff's role in inmate mental health
By virtue of how many people in the jail are dealing with mental illness, the sheriff has to have a role in mental health, Robinson believes.
"To ignore that is completely irresponsible. And I won't," he said. "I will be an advocate for mental health in that facility."
His goal is to offer incarcerated individuals a chance to address substance abuse and mental health issues while in the jail, as well as offer them solutions and connect them to support when they leave.
"Eventually these inmates will be released. They are released. We book in 10,000 inmates a year, so obviously we don't have 10,000 inmates in our jail right now," he said. "These inmates are coming back and they're moving in next to your family, my family. They're living in our community."
Offering programming and partnerships with local organizations will lead to less crime and fewer individuals returning to the jail for another incident, Robinson said.
"Not all, but some of these inmates have a root cause for their behavior," he said. "And to the extent possible where we can address it, we'll save money in the long term by avoiding re-arrest.
"Who would you rather have living next to you?" he said. "Somebody who has been through 12 months of programming or 12 months of sitting in a box?"
Sarah Loesch can be reached at email@example.com with comments and story ideas.
This article originally appeared on Evansville Courier & Press: Vanderburgh sheriff hopefuls are split on mental health in jails