Lost in the system
Justice departments increasingly find the mentally ill at their doorstep
Whenever Art Cuddy felt the urge to visit his daughter, he stole a car.
Habitually homeless, drunk and schizophrenic, Cuddy would saunter onto a car lot and take whatever looked good, provided the keys were in the ignition. For 22 years, he stole cars again and again, spending more than five years in prison and many more months in jails.
Like Cuddy, many who struggle with mental illness on the fringes of society find themselves in jail, often for petty crimes. They eventually make it to court and perhaps wind up in prison or on probation. If no one intervenes in a meaningful way to help them with their mental illness, many are bound to repeat the cycle again and again, health care workers say.
Nobody with a major mental disorder comes to the jail once. They come again and again, said Richard Sherman, health services manager for the Lane County Sheriff's Department. Lane County has established a new court program to deal specifically with the mentally ill.
— Police, jails and courts statewide report having more and more contact with the mentally ill. With cutbacks to state-funded services, many criminal justice officials are betting the problem will only get worse.
With most of these folks, it seems like there should be a better way of dealing with them than the criminal justice system, said Abe Huntley, deputy director of Jackson County Community Justice. These people get funneled into the criminal justice system, and they just don't fit well.
Yet about 15 percent of probationers supervised in Jackson County have mental health issues, and about half of those are persistently mentally ill, Huntley said. About 5 percent of the total jail population has a serious mental illness, according to Dennis McNamara, the jail's mental health coordinator.
The jail screens inmates like Sandra Bryant, 38, of Central Point who exhibited signs of mental illness Friday as she was booked on a charge of car theft. Mental health investigator David Eisenhaure determined that Bryant likely suffered from bipolar disorder.
She was released on bail that evening. If she had remained in jail, Bryant would have received counseling and medication. Beyond that, however, the jail is simply not equipped to house the mentally ill, who often don't mix well with the general jail population and may end up in isolation cells, officials said.
We all recognize that incarcerating the mentally ill is at best a bad option, said Jim Adams, Circuit Court administrator for Jackson County. It's not an appropriate place therapeutically.
Yet nearly every jail across Oregon has reported an increase or sharp increase in the number of mentally ill inmates in recent years, according to a 2001 survey of county jails, Sherman said. Nationally, between 6 and 15 percent of inmates booked into jail have mental health issues, he said.
And police are responding to more mental health crises, said Diane Sandler of the Medford Police Department. Calls for mental health assistance have increased by almost 20 percent in the first six months of this year compared to 2002, according to police department statistics.
Medford officers in January saw a spike in mental health-related calls, Sandler said. Patients would call 9-1-1 threatening to hurt someone in hopes of being taken to jail where they would receive medication, she said. Many services, including mental health, were to be cut when voters in January didn't approve a state income tax increase.
How desperate, when people feel they have to commit a crime to get some help? Sandler said.
Mental health crises are not guaranteed to decrease with the restoration of many state-funded mental health services, Sandler said. Patients who lost prescription benefits for a time most likely will be unstable for months or years to come. Oregon Health Plan clients likely will have to wait until January for the federal government, which provides Medicaid money, to restore benefits, said Hank Collins, director of Jackson County Health and Human Services.
However, health care coverage is not always enough to deter repeat criminal behavior in the persistently mentally ill.
Recently convicted of robbing a Jacksonville couple in their home, 25-year-old Shawn Corbin visited Jackson County Mental Health several times a year to receive medication for bipolar disorder, said his mother, Kathleen Corbin.
Misdiagnosed as schizophrenic when he was 17, Shawn was not taking appropriate medications when in 1998, he vandalized Lithia Park and buildings at the Oregon Shakespeare Festival and stole a car while on a psychotic episode. He was diagnosed with bipolar disorder in jail, was placed on probation and started taking the proper medication.
But something was amiss. Although he followed the conditions of his probation, was released from supervision and received periodic mental health care, Shawn suffered several more psychotic episodes. The psychiatric ward at Rogue Valley Medical Center wouldn't admit him for treatment, his mother said. After getting no sleep for about a week, Shawn took off from his mother's Talent home one night in October last year. He ended up on the outskirts of Jacksonville, broke into a home, threatened the residents and tried to steal their car.
Facing a lengthy prison sentence if convicted, Shawn and his attorney negotiated a plea of guilty except insane, placing Shawn in the Oregon State Hospital for a time and under the supervision of the Psychiatric Security Review Board for 40 years. While the punishment seemed like a life sentence, Kathleen Corbin is convinced it was the only way her son could manage his mental illness.
I didn't want him to rot in jail, she said. I wanted him to get help in a mental institution.
Unlike prison, a sentence under the state's psychiatric review board teaches patients how to manage their mental illness, compels them to take medication and complete substance abuse treatment and eventually releases them to society.
For the 22-year habitual offender Cuddy, 51, the board finally put the brakes on his schizophrenia and lifestyle of crime.
Cuddy stole his first car in 1976 and shuffled in and out of prison before finally coming under the board's wing in 1998. He spent five years in the state hospital in Salem before his release in January.
As far as going to the hospital, they gave me a second chance at life, Cuddy said. In prison I never learned anything about my illness.
Cuddy drank or used drugs whenever he was out of custody. At one point, believing he was miraculously healed by God, Cuddy flushed his medication down the toilet. He always violated his parole, usually by leaving the state.
The whole time I was on parole, they never gave me a urine test or told me to go to AA (Alcoholics Anonymous), Cuddy said.
After two years in the state hospital, Cuddy said he stopped craving alcohol. He tracked his medications and can now recognize symptoms that goad him into criminal behavior.
Released from foster care in June, Cuddy now lives independently, cooking and gardening at a west Medford home owned by ACCESS Inc., a non-profit agency. Drinking again or not taking his medication could land him back in the hospital, but he's confident he'll never spend another day there ' or in jail.
PSRB keeps what I'd call a tighter rope on you, which is good, Cuddy said.
Several criminal defendants each year are sentenced to the board's supervision in Jackson County, said Circuit Court Judge Ray White. The board's wards steadily have increased by about 25 percent in the past 10 years. Sixty-two new offenders have been added to the list so far this year, bringing the board's numbers to about 650, said Executive Director Mary Claire Buckley.
Yet room for growth is largely dependent on beds in the state hospital, which holds patients until they are deemed stable enough for release. With just 350 beds available, some patients wait years for an opening in one of Oregon's counties. The process ties up beds needed for new offenders sitting in county jails waiting for a psychiatric evaluation in Salem.
People don't get out just because the hospital is overcrowded, Buckley said. Money issues have become the primary thing. It's not that clients aren't ready.
Twenty-two Oregon counties supervise a small number of the board's offenders. Jackson has 15, ranging from murderers to vandals. Just 2 percent of those under the board's supervision commit new crimes, Buckley said. In Jackson County, no client of the psychiatric review board has committed a new crime in at least the past 10 years, said mental health caseworker Tim Smith.
Although the psychiatric board's clients are staying out of the criminal justice system, the board can only serve a fraction of criminal offenders who suffer from mental illness. That leaves officials wondering how they can intervene with a population that historically isn't a high priority for funding. Everyone wants to jump on the bandwagon when it comes to protecting women and children, but certainly not the mentally ill, said Christine Herbert, a Medford criminal defense attorney.
Dealing with mentally ill people is not real attractive, Herbert said. These are the lost members of society. These are the people we don't want to hear about.