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Marion County cut jail bookings by boosting mental health care

Opening a 24-hour mental health crisis center and teaming therapists with police has helped Marion County cut the number of people booked in its jail by thousands each year.

Marion County Jail Commander Tad Larson said a similar approach could help ease overcrowding at the Jackson County Jail, but he still thinks Jackson County needs more jail beds and space for treatment programs.

“Since we’ve introduced collaborations between mental health and law enforcement, we’ve seen a downward trend in bookings,” he said.

The Marion County Jail saw about 19,000 to 20,000 bookings each year a decade ago, but bookings now hover at about 15,000 to 16,000 per year, Larson said.

The jail has 415 beds, compared to 315 at the Jackson County Jail. The Marion County Jail also has a more modern layout and space to offer treatment programs with community partners, Larson said.

“It looks like more room would be necessary to allow more collaborations and offer more programs,” he said of the Jackson County Jail.

A broad spectrum of Jackson County residents gathered Wednesday night at the Medford Police Department to hear first-hand how Marion County cut jail use by boosting mental health services. Larson traveled down from Salem with Ann-Marie Bandfield, acute and forensic behavioral health program manager for Marion County Health and Human Services.

Bandfield said mentally ill people in Marion County were being arrested but weren’t being connected with services that could help them.

“The jail stats were so high. People were just revolving through the jail,” she said.

Marion County launched a psychiatric crisis center that is open 24 hours per day, seven days a week. People can drop in for services at any time. Police can also bring in people experiencing a mental health crisis — providing an alternative to hospital emergency rooms or jail.

“I think it’s super important to have somewhere else for someone to go when they’re in crisis,” Larson said, adding that jails weren’t designed to hold and treat people with mental illness.

Jackson County has a walk-in mental health crisis center, but it’s only open from 8 a.m. to 5 p.m. Monday through Friday. It has to be accessed through the lobby of the Jackson County Health and Human Services building on Holly Street in downtown Medford.

A different building, more staffing and additional funding would be needed to operate a true 24-hour drop-in crisis center, said Rick Rawlins, crisis and outpatient services manager for Jackson County Mental Health.

The mental health organization ColumbiaCare operates the 14-bed Beckett Center in Medford for people experiencing a mental health crisis. The center receives funding from the county plus Oregon Health Plan coordinated care organizations AllCare Health and Jackson Care Connect, according to the center’s website.

Rawlins said the center is not for drop-in patients. Police have to take people first to a hospital to get a medical clearance before they can be accepted into the Beckett Center.

Jackson County does operate a 24-hour crisis phone line, and mobile response therapists are available to go out at all hours to help police handle situations involving people with mental illness, Rawlins said.

The therapists are not embedded with law enforcement agencies as they are in Marion County.

Jackson County Mental Health once had embedded therapists, but lost funding to continue the program after coordinated care organizations decided to shift most of their mental health care dollars from the county to other providers in the community, Rawlins said.

At the time of the shift, the CCOs said their patients weren’t receiving mental health care fast enough from the county.

Bandfield said Marion County’s therapist and law enforcement crisis response teams are so effective at helping people with mental illness that they only arrest people in 3% of situations. Of those they do arrest, 90% are brought in because they have warrants out for their arrest, not because they’ve committed new crimes, she said.

In Marion County, officials have worked together on a variety of other strategies to divert mentally ill people from the criminal justice system.

Bandfield said an analysis showed people with mental illness were averaging 75 days in the Marion County Jail compared to 15 days for people without mental illness who faced the same charges. Mentally ill people were trapped in jail on charges like trespassing and criminal mischief.

“We’re talking about ridiculous charges. They were waiting forever in our jail,” Bandfield said.

The Marion County District Attorney’s Office now reviews the cases of mentally ill defendants and sometimes decides not to prosecute if the danger to the community is low, she said.

When the DA’s office does move forward with prosecution, it fast-tracks cases since people’s mental health tends to deteriorate in jail, Bandfield said.

Marion County started a robocall system to remind people to attend their court hearings — much like a dentist or doctor’s office calls to remind people about appointments.

Offering more treatment has helped cut the chances people with mental illness will reoffend and wind up back in jail. Recidivism for the most mentally ill people dropped from 52% in 2015 to 13% in 2019, Bandfield said.

Like Jackson County, Marion County started a Mental Health Court and pays close attention to the cases of defendants who are too mentally ill to assist their defense attorneys on their cases.

But rather than send those defendants to the Oregon State Hospital for restoration services, Marion County works to treat defendants out in the community. Marion County once sent the second highest number of those defendants to the state-run mental institution, but now sends the least.

Marion County provides mental health treatment in its jail. Inmates are screened for mental health problems just as they are screened for physical health problems, Larson said.

Both Marion and Jackson County now release inmates during the day so they can access services from community partners — rather than being dumped onto the streets in the middle of the night when they are more likely to get in trouble.

Since Marion County has a 24-hour psychiatric crisis center, it can also release inmates with mental illness to the center, Larson said.

Bandfield said Marion County is still struggling to get people into outpatient services because of long wait times. It also needs to do a better job coordinating care for mentally ill people who also have developmental disabilities.

Larson said he was encouraged to see the range of people who attended the Wednesday night presentation at the Medford Police Department. Attendees included people involved in mental health, law enforcement and politics.

He said not all counties have close working relationships like those found in Jackson County.

“I was encouraged by the collaborations I saw here,” Larson said.

Community members are exploring jail issues because of chronic overcrowding and forced inmate releases at the Jackson County Jail.

Jackson County Sheriff Nathan Sickler has proposed building a new $170.9 million jail that could house 800 inmates and offer mental health and addiction treatment services.

Reach Mail Tribune reporter Vickie Aldous at 541-776-4486 or valdous@rosebudmedia.com. Follow her on Twitter @VickieAldous.

A female inmate watches television in a common area at the Jackson County Jail. Mail Tribune/ Denise Baratta