In a broken mental health system, a tiny jail cell becomes an institution of last resort

By Katheryn Houghton KFF Fitness News POLSON Mont When someone accused of a crime in this small northwestern Montana town requirements mental robustness care chances are they ll be locked in a basement jail cell the size of a walk-in closet Prisoners selected held in this isolation cell for months have scratched initials and the phrase love hurts into the metal door s brown paint Their pacing has worn a path into the cement floor A large number of are held in a sort of limbo not convicted of a crime but not stable enough to be issued They sleep on a narrow cot next to a toilet The only view is a fluorescent-lit hallway visible through a small window in the door Lake County Attorney James Lapotka stood at the cell s center talking about the people he helps confine here He stretched out his arms his fingertips just shy of touching opposite walls I m getting anxiety just being in here Lapotka commented Chosen are held there for months as they wait for an open bed at the Montana State Hospital Katheryn Houghton KFF Wellness News TNS The Lake County jail is in the basement of the courthouse in Polson Montana a town of on the southern shore of Flathead Lake one of the largest lakes west of the Mississippi River Katheryn Houghton KFF Wellbeing News TNS Joel Shearer a Lake County Montana detention commander walks into the jail in the basement of the courthouse which has become a fallback for holding people in a mental wellbeing predicament who can t access inpatient rehabilitation at the state psychiatric hospital Katheryn Houghton KFF Wellbeing News TNS Someone in emergency in Lake County has two options jail or an urgency room The room reserved for people in emergency at Providence St Joseph Therapeutic Center leaves patients both isolated and without privacy The locked door s thick glass looks onto a busy urgency room hallway Katheryn Houghton KFF Fitness News TNS The Lake County Montana jail s crisis restraint chair is used to bind prisoners considered a danger to themselves or others Their shoulders arms and legs are tied down and they are given a break to stand once an hour until they calm down Due to lack of space those strapped into the chair are placed in either a hallway or a locker room It sounds horrible it is horrible disclosed Joel Shearer a Lake County detention commander Katheryn Houghton KFF Fitness News TNS Vincent River has worked as the Lake County jail s sole mental strength clinician for years Katheryn Houghton KFF Fitness News TNS Specific are held there for months as they wait for an open bed at the Montana State Hospital Katheryn Houghton KFF Physical condition News TNS Show Caption of Particular are held there for months as they wait for an open bed at the Montana State Hospital Katheryn Houghton KFF Fitness News TNS Expand Last year a man sentenced for stealing a rifle stayed in that cell days He was waiting for a spot to open at Montana s only state-run psychiatric hospital after a mental robustness evaluator deemed he needed care according to court records A man in the next cell around the same time was on the same waitlist roughly five months He faced near-daily stints in the jail s exigency restraint chair a steel contraption wrapped in foam with straps for his shoulders arms and legs He regularly saw the jail s mental physical condition expert Still Joel Shearer a Lake County detention commander announced the man routinely experienced psychotic episodes and demanded to be locked in the chair when he felt one coming on and stayed there until his screams subsided Somebody who s having a mental robustness problem they don t belong here Lapotka explained We don t have anywhere else Lake County s two roughly -square-foot isolation cells are an example of how communities nationwide are failing to provide mental robustness services emergency care in particular Nearly half of the people locked in local jails in the U S have a mental illness More than half of Wyoming s sheriffs stated lawmakers there that they were housing people in emergency awaiting mental healthcare care for months WyoFile disclosed in January Nevada has struggled despite a daily fine for each jailed recipient whose healing is delayed Disability Rights Oregon has declared delays in that state continue after two people died in jail while on the state s psychiatric waitlist In Montana counties are jailing mental healthcare patients they re not equipped to handle when the Montana State Hospital is at quota Inadequate local hospitals have their own inpatient psychiatric beds As a conclusion people arrested for anything from petty theft to felony assault can be jailed for months or longer as their mental wellbeing worsens Multiple haven t been convicted of a crime Montana agents have known for years they have a predicament State functionaries have noted they don t have space for all the people ordered to the hospital The psychiatric hospital has beds with for people in the criminal justice system Staffing shortages can shrink that ceiling further The Montana Department of Residents Strength and Human Services backed two bills this legislative session that would shield the state from liability for delays when the Montana State Hospital is full Ahead of the bills the agency wrote the hospital has struggled to maintain appropriate levels of care due to money and staffing constraints a lack of community-based services and having no control over the flow patients Montana courts send its way The agency also revealed April that million was available through one-time grants to help set up jail-based mental medical stabilization services Officers have declared patients deserve care closer to home in less restrictive settings But counties say the local services needed don t exist You have to do the hard things first explained Matt Kuntz executive director of the Montana chapter of the National Alliance on Mental Illness You have to build the beds Related Articles AED installed at Stillwater field where teen nearly died during football practice Nearly a quarter of people on long-acting opioids develop addiction Moderna examination shows immune response in older adults for a combo flu and COVID- shot Washington County horse barn under precautionary quarantine Dog material may help track dangerous affection for humans Healthcare advocates have backed a proposal that would require the state to pay for neighborhood commitments That measure is headed to Republican Gov Greg Gianforte after passing the state House and Senate Another bill that was still pending would create a new psychiatric hospital for people in the justice system But implementing those ideas could take years The number of inpatient beds for people with a serious mental illness nationwide has plummeted At one time that drop was intentional part of a movement away from locking people up in state-run mental hospitals But the intended fix local homelike centers hasn t filled the void One of Montana s biggest providers Western Montana Mental Soundness Center had to close specific of its dilemma sites because of money problems announced Western s CEO Bob Lopp That includes a facility less than a mile from the Lake County jail If that s not where the funding is you can t just do it for the sake of argument and hope that it comes Lopp explained Gianforte has promised to pour money into rebuilding the state s behavioral wellbeing system Mental healthcare workers in small towns find such promises hard to trust after seeing local services come and go for years Medical department spokesperson Holly Matkin commented the agency is proud of its work to fix systems that have been broken for too long and that it will improve services for people who need inpatient care in their communities Lake County is known to outsiders as an Instagram-worthy stop on their way to Glacier National Park It overlaps with the Flathead Indian Reservation land of the Bitterroot Salish Upper Pend d Oreille and Kootenai tribes It s home to a slice of the Rocky Mountains and a gateway to millions of acres of wilderness Polson the county seat and site of the jail is a town of on the southern shore of Flathead Lake one of the largest lakes west of the Mississippi River Vincent River has worked as the jail s sole mental physical condition clinician for years He announced he s not dependably available because he s the only psychologist in four northwestern Montana counties evaluating whether a person in jail necessities psychiatric care Particular are circulated without care if they linger too long on the state hospital s waitlist I talk to these family members I hear them plead with me with their fear in their voices and tell me all that s been going on for days or weeks or months River announced And then I can t get people into the hospital That is a giant dilemma It s not just the state hospital River announced he can t get people into any psychiatric bed in Montana because there are too limited Instead he tries to stabilize people while they re jailed That has shortfalls The jail can t force someone in psychosis to take medication without a court order and a qualified expert on hand to administer the prescription Lake County s aging facility has faced lawsuits because of poor conditions amid overcrowding and River has to see patients wherever there s room There isn t even space for the jail s restraint chair Jail workers leave strapped-down prisoners in a hallway or locker room River mentioned multiple gradually get better and leave isolation Particular don t They languish there psychotic and lonely he noted at the mercy of what the voices are telling them Locals are working to fill chosen gaps A mobile organization launched in February is staffed by people who have lived with mental and substance use disorders to provide peer encouragement But someone truly in predicament has only two options jail or an urgency room The room reserved for people in emergency at Providence St Joseph Biological Center in Polson leaves patients both isolated and without privacy The locked door s thick glass looks onto a busy crisis room hallway Those who deteriorate enough to be deemed dangerous to themselves or others are sent down the road to jail Rebecca Bontadelli an ER physician noted patients can be housed in the room for days as hospital staffers scour Montana and nearby states for an open psychiatric bed Specific reject care in the meantime We re not really helping them Bontadelli revealed They feel like they re in prison KFF Wellness News Distributed by Tribune Content Agency LLC