Early last year, two suicidal patients showed up at a hospital emergency room in Pierre, S.D., seeking help. Although the incidents happened weeks apart, both patients ended up in an unexpected place: jail.
Across the country, and especially in rural areas, people in the middle of a mental health crisis are locked in a cell when a hospital bed or transportation to a hospital isn’t immediately available. The patients are transported from the ER like inmates, handcuffed in the back of police vehicles. Laws in five states — New Mexico, North and South Dakota, Texas and Wyoming — explicitly say that correctional facilities may be used for what is called a “mental health hold.” Even in states without such laws, the practice happens regularly.
“It is a terrible solution…for what is, at the end of the day, a medical crisis,” said John Snook, executive director of the Treatment Advocacy Center, a national group that advocates for the severely mentally ill. Research shows that the risk for suicide, self-harm and worsening symptoms increases the longer a person is behind bars.
But in a shift, Colorado recently outlawed using jail to detain people in a psychiatric crisis who have not committed a crime. The state delegated just over $9 million — with $6 million coming from marijuana tax revenue — to pay for local crisis centers, training for law enforcement and transportation programs.
The new law was passed after Colorado’s sheriffs lobbied the state to extend the amount of time a person could be detained. In rural counties, sheriffs testified, lack of manpower meant they were forced to hold onto people longer than the 24-hour legal limit. A state task force instead recommended ending the practice entirely.
There are no national figures on how many people are held each year in jail just