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Cook County Jail aims to help inmates with civilian version of PTSD

The man in the blue hooded sweat shirt rocked back and forth — seemingly in a trance — in an intake pen surrounded by a chain-link fence in the basement of the Cook County Jail. He sat quietly on a wooden bench with his back against a cinderblock wall, oblivious to the yammering of a fellow inmate boasting about a street fight.

Elli Petacque Montgomery, the chief clinical social worker in the Cook County Sheriff’s office, stood behind a white counter outside the pen with a checklist in front of her. She asked a deputy to fetch the 25-year-old dreadlocked man in the blue hoodie, Anthony. The deputy yelled out Anthony’s pre-bond intake number: “42! Number 42!”

It slowly dawned on Anthony that he was Number 42, and he was led to the counter. On that late December day, he was one of 54 men interviewed by Montgomery and her staff before they appeared in bond court. Of them, 22 showed signs of mental illness, including five with symptoms of post-traumatic stress disorder.

That was normal: An average of five to 10 detainees a day are diagnosed with PTSD in those morning screenings. Anthony and one of the men dozing in his pen were among those deemed to have PTSD.

PTSD is a commonly known ailment among combat veterans returning from Iraq and Afghanistan, but in recent years the Cook County Jail and other institutions — including the YMCA of Metro Chicago — have turned their attention to civilians with symptoms of the disorder. The killing fields of Chicago have left thousands of people damaged by the same trauma that veterans have experienced overseas, officials say.

A detainee grips the fenced off pen where he waits to be processed in Cook County Jail on Dec. 24, 2014. The county Sheriff’s Department is screening all detainees for mental illness and PTSD. | Jessica Koscielniak/Sun-Times

Men with PTSD are likely to have problems controlling their anger and they often self-medicate with drugs and booze, Montgomery said.

“What we have down here [in the jail intake] is Chiraq,” Montgomery said, referring to the new nickname for Chicago’s urban battlegrounds. “We see people without eyes, missing limbs, in wheelchairs, disabled from being shot. They’re just like veterans of wars.”

Some of the detainees tried to flirt with Montgomery during their interviews, but she took on a motherly role with the men.

“I’m worried about you,” she told Anthony, who was in jail for allegedly crashing into a Chicago Police vehicle with a stolen Chrysler Sebring, injuring both officers in the squad car.

Montgomery asked him to name the current president of the United States.

“Bill Clinton,” he said.

“Really?” she said.

“Uh, Obama?” he replied after a long pause.

Anthony said he saw a stranger killed in front of him on the street when he was just 12. Two years later, he was shot four times — in the back and a leg. He told Montgomery he was continuing to have nightmares about both experiences.

He told her he was diagnosed with attention deficit hyperactivity disorder and was taking medication to sleep. Sleep disorders are one of the indicators of PTSD, Montgomery said.

Anthony also said he had been treated at Hargrove Hospital, a psychiatric treatment center.

Montgomery asked Anthony a simple question tailored for people she suspects are suffering from PTSD: “Do you like the Fourth of July?”

“No, I try to sleep through it,” Anthony said.

People who have been traumatized by being shot or witnessing gun violence don’t like the sound of firecrackers and bottle rockets exploding, Montgomery explained.

Anthony, who appeared before a judge later that day, was ordered held in lieu of $100,000 bail. The Chicago Sun-Times is not giving his last name to protect his privacy because of his medical condition.

Montgomery, who is deputy director of the sheriff’s Office of Mental Health Policy and Advocacy, said she would recommend Anthony as a candidate for mental health court, which handles about 200 cases a year.

Among the other men diagnosed with PTSD that day were a 57-year-old Army vet whose wife had once stabbed him in the arm; a 24-year-old man who had suffered graze wounds in three separate shootings; a 33-year-old man shot three different times in the chest, with one bullet still lodged there; and a 56-year-old man who had been shot eight times and stabbed in the head in the late 1990s. Pathetically, that man was in jail for allegedly shoplifting $98 of merchandise to give his family for Christmas.

Montgomery and her staff present their evaluations to the Cook County Criminal Court to help judges decide on bond for the detainees.

The inmates are given red cards listing telephone numbers for Montgomery’s office and other social service agencies that can assist them. The cards are aimed at detainees who are released on bond and walk out of the jail on the same day. Montgomery said her office tracks those inmates when they leave the jail.

Other inmates who aren’t released on bond — such as Anthony — will go through a second, afternoon screening by Cermak Hospital, an independently run county facility on the jail grounds. The hospital creates treatment plans for inmates diagnosed with mental illness. The jail shares its own evaluations with Cermak officials.

The pre-bond screenings in the basement of the Cook County Jail have been going on for about two years, said Cara Smith, executive director of the jail for Sheriff Tom Dart. About 35 percent of the detainees in the sprawling jail — about 9,000 a day, on average — are found to be suffering some sort of mental illness, she said.

“The presence of PTSD is extremely significant,” Smith said. “It tells you about the trauma that is experienced on the streets throughout our county. When you have experienced the level of violence that most of our population has, the world does not look the same. This colors your whole outlook on life.”

Outside the jail, other social workers and mental health experts have been connecting the dots between Chicago’s street violence and PTSD — and looking for innovative solutions.

The YMCA of Metro Chicago has been working with teenage males over the past year to help them recognize their symptoms of PTSD and cope with them.

Eddie Bocanegra runs the program, called Urban Warriors. He’s a former gang member who witnessed shootings in his Little Village neighborhood and later served 14 years in prison for committing a fatal shooting.

Under the program, post 9/11 veterans serve as mentors to Chicago teens with similar symptoms. Most of the veterans have been in combat. The youths have experienced everything from domestic violence to seeing their friends get shot. The teens also have been involved in the criminal justice system in the past.

Bocanegra and his brother, an Iraq combat veteran, came up with the Urban Warriors concept while Bocanegra was completing his prison term in 2008. He said he and his brother were both suffering from PTSD at the time.

The Adler Professional School of Psychology is tracking the teenage participants in the program. Bocanegra, who is executive director of youth safety and violence prevention for the YMCA of Metro Chicago, said a formal evaluation isn’t completed, but the evidence so far is positive.

Of 14 teenagers in Pilsen and Little Village, one has been back to court, to pay a fine, Bocanegra said. And of 15 youths in South Chicago, one was re-arrested, he said. The hope is that the program will keep most of the teens out of the Cook County Jail — and prison.

“When these symptoms go untreated, it has a ripple effect,” Bocanegra said. “People who become victims often later become perpetrators. We’re trying to change the narrative.”