At the jail, doing something about a ‘national disgrace’

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The Cook County Jail on Wednesday, September 18, 2013. | Chandler West/For Sun-Times Media

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When you are “crazy” in Cook County, you end up in jail.

You hide in bus shelters, huddle under piles of rags in dank storefronts, ride all night on the L. You curse and rant on the streets.

We avert our eyes, and hope you go away. When you don’t, the police arrest you and drop you at Cook County Jail.

The state mental hospitals and Chicago’s neighborhood mental health clinics have cut back or closed. So the jail has become known as the largest mental hospital in America.

In 2013, Cook County Sheriff Tom Dart decided, that “if people are going to make us the largest mental health hospital in the country, we are going to be the best mental health hospital in the country.”


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I visited the jail’s intake center, the stop before bond court, on a recent sunny, cool morning. Dozens of prisoners are brought in daily. Most are poor and people of color. Some are bipolar, schizophrenic.  They self-medicate with alcohol and illegal drugs.

Their behavior puts them on the street, to commit what jail officials call “crimes of survival.” Retail theft, criminal trespassing, drug possession.

Cook County is the only jail in America that provides mental-health screenings and programming, officials say.

“The mentally ill have been criminalized,” said Elli Montgomery, director of the Sheriff’s Office of Mental Health Policy and Advocacy. Their behavior can seem “bizarre and odd.” Police officers are not trained in intervention.

“Around 30 percent of everyone we interviewed this morning will have self-reported to us a severe mental illness and mental health issues,” she said over the jailhouse din.

The tally that day: 16 men and three women.

Counselors assess inmates’ physical and mental medical histories. They are offered government-funded medical insurance. They get a “discharge plan” with referrals for medical services, transportation, access to a 24-hour crisis hotline.

Those who can’t afford bond can languish in jail for months, awaiting trial.  The jail’s Mental Health Transition Center provides therapy, parenting classes, job fairs and skills training and referrals, housing.  There’s “a photography class that helps them see them learn to see the world in a new light,” said Benjamin Breit, director of communications for the sheriff’s office.

I chatted with about a dozen inmates. Before jail, all said they had been “self-medicating” to cope. In jail, they are recovering.

“It made a big difference to be diagnosed and to be able to target my problems and know how to work with my problems by talking to a psychiatrist,” said David, who has been in jail since Jan. 1. (The jail requested his last name not be used).

He has developed “cognitive thinking skills, he added.  “So when I get back into free society I know how to use these skills in my everyday life.”

And “if we had these programs in the (outside) world, a lot of us wouldn’t go to selling drugs.”

Is this the job of a jail?  No. But Dart is doing it anyway, without additional funding.

A few days later, Dart spoke at an “On the Table” gathering, sponsored by the Chicago Community Trust. He appealed to representatives of foundations, medical facilities and civic leaders.

The criminalization of the mentally ill is “a national disgrace,” Dart declared. “We need to start treating these folks the way they deserve to be treated. As someone who has an illness. And (who) needs to have help.”

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