FORT WAYNE, Ind. (WANE) A federal lawsuit against Allen County claiming inhumane conditions at the Allen County Jail upended the community when a federal judge sided with the inmates.

As details are worked out to provide an updated correctional facility, with, many hope, an infirmary and mental health wing, it’s still up to the Allen County Sheriff and his department to house individuals the criminal courts send their way.

The combination of an overcrowded jail and an outdated, semi-rotting facility without the necessary numbers of staff to take care of inmates led federal judge Damon R. Leichty to side with inmates. In March, Leichty ordered the sheriff and county commissioners to remedy the situation.

What’s become clear is the sheriff can only do so much, particularly because county jails have become the local mental health facility.

“Allen County is no different than what the state has faced in the last 20 years when the state closed down a lot of the state mental institutions,” said Deputy Chief David Butler, Allen County Jail Commander. “All these people get displaced into the community, and, unfortunately, a lot of them end up in the county jails. And then we’re forced to try and manage that and deal with it. It’s a challenge for us and it’s a challenge for every other jail in the state.”

“Regardless of insurance or Medicaid or whatever that doesn’t cover while they’re here, the sheriff is mandated to provide everybody medical care and  cover them while they’re in custody,” Butler explained in a sit-down interview with him, Capt. Mark Sickafoose, assistant jail commander, and Troy Hershberger, Chief Deputy of the sheriff’s department.

While the judge pointed to a high level of assaults between inmates and inmates and officers because of the overcrowding, many of the problems come from housing too many inmates with untreated mental health issues.

Capt. Mark Sickafoose, left, and Deputy Chief David Butler, Jail Commander and Assistant Jail Commander, say a new jail with a mental health ward would be the best thing.

According to the National Alliance on Mental Illness, 44% of people held in local jails have a history of mental illness and 70% of youth held in the juvenile justice system have a diagnosable mental health condition. Further, 45% of people with a history of mental illness incarcerated in local jails don’t get help for their illness.

With a range of people that include those incarcerated on court ordered medications to people with undiagnosed mental illnesses to those who may be diagnosed but shun medication because it makes them feel bad, the Allen County Jail is most likely up to at least 60% of people with mental illness. Sheriff David Gladieux has said that about 60% of the jail population is on psychotropic drugs.

How treatment is delivered is debated in community forums and on social media. Hershberger and the jail commanders say they’d like more outside collaboration to tackle the problems with the mentally ill inside the jail.

“We’re hoping the entire community will come together to help us in the future,” said Sickafoose, who spends a great part of his day talking with inmates and their families.

Delivering care in jail

Even though the jail’s medical provider, Quality Correctional Care, a for-profit company based in Carmel, is responsible for mental health evaluations and treatments, the jail staff works alongside local QCC employees to deliver care.

Inmates come into the jail and have an initial screening with jail staff. The staff checks for medical needs and asks them if they’re taking medications for anything or if they are feeling suicidal. Hershberger said questions include:

  • Do you need to go to the hospital?
  • Have you been in a physical altercation or been assaulted?
  • Are you under the influence of drugs or alcohol?
  • Have you received Narcan?
  • Are you pregnant?
  • Do you have tuberculosis?

A second screening by QCC includes a lot of the same questions: have you been in a motor vehicle accident, are you in pain, do you have allergies, heart problems, diabetes, on a withdrawal from drugs or alcohol, do you have epilepsy, take medications, have you had a traumatic head injury in the last 48 hours, have you had mental health counseling, do you take any meds for mental health, etc.

The jail’s goal is to get people bonded out of the jail, Hershberger said. It’s up to QCC to take care of people’s medical needs inside the jail, they said. The QCC contract costs about $3 million annually.

Once inmates are taken outside the jail for treatment, Medicaid will kick in, but the county is responsible for extra costs and total costs if the inmate is without health insurance, they said.

In the jail population – today at 709 inmates, typically there are a dozen diagnosed with severe mental health who are tracked daily, the commanders said.

“They’re under some kind of forced medication with court ordered medications. Typically, they can’t be in the general population because they become combative and would assault other inmates,” Butler said.

Jailers get mental health training

Confinement officers who get mental health instruction in their 40-hour training often develop strategies, working with Butler and Sickafoose to help control inmates.

“Whether they want to be or not, to some degree they’re mental health workers, too. You have to learn how to deal with these people and I have people  thankfully who are better at it than others, that are good at going and talking somebody down or talking them into taking their meds on a particular day,” Butler said.

When an officer learned that one inmate charged with a high felony liked to color, Butler ordered coloring books and crayons for him and it worked. No problems after that, he said. Officers working with difficult inmates might resort to offering a candy bar to convince that particular inmate to take a shower, he added.

After the inmates with court ordered meds, there are another dozen or so who local or state hospitals won’t deal with anymore, Sickafoose said.

 “They’ve been in their programs. They can’t help them. They don’t have places for them and would have difficulty following through with outpatient treatment,” he added. These individuals very often wind up again and again at the jail.

Another group of between 20 and 50 individuals have been identified as being on some kind of psych meds “but it doesn’t include how many more here we don’t know about,” Sickafoose said.

Often jailers will hear: “I don’t want to take it because I don’t want to feel bad,” Sickafoose said.

More humane facility needed

What Butler, Sickafoose and the jail staff are hoping for is a new jail facility that will have a medical unit, preferably with a special section for the mentally ill, something like Marion County has just built and they toured with Allen County Commissioners.

Meeting with the designated architects on the new jail, Elevatus Architecture, the jail commanders told them the Marion County facility is a “lot more efficient and better laid out,” and ultimately more humane.

“Ideally what we would like to see in the future is a better designed medical infirmary that would include not just people for immediate medical needs, but then also a mental health unit that has close proximity to the mental health providers that are in-house,” Butler said. It would allow inmates with mental health issues to be more easily managed and services for them would be immediately accessible “rather than spread all throughout the jail in different locations which is how it is now,” Butler said.