By COURTNEY BLANCHARD
A numbers problem An estimated 16 percent of America’s prison inmates suffer from a mental illness, compared to 5 percent of the general population, according to 2002 data collected by the Criminal Justice/Mental Health Consensus Project. News You can use
Timothy Bribriesco stands more than 6 feet tall, and tattoos stretch over his 350-pound frame. But last week, the man’s voice wavered with an unexpected vulnerability. As he sat in the Dubuque County Jail, he called his mother and began to sob.
Another woman was vying for his attention: Lindsey.
“She tells me bad things, laughing at me,” Bribriesco, 32, told his mother, Deb Bykowsky. “She’s just evil.”
Lindsey appears as a suggestive tattoo on his right arm. With bright-red lips and yellow fishnet stockings, she resembles a tattoo parlor cliche, but her presence on Bribriesco’s arm is sinister to him.
Lindsey is a voice, a symptom of schizophrenia, which has haunted him since he was 14.
When she speaks, the big man nestles his chin into his right arm, and anger clouds his face, Bykowsky said. Lindsey once told him to run over a goat on a riding lawn mower at their farm in rural Linn County, Iowa, she said.
He stopped just short of it, knocking the animal off its feet.
Bykowsky worried about her son while he sat in jail, because he told her that he hadn’t received at least seven of his medications, including one for schizophrenia. Without it, she said, the voice gets worse.
But Dubuque County Jail officials say Bribriesco received all necessary medications. Dr. Norman Johnson, chief executive officer of the jail’s health care provider, Advanced Correctional Healthcare, said he received treatment based upon the jail doctor’s evaluation and recommendations from federal authorities.
“This guy is getting virtually everything. He’s manipulating, he’s violent,” Johnson said. “He’s actually swung at our nurses. He’s very difficult. In spite of all of this, our nurses are doing yeoman’s work. He is getting excellent care.”
Inmates like Bribriesco present a challenge to county jails, which are not equipped to deal with growing numbers of mentally ill inmates – especially those with violent tendencies.
However, mental illness of all varieties presents a strain on the corrections system. Law enforcement and community members address the problem with treatment options and alternatives to jail.
In Dubuque, the alternative is the jail diversion program.
Closing the revolving door
While violent, mentally ill inmates are rare at the Dubuque County Jail, many inmates have some kind of substance abuse problem or mental illness. About a third of Iowa’s prison inmates are mentally ill, and half of female inmates suffer from a mental illness, according to a 2006 report by the Iowa Department of Corrections.
When mentally ill inmates find treatment and support, they’re less likely to move in and out of jail, experts say. In Dubuque County, support programming evolved from a $1 million grant for a three-year jail diversion program, which kicked off in 2003.
Under the program, police officers learned to recognize the signals of a mental illness. When officers encountered someone with a possible mental illness, they called a mobile counselor to evaluate the person and, in some cases, referred the individual to a treatment center instead of the jail. Then, case managers guided the person through the judicial process and sought services to stabilize the person’s diagnosis.
Mood disorders, depression, bipolar disorder and anxiety topped the list of diagnoses, according to county data.
The varying forms of mental illness made everyday activities difficult, said Joel Lightcap, former director of the program. He remembers one participant who didn’t know how to get from his apartment to the doctor’s office. Lightcap bought a bus ticket and rode with him to the clinic. After his next appointment, the man stopped by Lightcap’s office.
“He comes in with a big smile on his face and he says,’I know how to get up there now!”” Lightcap said. “For him, it was a major accomplishment. For the average person, he got on a bus and went to a medical appointment. No big deal.”
When the grant ran out after three years, the county handed the reins to the Iowa Department of Corrections and eventually set aside around $72,000 annually to create a community treatment coordinator position, to find services for mentally ill inmates.
A question of control
Some worry that the slimmed-down funding doesn’t cut it.
Former Dubuque City Council member Ann Michalski said she expected local sources to keep the diversion program going at the same level of funding after the federal grant ran out.
“At the end of that three years, things were better but the system had not totally changed,” she said. “It really had the potential to do remarkable things if it had been funded fully.”
Lightcap said he was skeptical about the Department of Corrections’role.
“The Department of Corrections has the power to just throw (participants) in jail for violations,” he said. “You really can’t be an advocate if you’re tied into an agency that has that much ability to have control over people.”
Nathan Duccini begs to differ. Hired as the department’s community treatment coordinator in February 2007, Duccini has worked with nearly 100 clients. Fewer than a dozen went back to jail, he said.
“Almost all of them have wanted help, and they come in here desperate, wondering why they couldn’t get the help,” he said. “I have people who show up on a daily basis, and I don’t require it.”
Kyle Stewart, probation and parole supervisor, said the jail diversion program paved the way for unprecedented community collaboration. Agencies addressing homelessness, substance abuse, mental illness and job placement banded together to give Duccini the resources to help inmates acclimate to life outside of jail.
“We’re finally addressing the mental health issues within our own community and not just closing our eyes to what’s going on right in front of us,” Stewart said.
Saving money and lives
Dubuque Police Chief Kim Wadding said diversion efforts can appear costly and ominous for law enforcement agencies, but it saves time and money in the long run.
“We benefit not only ourselves, as far as saving resources, but we really, truly save the person,” he said.
Law enforcement officials point to voluminous data indicating that the costs of community-based programming such as jail diversion initiatives are significantly less than the cost of incarceration.
The Jail Diversion Committee, which has met regularly since the end of the federal grant, is considering establishing a Community Accountability Board, similar to a program run by Black Hawk County. Upon release, the inmate sits down with a group of corrections personnel, social service providers and people from the faith community to engage in an active discussion on his or her future, said Todd Lange, president of Dubuque National Alliance on Mental Illness, who recently observed a panel in Black Hawk County.
“It seemed like we’re dealing more with concrete problems and issues, there’s more solution-focus. You’re dealing with someone with more of a real-world situation,” Lange said.
A system’in transit’?
As communities continue to move forward with programming to help inmates with mental illness, there’s still a hole in the system for the most extreme cases.
Dubuque County Sheriff Ken Runde said most jails aren’t equipped to handle inmates with violent mental illness. Over the past few years, he sent two mentally ill and violent inmates to the Iowa Medical and Classification Center in Oakdale, Iowa, after a struggle over where to go.
“Corrections will be the first to tell you that the mentally ill shouldn’t be in our jails,” Runde said. “We can’t deal with them because we don’t have the medications to deal with them. When they’re on some of the particular medications they need, we don’t have the machines to monitor them, and we don’t have the restraining tools to restrain them if they need restraining.”
Bribriesco left the Dubuque County Jail and was listed “in transit” Friday, according to the Federal Bureau of Prisons. He’s been shuffled from facility to facility, and Bykowsky said she feels like people are just trying to get rid of her son.
When Bykowsky spoke to her son on Tuesday, she said his mental health medication had been replaced with an older psychiatric drug. He didn’t respond well to it.
“He’s decompensating (deteriorating mental health) really bad. I said just go to your bunk, think of pleasant things, take it a minute at a time,” she said. “He said he feels like he’s dying.”
Originally published by COURTNEY BLANCHARD TH staff writer/cblanchard@wcinetcom.
(c) 2008 Telegraph – Herald (Dubuque). Provided by ProQuest LLC. All rights Reserved.
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