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Jail population presents new challenges

A jail is a grassroots reflection of societal problems. "It's a little city, a complex society," Hubbard County Chief Deputy Frank Homer said of a jail. "Everything that's on the inside, is on the outside." And what's being seen "on the inside" h...

A jail is a grassroots reflection of societal problems.

"It's a little city, a complex society," Hubbard County Chief Deputy Frank Homer said of a jail. "Everything that's on the inside, is on the outside."

And what's being seen "on the inside" has evolved over the decades.

Jail administrator Sherri Klasen joined the staff in 1986, when "alcohol was the main contributing factor" to those who were incarcerated.

"Now it's drugs," she said. "And a huge part of it is methamphetamines."

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She estimates 80 percent of the inmates' sentences are related to alcohol or drugs.

And the Hubbard County Jail is seeing an increase in those with symptoms of mental health problems, as well.

"We were warned of this in the late '90s," Homer said. State funding was "falling short." State hospitals would be closing. The patients were to be given medication and sent "home." Law enforcement was cautioned the impending problems could fall in their lap.

He cited the closing of Ah-Gwah-Ching as a "classic example."

The satellite facilities that now house many of the former patients "are non-secure and understaffed," Homer said.

As secure facilities disappear, the jail is dealing with more inmates with mental health issues - and for longer periods of time, Klasen said.

She cited a recent incident. A male who'd had a history of mental issues was arrested in Hubbard County. Upon questioning, officers learned he was not taking his medication.

He was transported to the Brainerd facility, where he was stabilized and subsequently returned to Hubbard County.

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He was released on his own recognizance, his father arriving to pick him up, with the recommendation he be taken to the Upper Mississippi Mental Health Center (UMMHC).

"We were forewarned," Homer said of seeing an upswing in mental health problems. "I didn't take it seriously at the time... But it's here."

'Silent epidemic'

Nationally, correctional facilities are seeing more mental health problems, UMMHC executive director Manfred Tatzmann said.

A recent survey by the federal Justice Department statistics bureau estimated 56 percent of the nation's 1.25 million state prisoners, 64 percent of its 747,000 jail inmates and 45 percent of its 156,000 federal prisoners reported treatment for or symptoms of major depression, mania or psychotic disorders such as hallucinations or delusions in 2006.

Treatment behind bars was most common among state prisoners - 34 percent of those reporting symptoms, compared with 24 percent of troubled federal prisoners and 17 percent of county jail inmates with problems.

Conditions faced by inmates may include fetal alcohol syndrome (FAS) or those who've suffered traumatic brain injury (TBI).

TBI occurs when a sudden trauma causes damage to the brain. It may result when the head suddenly and violently hits an object or when an object pierces the skull and enters brain tissue.

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The brain is not fixed, but floating free, Tatzmann explained. When the brain hits the skull, damage occurs.

TBI affects impulse control and memory. "They may forget to take their medications," Tatzmann said.

Offenders with TBI may suffer from depression, anxiety, cognition problems, violent thoughts, suicide attempts and discipline violations, according to the Minnesota Department of Corrections, which received a three-year federal grant to identify and support offenders with TBI.

The conditions, not always discernible to the public eye, may cause impulsive behavior and difficulties with the law, Tatzmann said.

Up to 80 percent of veterans returning from Iraq and Afghanistan may have suffered brain injuries, Tatzmann said.

It's been called the silent epidemic because there are no visible signs. "No two are alike," Tatzmann said of patient symptoms resulting from TBI.

People with brain injuries tend to self-medicate and domestic violence increases.

The number of people with TBI has grown dramatically in the past 10 years because of medical advancements. Fifty percent of the people sustaining a TBI faced mortality previously, Tatzmann said. The condition was not formally recognized until 1996.

FAS, prenatal alcohol exposure, causes changes in behavior, cognitive function, language, attention, attachment and fine motor skills.

Young adults without appropriate support have difficulty maintaining employment and relationships with friends, families and partners.

"The problems are not insurmountable," Tatzmann said, advocating jails and mental health services work together.

Michigan, Tatzmann's former state of residence, has developed a diversion program as an alternative to jails. The state's mental health program works within the jails. He advocates developing a triage system in dealing with mental health issues.

"The key is developing programs for discharge," he said. "We need to look at this as a community safety issue. The recidivism will be high if we don't have services and support."

Jail now 'secure facilities'

In many instances, jail personnel are unable to transfer an inmate who's in need of psychological treatment at a mental health facility, Homer said. The jail staff is trained, "but we're not doctors."

But Homer congratulated a staff that maintains conscientious oversight of inmates.

"In the 1980s, it was catch and release of drunks," Klasen said of people detained during her first years working at the jail. "Now it's serious drugs. And we're seeing 18-year-olds whose source of income is SSI "(Social Security Income).

Drugs that were formerly unheard of in rural areas - crack, heroin, meth and cocaine - are now available in "small town America," Homer said of Hubbard and surrounding counties. "That's definitely a contributing factor in this facility.

"Drugs and drinking are a whole different ballgame," Homer said. "We don't have the (psychological) expertise found in state facilities" to counsel addicts.

Meth addicts experience hallucination and paranoia, Klasen said.

"We are seeing a number of self-inflicted mental health issues," jail programmer Bill Devine said. Bipolar disorder numbers are on the rise, he said. This "unpredictable" behavior requires "special management on the part of personnel."

The new facility's five holding cells - as opposed to the former single cell - have been a welcome addition, Klasen said. Meth addicts, for example, require ongoing visual checks, cameras augmenting the task.

And the chemical and mental health issues come with a big price tag - medications for a single inmate can cost up to $500 a month, borne by taxpayers.

Most of the prisoners have not completed high school, Homer said. Many are not able to write at a third grade level. "Their letters are atrocious."

Klasen expressed concern with cuts to special education funding, which could exacerbate the problem.

"Those who fail in society end up here," Homer said.

"I'm now seeing the children of people I met here 20 years ago," Klasen said.

And the number of women incarcerated has increased significantly," Homer added.

"When I started, I rarely saw a female," Klasen said.

"Years ago, the court system was more lenient on females," Devine noted.

People need to change their thinking on how inmates should be treated, Devine said.

"There's no doubt that people in this facility 20 years ago would have been in Ah-Gwah-Ching, Fergus Falls or another institution," Homer said. "If Ah-Gwah-Ching was up and running, these people wouldn't be here. There's no doubt that we wouldn't have the same clientele."

"Secure facilities are disappearing," Klasen agreed. "Now we're the secure facility. We are dealing with people (with mental health issues) more often and for a longer period of time."

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