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"Throughout the Men's Central Jail (MCJ), the cells and dormitories violate minimum standards in terms of both social and spacial density (including) compensatory out-of-cell time for jail prisoners confined in substandard cells or dormitories. (It's) intolerable to leave prisoners in harsh, crowded conditions that we know cause psychiatric breakdown."
Conditions also affect staff. They get impatient, angry, and take it out on inmates for minor infractions. They, in turn react, and the longer they're incarcerated awaiting trial (at times years), the worse their condition becomes.
Like the MCJ, conditions in the Twin Towers are poor. Yet some positive mental health programs are in place, including inpatient beds in the Forensic Inpatient Program (FIP), crisis intervention/observation capabilities in TT 1, a step-down or subacute mental health unit, mental health housing, pre-release linking with community mental health services, and Jail Mental Evaluation Teams (JMET). The latter are "excellent in concept," but inadequate in implementation, prisoners outside mental health housing units saying they're not helped.
For the most part, little besides psychotropic medications are provided. Yet prisoners complain about not getting them or having them discontinued, their charts corroborating their accounts. Most inmates needing help wait weeks or months to be seen, that at best lasts a few minutes. Others are never seen because of too few staff to handle large numbers in need.
"I was told repeatedly by prisoners that there is nothing available in the way of mental health treatment except the prescription of psychiatric medications. This is far from adequate mental health treatment....There is a Pattern of Failure to Diagnose and Inappropriately Down-grad(e) the Diagnoses of Prisoners who Cannot be Accommodated in Mental Health Housing."
Some inmates are never diagnosed despite complaining of "significant psychiatric history." Others, seriously ill, are "un-diagnosed;" for example, Schizophrenia to a personality disorder, an "adjustment disorder," or "malingering." Without treatment, symptoms inevitably worsen, often jeopardizing inmate safety.
"It is important to note that serious mental illnesses are, mostly, lifetime conditions that pursue a waxing and waning course. An individual suffering from Schizophrenia might go into remission," especially if properly medicated, but it doesn't mean he's cured. Future eruptions can happen anytime and do. Under LA County Jail conditions, a complete breakdown or suicide can result.
"It is striking how indifferent mental health staff are to evidence of serious mental illness by history - past hospitalizations, Social Security Disability benefits, or even competency evaluations." Instead, they focus only on current symptoms, and do it poorly by misdiagnosing.
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