“Welcome to the zoo,” said LA County Sheriff’s Deputy Jacob Allen, motioning to the figures behind him wearing bright-colored jumpsuits stamped with the words LA COUNTY JAIL. The men are separated from Allen and other guards by a thick glass wall. In addition, each inmate is behind a locked metal door, with the exception of a tall, bearded man standing chained to a wall in the center of the room. His brown eyes look glassy and dull.
This is module 142 at Twin Towers Correctional Facility, located one mile north and east of Los Angeles City Hall. The inmates in this section of the jail can only come out of their cells individually for an hour at a time. There is a yellow line on the floor to indicate the path inmates must take when they are out of their cells. During this time, they wear a waist chain and their hands are cuffed.
Behind the glass are desks and chairs, where guards monitor the men’s behavior and dispense meals and medication. The yellow line cuts through this room to others containing such amenities as a refrigerator and lockers for the guards, a large patio with a basketball hoop, which inmates can sometimes use, and private areas for therapy and legal appointments.
Although the population in California jails, in general, has dropped over the last ten years, the proportion of those suffering from mental illness in those same jails rose 63 percent between 2009 and 2019. In LA County’s jails, as of June 2019, there were 5,544 people who were either held in mental health housing units, taking psychotropic medications or both — or about 30 percent of the county’s total jail population.
Twin Towers, which has a history peppered with inmate abuse and neglect, is where most of the system’s mentally ill are housed and is considered the nation’s largest mental health facility. Despite several large lawsuits, followed by two major settlement agreements intended to improve conditions inside the place, Twin Towers has consistently failed to meet some of the basic requirements for inmate care.
The jail is made up of two main “tower” buildings and the adjacent Correctional Treatment Center (CTC), which houses the mental health cases with the most serious problems. Justiniano Jaojoco, the Nurse Manager at CTC, said that understaffing and inadequate resources make it difficult to provide inmates with the care they need.
“If we had more staff and more supervision we could take them out [of their cells] more,” Jaojoco said. “Meds could be delivered a little better, faster.” There would be “less arguing with the patients.”
When the staff is short causing a delay in getting the medication to the men, patients become agitated, he said. “Before you reach that patient,” things are “already out of control.”
This is true, according to Jaojoco, even after the improvements forced by the lawsuits and the settlements.
Prominent among these legal deals is the 2015 Department of Justice settlement agreement with LA County and the Los Angeles County Sheriff, citing inadequate mental health protocols, failure to protect prisoners from serious suicide risks, and excessive use of force.
The agreement mandated a series of reforms within the county’s correctional facilities in order to make sure the jails, particularly Twin Towers, provided “constitutionally adequate care for prisoners with serious mental illness.” The DOJ agreement was—and still is— overseen by an independent monitor and enforced by a federal judge.
Yet, despite increased financial resources being delegated to the jail system as a result of the lawsuit, nearly five years later several critical conditions of the settlement are still not hitting the necessary marks.
Richard Drooyan, an LA-based attorney, who has served on a string of high profile law enforcement reform panels, is in charge of monitoring the terms of the federal settlement. He said the biggest concern is the lack of out-of-cell time for inmates.
The jails, Drooyan said, “just haven’t been able to meet the number of [out of cell] hours required under the settlement agreement for inmates in the mental health housing,”
Specifically, the text of the settlement stipulates “ten hours of unstructured out-of-cell recreational time and ten hours of structured therapeutic or programmatic time per week.” Minimum.
As of his most recent report in August 2019, Drooyan said, Twin Towers remains noncompliant with both these basic requirements. (An updated report will be released from his office later this month.)
The effect of solitary confinement and isolation on incarcerated people has proven to have a long-term impact on their mental health. Extended periods of isolation can cause depression and psychosis symptoms in people who have never experienced mental illness before. For those with pre-existing mental health conditions, isolation exacerbates their symptoms and significantly increases the risk of suicide.
Drooyan said the shortage of out of cell time also affects the inmates’ ability to access individual and group therapeutic services.
Jaojoco agreed that, as it stands, too often inmates don’t get access to the most basic resources they need.
Many of the inadequacies can be tied to lack of staff and insufficient staff training, said Jaojoco.
A chronic and well-documented shortage of LASD deputies has impacted the Sheriff’s department for quite some time, affecting the number of deputies in some of the department’s “contract cities,” in unincorporated areas of LA County, and reportedly also in the county’s jails. Although Sheriff Alex Villanueva has been energetically recruiting, the still low numbers also mean there are fewer deputies inside with the specialized training needed to work effectively with mentally ill inmates, according to both Drooyan, and staff members like Jaojoco.
“We haven’t had sufficient staff for the past few years,” Jaojoco said.
“These are the crazies,” Deputy Ralph Sanders said as he walked past the men in module 172. On the heavy doors of each cell, one sees labels: “spitter,” “gasser” and “extremely violent.”
For those unfamiliar, gassing is a slang term for throwing feces or bodily fluids such as urine or semen at deputies or fellow inmates. While often a symptom of untreated mental illness or the result of mental stress due to conditions of incarceration, the act can also result in additional felony charges and more time inside.
Sanders has been working as a correctional officer at Twin Towers for four years. He also has six years of experience as a U.S. Marine and still keeps his light hair cropped short and speaks in brief, curt sentences. Sanders’ general approach to his job in the jail shows remnants of his time in the military.
The floor where Sanders works is the first stop for those who are locked-up at Twin Towers. There, inmates are supposed to be given a psychiatric evaluation by a clinician, either a psychiatrist or nurse, within 24 hours. When the men arrive, they are stripped and given rip-proof gowns to wear while they wait so they cannot create a noose out of their clothing.
“With a normal person, you can just go up and talk to them. With these guys, you just never know. We’re lucky if they have clothes on,” Sanders said.
Deputies often have little idea about the mental or emotional states of the inmates they are meant to oversee. For reasons of medical privacy, the guards are given no specific information about inmates’ physical and mental conditions unless someone has expressed a desire to hurt himself or someone else.
Then, observation protocol is supposed to become rigorous and guards are required to check in on such inmates every 15 minutes.
“We’re not qualified at all for mental health situations. We just don’t have the training,” said Deputy Jose Flores. Flores has been working at Twin Towers for three years, after completing a degree in criminal justice.
Guards at Twin Towers are given just one 40-hour training dealing with mental health issues facing inmates. The training focuses mainly on de-escalation techniques through verbal cues, Flores and Sanders explained.
Nevertheless, Sanders and Flores speak about the struggles they encounter with such daily tasks as bringing mentally ill inmates out of their cells and readying them for transport to court, giving them their medications, and breaking up fights.
“It can be hard sometimes…” Sanders said.
Restraints and diversion
The advent of the DOJ settlement that Drooyan is overseeing, plus that of Rosas v. Baca (a major class-action lawsuit alleging extreme violence against inmates in LA County’s jails, which was settled in December 2014) precipitated a shift in the jails’ procedures and the system’s general culture. The department was forced specifically to address its history of inappropriately using restraints by implementing new standards of use, which first had to be cleared with the feds.
One method of inmate control, sometimes called tethering, involves binding a man or woman’s limbs tightly together with locking straitjackets or straps called hobbles. In past years, tethering has been cited in multiple reports of abuse where inmates were left alone, bound, sometimes naked, for many hours at a time – as in one 2015 case in at Twin Towers which resulted in a man’s death.
Jaojoco’s unit, in particular, he said, has made significant strides in the use of restraints on inmates. According to Jaojoco, CTC used to keep 30-40 patients per month in restraints. In the past year, restraints were only used on three patients.
Yet, despite some improvement, critical systemic problems such as staffing shortages and inadequate training have not gone away. These issues cannot help but create stressful work environments for those employed in the jails, and conditions that result in psychological harm, or worse, for those who are sentenced to Twin Towers.
With these problems in mind, the 2019-2020 budget for LA County allocated $93 million towards mental health services and diversion from the criminal justice system. Of that, $20 million has been budgeted toward additional treatment beds, $20 million for expanding supportive housing with the Office of Diversion and Reentry, and $53 million for increased support of diversion programs, which have been proven to be less expensive, less harmful, and far more effective than incarceration at reducing recidivism for those struggling with “behavioral health.”
In 2018, the Los Angeles County’s Board of Supervisors asked for a study of the existing mental health population in LA’s jails to identify those who would likely be eligible for diversion based on legal and clinical factors. The results of the study were released in January by the RAND Corporation and the news was generally good. Researchers found that an estimated 61 percent of the jails’ mental health population was likely appropriate for diversion. Another 7 percent was potentially appropriate.
Yet, this still left 32 percent who, according to RAND, were likely not appropriate candidates for diversion. A lot of those people will be sent to Twin Towers and subjected to its problems.
The revolving door
Getting people what they need for the transitional period from jail to life outside is also problematic, according to Mary Whaley, who oversees the jail release transition for inmates being treated for mental health.
“There are not enough resources,” Whaley said. “There just simply are not.”
After release, the jail system provides everyone with 30 days of medications and 90 days of services via what is known as the Community Transition Unit, through which the departments of Probation, Mental Health, and Public Health, theoretically help those leaving custody to connect with outside resources.
Unfortunately, a large number of those released from a mental health unit don’t access those services, or continue any kind of mental health treatment beyond 30 days, Whaley said. Too often, when someone struggling with mental illness is released, their first priority is food and shelter and everything else falls by the wayside, she said. It doesn’t help that many don’t have insurance and struggle to navigate the Department of Mental Health system to schedule follow-up appointments and refill their medications.
In addition, Whaley said, there aren’t enough community programs to assist with living arrangements and reintegration. Most of the programs she knows of are useful, she said, but supportive housing fills up fast and it can be a struggle to find placement for her most mentally ill clients.
“We’re supposed to find housing and resources for individuals and it’s just not out there,” Whaley said.
Whaley and Jaojoco both reported that some men and women actively try to return to jail because it is the only place where they have access to consistent medication and psychiatric services.
Outside, Whaley said, the most vulnerable often self medicate or commit petty crimes like loitering while naked, knowing they’ll be picked up and sent back to the Twin Towers.
“They say, ‘I’ll see you next time,’” Whaley said.
Although the LA County District Attorney’s office contends that they generally divert mentally ill people who commit such misdemeanors, many public defenders with mentally ill clients say otherwise.
Jaojoco does not paint a rosy picture either, referring to the LA County Jail system as a “revolving door” when it comes to many of those battling mental health issues.
And, for those who return, while they might get needed medication, Whaley and Jaojoco conceded that jail is not a place of healing.
“Jail will make you really sick,” Jaojoco said, his voice softening. “I would be sick here if I was on the other side.”
Justice advocates, like those at Dignity & Power Now, and others who are behind Measure R, say that the conditions in Twin Towers are far worse than those who work there are admitting. They cite the 2018 deaths of Quinten Thomas and Lewis Nyarecha, who both died under questionable circumstances at Twin Towers, as evidence that LASD officials have not yet begun to adequately address basic inmate safety concerns.
(Measure R is a local ballot proposition that will be on the March 3 ballot and, if passed, will strengthen civilian oversight for the LA County Sheriff’s Department, and require the county to come up with a plan to use mental health treatment in order to lower the jail population.)
Reporter Katherine Tangalakis-Lippert is an investigative journalist living in Southern California with her retired service dog, Liberty. Through her work, Katherine aspires to help strengthen the fragile trust between journalists and the public. You can find her on social media as @scrawlgirl.
Sophie Bress and Rebecca Katz contributed to this story.
Top photo courtesy of LASD.