The Los Angeles County Sheriff’s Department “made substantial progress” into compliance with many of the 69 conditions of a 2015 settlement with the US Department of Justice to improve mental health care in the county’s jails, according to the latest report from Richard Drooyan, the monitor appointed to oversee the mandated reforms. However, the department was in non-compliance on 10 of the required reforms, including increasing out-of-cell time for mentally ill inmates, and improving —and faces “significant challenges” on the road toward achieving compliance with the terms of the settlement.
The 2015 settlement is the culmination of two DOJ investigations spanning two decades of scrutiny of LA’s county lock-ups, starting in June 1996, “to determine whether the conditions in the jails violated the constitutional rights of its prisoners.” The investigations found that the department failed to provide a safe, appropriately monitored, non-abusive environment, including “adequate mental health services,” for the mentally ill in the LA County’s long-troubled jails.
Drooyan is the former general counsel for the Citizen’s Commission on Jail Violence, former head of the Los Angeles police commission, and a former chief assistant US attorney.
Of the 69 provisions, Drooyan found the department to be in “substantial compliance” with 22, and in partial compliance with 27, but out of compliance with 10. The report gave mixed reviews on seven of the provisions, and three were no longer being monitored.
The department proved to be in compliance with reforms regarding investigating staff misconduct, supplying control booths with suicide prevention kits, and ensuring that all inmates have access to basic hygiene supplies.
Among the reforms that the department had achieved partial compliance were implementing suicide prevention training and crisis intervention training, developing and implementing specific disciplinary policies for mentally ill inmates, and ensuring that inmates’ mental health diagnosis doesn’t preclude them from being eligible for education, work, and other programs.
The report found the department was non-compliant with a requirement that the sheriff’s department ensures that inmates who verbalize or exhibit suicidal ideation will be transported to the Inmate Reception Center (IRC), Century Regional Detention Facility (CRDF), or a medical facility as soon as possible. Before suicidal inmates are transferred, they must be either within unobstructed view of jail staff, or in a “suicidal restraint location” with welfare checks every 15 minutes.
The settlement also required the department to make sure that psychotropic medications given to inmates “are administered in a clinically appropriate manner to prevent misuse, hoarding, and overdose.”
While the LASD self-reported to Drooyan that it was in compliance with properly administering medication, the report found otherwise. According to Drooyan, he questioned whether the pill calls he observed at Twin Towers Correctional Facility and Century Regional Detention Facility were an accurate reflection of everyday pill calls. When he requested video of pill calls on other days, he found that the administration of medication was not careful enough to keep inmates from hoarding or misusing medication. The footage showed inmates walking away from the nurse’s station without first swallowing their pills, according to Drooyan.
During the first quarter of 2017, 34% of mentally ill prisoners in High Observation Housing, 14% in Moderate Observation Housing, and 33% of prisoners in other housing areas who also have serious mental illness were “offered clinically appropriate mental health treatment and were seen by a [qualified mental health professional] at least once a month.”
However, the Mental Health Subject Matter Expert that works with Drooyan to measure compliance “found virtually no evidence of treatment that qualified as structured or clinically appropriate.”
The settlement also required that by 18 months after July 1, 2015, the sheriff’s department would provide 100% of prisoners held in High Observation Housing at least “ten hours of unstructured out-of-cell recreational time and ten hours of structured therapeutic or programmatic time per week.” The ten hours could include five hours of education or work programs, but at least five hours had to be therapeutic in nature.
According to Drooyan’s check-up, the department is having serious problems with tracking the out-of-cell time. Custody staff reported that they offered the out-of-cell time to 72.6% of inmates, and Department of Mental Health Staff reported that they offered out-of-cell time to 17.2%. According to the Mental Health Subject Matter Expert, the county qualifies “large numbers of hours when the inmate was not in fact out of his or her cell,” as out-of-cell time, by labeling it “refused/ineligible.”
Drooyan said he believes that the LASD can come into “substantial compliance” with most provisions within 18 months, as predicted by the department, but that the provisions they are still struggling with will take “considerably” longer than 18 months.
Photo of Richard Drooyan by the LA County Board of Supervisors.
How are they suppose to make sure inmates take their medication and don’t walk way? How do you enforce this? There’s no way you can even make a free person take their medication unless they’re deemed incapable of doing it themselves.
Why doesn’t the Federal Government just take the reigns of the LASD jails, put it’s staff in place in the problematic facilities and have at it. It looks like LASD just can’t be in compliance with the provisions. Go Feds, have at it.
As usual the Feds have no answer for HOH inmates who refuse to participate in programming, yet they insist on penalizing the department for the refusals.
Perhaps this SME and Drooyan can spend some time in HOH housing themselves, dodging feces, so they can show the sworn staff how it’s done.
What’s so evident and is like the proverbial “Pink Elephant” in the room is the fact LASD, namely Twin Towers, has/is becoming a defacto “mental health hospital” of the type political leaders and mental health professionals said would never be brought back. Instead of telling the taxpayers the truth and building purpose built mental hospitals to house the mentally ill, they instead force jails to bend, modify and break in order to fill the void.
The politicians and mental health professionals continue to dance around the real issue by proposing housing for the homeless (a large number of whom are mentally ill) and “access to resources”. It’s truly inhuman and a travesty to see mentally ill people on the street, get arrested, go to jail, “receive treatment”, get released and weeks or months later (if your lucky) come right back to jail in the same deplorable state. These folks won’t take their medications on the street or avail themselves of the “resources”. They are mentally ill, can’t live on their own and a civilized society would recognize. A civiliz d society would own up to the reality and put the mentall ill in facilities where they would be taken care of by trained mental health professionals and not law enforcement officers. Just spinning wheels right now with oversight committees justifying their existence by holding people accountable to unrealistic or attainable goals. Real progress.
Just dumb!
Cx – Amen and well said. I’d like to see monitors/auditors who make these demands also explain how to accomplish them with more seriously mentally ill inmates in the confines of a jail. There are thousands of mentally ill people living on LA streets. Fund county mental hospitals to provide proper housing and real help for these people rather than warehousing them in a jail facility. Fund housing of some sort for them to live in once they are released from a hospital facility so they have a place to stay and make it easy for them to get their meds within the areas they gravitate to. The system now sets them up to fail.
First question, how much actual time is Mr. Drooyan spending walking in the shoes of these deputies that he is so freely criticizing rather then just sitting in that very nice comfortable office watching videos and passing judgement?
Second question, when did deputies become mental health workers?
I am pretty sure when these deputies went through the Academy they were not given a Psychology/Medical degree. So why are they expected to take on these roles?
This is jail and as far as I know the only way to end up there is to break the law. So why in anyway should these individuals be given any kind of special treatment? If there are no consequences in going to jail, then what is the deterrent keeping them out? I was always s told by my father “if you can’t do the time don’t do the crime.” Seems pretty simple to me. We are not sending these individuals to jail because they are outstanding citizens, they are there because they broke the law and they now have a debt to repay to society. Maybe if they were allowed to be treated as the criminals they are, they wouldn’t feel so much like jail was a simple vacation from society offering three hots a cot and an endless supply of free health care.
It’s a very simple concept, jail is for those that choose not to follow the rules and laws of our society and therefore this should be a punishment and in no way a reward. If the individuals are sick (mentally) then they should be in a facility that offers them help rather then in a cell with individuals watching over them that are not qualified to truly do so. If you ask me it is not the fault of these deputies, but rather the state and those in power that put deputies in these situations. These kinds of articles and actions are a simple slight of hand done to shift the blame from where the true focus should be.
The use of law enforcement in the role of medical professionals not only subjects them to working out of the scope of their professional training, but also leaves them legally and civilly vulnerable. Medical/mental health professionals are always thought to be helping individuals as is understood by the nature and scope of their profession. Besides the medical boards and accreditation agencies unique to the profession, there is little to no oversight with respect to their job performance and a very high hurdle for an individual to leap if they wish to prove incompetence or malpractice. Society loves folks in the proverbial “white coats”.
By using law enforcement in these roles they are perceived as “enforcers” versus helpers. They are held to strict standards established by their departments, cities/counties, courts, state legislatures and US Constitution. All law enforcement personnel who are not trained to deal with mentally ill people as part of their professional practice are put in positions where their actions will be judged under the strictest scrutiny as law “enforcers” and with the strictest consequence for perceived mistakes.
When you consider societies suspicious and jaded view of law enforcement versus the favorable perception of medical and mental health workers, it’s a no-brainier regarding who is in career jeopardy.
At this pace, I would encourage anyone in law enforcement working in a hospital and patient care type setting to purchase a malpractice insurance policy.
Amen!!!