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Hospital backlog has mental health patients sitting in county jails

CDHS talks openly about the problem as they work toward a solution
Inmates awaiting mental health treatment
Posted at 5:23 PM, Jan 27, 2022
and last updated 2022-01-28 11:53:25-05

COLORADO — A News 5 investigation found hundreds of people who are supposed to be receiving inpatient care at the Colorado Mental Health Institute at Pueblo (CMHIP) are sitting in jail awaiting a bed.

The Colorado Department of Human Services (CDHS) was open, honest and transparent about a problem we discovered through a series of information requests we filed for public records and data.

Through our research, we learned county jails, the court system and State are well aware that people with a diagnosed mental illness are left sitting in a jail cell---waiting for a bed to open up at the state hospital.

"He is just sitting in jail," June Miller, a Colorado Springs mother said.

June Miller's son, Steven
June Miller's son, Steven

Miller's son, Steven, has been locked up in the El Paso County Jail since October 2021.

Records show he has been deemed mentally incompetent to stand trial on a case that involves harassment and assault charges.

"He's incompetent to proceed," she said. "They can't proceed with anything. He's not been convicted of anything and he has not been found guilty."

Miller says her son was diagnosed with Schizophrenia when he was 15 years old. For a while, she says he was doing well on medication.

JUNE_MILLER.jpg
June Miller talking with News 5 Investigates

"After he went off his medication, he decompensated rapidly," she said. "He lost his job and ended up losing his marriage."

Since Steven is unable to stand trial due to his mental illness, the courts ordered him back in Nov. 2021 to undergo inpatient restorative mental health treatment. The only problem is that there is no bed space available at the state's only mental hospital.

News 5 Investigates asked Miller, "So at this point in time, your son is still sitting behind bars?"

"Exactly," Miller said. "People are sitting in jail for over a year—well over a year, and nothing (is happening)."

El Paso County Jail
El Paso County Jail

As of early January, the El Paso County Sheriff's Office reports 56 inmates are currently waiting on an open bed at the mental hospital.

On a state level, 347 inmates are in jail awaiting admission.

Miller says it's a major problem she's tried to get answers about.

"I've gone everywhere I can think of," she said. "I've written to the Governor. I've written to my Congressman. The court liaison says I need to talk to someone else and everyone pushes you onto someone else."

We took Miller's concerns and our questions to CDHS.

Jagruti Shah
Jagruti Shah talking with Chief Investigative Reporter Eric Ross

Jagruti Shah is the Forensic Services Director at the Colorado Dept. of Human Services. She's directly involved with competency evaluations and restoration services for the entire state.

"We are well aware of the fact that there are 347 individuals waiting on admission," she said. " We have begun partnerships with community-based hospitals to contract with them for services."

This Jan. 14, 2022 memo CDHS addressed to the criminal courts system and county jails provides a bit of hope for inmates sitting in jail awaiting mental health treatment.

We learned the Governor's Office has used emergency discretionary funds to add 64 inpatient beds at other hospitals across the state.

CDHS headquarters in downtown Denver
CDHS headquarters in downtown Denver

The Office of Behavioral Health (OBH), an agency within CDHS, has also received $5.5 million to add 30 private psychiatric hospital beds for six months.

$1 million in funding is also being used to run inpatient mental healthcare programs at local jails.

Currently, these jail based programs are in Boulder, Arapahoe and Denver County jails.

News 5 Investigates asked, "We know mental health is at the forefront of discussions locally and nationally, so 6 months to a year from now, what improvements can the community expect to see?"

"That's a tough question," Shah admitted. "I think it's really going to depend on the demand that we continue to see. I think part of what we've seen is a massive increase in volume of referrals we are getting for evaluations and then they turn into restoration orders and that's out of our control, but it's a huge part of this equation."

According to this Issue Brief from the Colorado Legislative Council Staff, under a 2012 federal settlement with the State, no defendant may wait more than 28 days for admission to the Colorado Mental Health Institute for a competency exam or restoration services. However, a review of public data shows that's not always happening.

138 patients who have been ordered to the state hospital have been waiting in jail for more than 90 days.

CDHS cited privacy concerns for not releasing the number of inmates who have been waiting longer than a year, but a spokesperson said it's less than 30.

According to CDHS, the agency hopes to have more beds they received funding for up and running by March 1, 2022.

In addition, Shah says she's working on getting the courts to consider outpatient mental health services. There is no wait list for these services, according to Shah.

News 5 asked, "Are there currently patients at the state hospital who may be better suited for outpatient care?"

"Yes," Shah said. "As those are brought to our attention, we have a program and staff that are specifically dedicated to looking at those individuals and transitioning them to an outpatient-based program."

News 5 also asked Shah about bed capacity at the state hospital. Records show the hospital has 516 beds, but only 365 are currently in use.

Shah says it comes down to staffing. The Jan. 14, 2022 memo we referenced earlier shines some light on the problem.

"The Colorado Mental Health Institute at Pueblo (CMHIP) continues to experience significant direct care vacancies due to the national healthcare staffing crisis and the impacts of COVID-19," Robert Werthwein, Director for the CDHS Office of Behavioral Health said. "CMHIP is currently on outbreak status, with 101 staff out due to COVID-19 of which 48 are direct care nursing staff."

News 5 asked how the state is planning on addressing immediate staffing concerns.

"We know during the 'Great Resignation' that people are leaving industries left and right," News 5 stated to Shah. "Couple that with COVID-19 and people calling out sick, how are you dealing with staffing shortages?"

"We're trying to be as creative as possible," Shah said. " We're working with the nursing students. Our state hospital is a teaching hospital and we're able to utilize that status to bring on nursing students to come in 1-2 days a week to get their training (hours) in."

As the state works to utilize the limited resources it has, there may be a glimmer of hope that things are starting to improve.

Shortly after we started talking with Miller about her son's case, we learned Steven was transferred to the Arapahoe County Jail---one of three jails with the state's restorative mental health program.

Miller is hoping the program will work, but still believes a jail setting in most cases isn't the appropriate place for people with mental issues.

"Instead of being taken to hospital where the can get the help they need, they are taken to jail and that just becomes a nightmare," she said. "There's no getting out of the system once you're in."

News 5 will stay on top of this issue and will follow up later in the year to make sure additional beds funded are in-operation.

CDHS also released this PowerPoint with more information concerning competency and mental health services.

We'll also be following up to see whether getting more people into outpatient services will increase availability of inpatient beds at the state hospital.

Have a story idea or problem you'd like News 5 to look into? Email us: News5Investigates@KOAA.com