The Mental Illness Crisis From The Dade County Jail Perspective

By LYDIA BERGLAR
News Editor

“When I first started working in law enforcement, we didn’t see mental health issues like we do now,” says Major Tommy Bradford (Dade County Sheriff’s Office chief deputy). “It’s gotten so bad here lately, and I never would’ve thought we’d see stuff like this.”

When the sheriff’s office talks about the mental illnesses that they deal with in our community, they’re primarily talking about schizophrenia, bipolar, and disorders of that nature (rather than depression, anxiety, etc.).

Bradford and his colleagues can list story after sad story about the mental illness crisis. Captain Matt Cole (road patrol captain) shared that in under four weeks this fall, the sheriff’s office dealt with one woman three separate times due to her mental issues. The woman had been entering neighbors’ homes without permission, but the neighbors knew she was harmless.

“The neighbors know she has mental health issues, so they don’t really want her in jail,” explained Bradford, “but at some point, they get tired of the system, of nothing being done.”

Captain Chad Payne remembered, “We had one man in the jail for a long time who was convinced that he had an implant in his eye that was making his brain do things and that people were watching everything he was doing to the point where he wanted to murder them.”

This man was transferred to a mental hospital in Atlanta. With medication, the hospital got him to a competent level so he could stand trial. Bradford reported that the man pleaded guilty to threats of murder.

Sheriff Ray Cross and Bradford have agreed that mental health issues cannot be pushed to the side anymore. This is one reason that the sheriff’s department shifted Dade County Jail’s leadership structure earlier this year—to give Captain Joe Chambers more availability to be a liaison to the state about mental health and addiction issues.

Payne (jail administrator) is now essentially the jail’s chief operating officer while Chambers (jail commander) acts more like a chief financial officer. Chambers also works with Rex Mayo (director of A Hand Up Ministry) to show other jails how Dade is addressing the addiction problem.

When it comes to mental health discussions at the state level, Chambers says, “Nobody is wanting to talk about it. It’s not a discussion item at the capital. We stay in close contact with Rep. Mike Cameron. He knows that if anything goes on at the capitol about mental health, I’ll be there, even if it’s just to sit in the room.”

The Dade County Board of Commissioners appointed Chambers to the state’s Mental Health, Developmental Disabilities, and Addictive Diseases Board at the August 2024 county meeting, but Chambers says, “When I attend those meetings, absolutely nothing happens. They’ll have somebody come discuss their struggles with mental health and how they’ve overcome it. I’m not downplaying any of that, but there’s no real solutions being found.”

The mental health “system” is a complicated one as it’s interconnected with the healthcare and justice systems, and sheriff’s offices are only involved in parts of it.

Bradford explains that when someone is committed to a mental health facility involuntarily and the stay is longer than seven days, a hearing must be held. “The judge will determine if they need to stay longer or if they can be released. A lot of that depends on whether or not they’re a harm to themselves, if they’re capable of taking care of themselves, or if they may be a harm to someone else.”

When no crime or charges are involved, involuntary committal happens due to a crisis intervention team being called or two people who have witnessed someone’s altered mental state within the last 48 hours providing signatures. In both of these examples, DCSO handles transportation, but people in these situations aren’t often housed at the jail for long periods of time. It’s when a crime has been committed that the jail is more involved.

Crimes related to mental illness that the sheriff’s office often sees are domestic altercations, trespassing, and drug-related crimes. “Anything like that, we have to bring them to jail,” Bradford says. “If it’s a violent crime, then you definitely can’t let them back out.”

Returning to the situation Cole described with the woman who entered neighbors’ homes, the neighbors did not want to press charges. However, the sheriff’s office has seen that people often eventually press charges when a person seems harmless simply because they’re tired of having to deal with the situation.

In Bradford’s words, “Eventually they’re going to get tired of it and say, ‘She’s safer in y’all’s facility.’ Nobody’s going to make her bond, so she’s going to have to wait and go through the process.”

Bradford anticipates that a public defender will be assigned to her who will see that mental issues are involved and will ask the court to do a mental evaluation. If she’s declared incompetent to stand trial, the sheriff’s office will have to house her until a bed becomes available at a mental facility. “They’ve got to get her competent to stand trial. Sometimes that takes a year or two because there’s not enough beds,” he says.

While the jail’s physician can prescribe antipsychotics, the jail cannot force medication on inmates; inmates have the right to refuse. Even in cases where the jail can convince people to take medication, officers have witnessed time and again that people will stop medication once they leave jail.

As Payne puts it, “We have a jail doctor that sees them, treats their mental health, gets them okay and balanced out, but they get out and go right back into the same boat they were in.”

Medication for inmates is paid for by taxpayers, but once released, it’s up to the individual to seek treatment.

Although not medical professionals, Bradford, Payne, and Cole have noticed that most of the cases they deal with have ties to drug use, traumatic brain injuries, or psychological trauma, but in some cases, people are simply born with mental illnesses.

The team suspects that drugs have contributed to a rise in the crisis. Bradford says, “I think it has to do with some of the meth, the prescriptions, and even the marijuana nowadays, as strong and potent as it is. I think it’s doing some harm, whether people want to believe that or not.”

Payne adds, “Drugs exacerbate underlying issues. When you start taking drugs, I think it exacerbates issues you already have to the point that you can’t control them. Almost every person that we deal with in the jail will tell you that they have mental health issues, and it almost always runs hand-in-hand with addiction.”

The team explained one mental illness case they’ve dealt with that seemed to start with a bad accident and brain injury, but the man then began using drugs. He can be very violent, but when on antipsychotics, he returns to his old self. However, he does not want to stay on medication because of the drowsiness side effect.

Chambers also lists our culture, social media, and violent video games as contributing factors to the rise in mental illness. “Along with drug use, society has shifted with social media. If parents allow it, kids have unfettered access to information. Was the human brain supposed to take in that much information with the kind of negative influence social media has?”

Of violent video games, he says, “How many deaths have kids sat there and witnessed over the course of their brain developing? That’s not the way we were wired.”

All four officers know of situations where it seemed like all of a sudden, something snapped in someone’s brain—unrelated to drug use or any other specific cause. Cole remembers a woman with a good job who seemed to “misfire” one day. “Next thing you know, she’s hoarding animals and living in the worst filth you’ve ever seen. And she was one of the smartest people I knew.”

They all know heartbreaking stories from our community in which someone turned violent out of the blue, and they know stories that ended in tragedy. They list stories of people defecating in public, jumping out of moving vehicles on the interstate, attacking their parents, or claiming that birds are spying machines instead of real animals.

Listening to these stories makes it clear that the human psyche is fragile. Payne says, “I’ve seen it in my career in EMS and law enforcement, every single one of us is just one misfire away.”

When talking about the issue, one word keeps coming up: frustrating. Payne says, “It’s frustrating. That’s the best way to put it. It’s frustrating for them to not be believed, and it’s frustrating for us. Some of these people, they got no business being in jail. They can’t help the way that they are. It’s sad. It’s something you carry around with you.”

He explained one non-criminal situation where a woman’s belief did not line up with reality. She called 911 every day for a period of time saying that her house was full of smoke. “I would get in there with her at 5:30 in the morning and say, ‘Ma’am, your house does not have smoke in it.’ She’d say, ‘Yes, it does! It’s everywhere.’ How awful it must be to believe something and have no one else believe you.”

Bradford says, “A lot of people think we’re just in this to lock people up, but that’s not what we want. Our end goal for the people in this jail is to try to help them. For addicts, we try to get them in A Hand Up and Celebrate Recovery and things like that.”

While there is an avenue to address addiction, the system around mental illness is much less functional. Bradford says, “It’s personal for us to an extent. We get frustrated because our hands are tied. There’s nothing that we can do for them.”

Dade is far from alone in facing these problems. It’s a state-wide and national issue, and the state level is where the sheriff’s office would like to see changes. Chambers recently heard a report that over 700 people across the state are housed in county jails while waiting for a bed to open up at a mental hospital.

Chambers reports that our Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) region only has 30 beds in state mental health facilities to serve the region’s 31 counties.

Bradford says, “The state looks to the communities to handle a lot of stuff, and I think we do great as a community when it comes to addiction, but if they’re asking the community to help with mental health, I think they’re asking too much.”

Chambers recapped some history about mental health issues at the state level, reporting that Rome Regional used to be the closest mental health hospital to Dade. In the wake of several lawsuits in the 1990s, Georgia began shutting down some state mental health hospitals, including Rome Regional.

“That’s when the tide changed for law enforcement,” Chambers says. “When they shut down the state hospitals, it inevitably put an unfunded state mandate to the sheriffs, to the jails, to the taxpayers.”

Two key lawsuits were Supreme Court case Olmstead v. L.C. in the second half of the 1990s and Georgia Supreme Court case “Georgia Mental Health Institute v. Brady” in 1993.

Chambers feels that the cases were justified but shutting down the facilities was a knee-jerk reaction by the state. “There were some bad things that had been done inside the state hospital, but you could say the same about the Department of Corrections. The U.S. Department of Justice has been in and talked to them about some mishaps and stuff going on, but we’re not shutting down the prisons.”

Chambers explains that the DBHDD currently sends counselors into jails to talk with inmates about the importance of staying on their medication, but the problem is that these state counselors still cannot force medication.

This program may satisfy court requirements for treatment, but Chambers thinks that the state is checking a box without providing adequate treatment. “I feel like the state is trying to satisfy the judge’s orders by being able to say, ‘We’re providing treatment,’ but if my officers can’t talk them into taking medicine, there’s nobody else that’s going to be able to talk or bribe them into taking medicine.”

Chambers reiterates that the jail routinely witnesses that people stop taking medication once released. “Because they leave here leveled out, they don’t feel like they need their medicine. Then, the cycle starts all over again.”

As for paths forward, Chambers says that since state-funded mental health hospitals have been done before in Georgia, why can’t we get back to where we were before the 1990s cases? He notes that whether people with mental issues end up in local jails or state facilities, taxpayers still foot the bill.

Currently, Dade taxpayers are funding the housing and healthcare of inmates in the Dade County Jail who have mental health issues. (One example: Chambers has been negotiating with insurance over one mental health inmate’s $99,000 bill and says handling bills like this is a routine part of his job.) Should the state provide more mental health hospitals, taxpayers will still be funding it, but the burden on local law enforcement would be lessened.

Returning to the estimated 700 people waiting, Chambers says, “I’m not saying the state needs to build a 700 bed facility, because once everything gets caught up, 700 beds would be too much, but if they would start out with 300-350 beds, it’s going to be maintainable in a few years.”

As for what happens inside the jail when an inmate with a mental illness refuses medication, Chambers explains, “Some people get continuously more agitated and aggravated. A lot of times when they hit that state, they can go 18 hours straight yelling and screaming, take a ten minute nap, then go another 18 hours.”

The jail purchased a wrap restraint for such instances. Chambers remembers the first time they had to use it. A patient had not slept for three days and was in an agitated state. “She finally got to a point where she was beating the door hard enough that we were concerned about her breaking or fracturing a bone.”

The jailers put her in the wrap restraint, and within two minutes, she fell asleep and slept for 45 minutes. “The doctor said it’s the same effect as swaddling a baby,” explains Chambers. “When a baby’s fussing and can’t get to sleep, you put it in your arms and hold it close. This has the same effect. They can’t stop themselves, don’t know how to stop themselves, but the restraint forces them to be still.”

That little bit of sleep helped this inmate calm down and reach a better mental state. “Later on during her stay, she felt herself going up and up and up and requested to go back in that restraint because she knew it worked.”

Unlike addiction recovery stories, the sheriff’s office isn’t aware of many mental illness situations that could be deemed “success stories,” but that’s partly because they’re only called when things aren’t going well.

Chambers says, “There’s a few success stories, but not that many. A lot of the medication stops working after some time, so it’s a continual going to the doctor to adjust and readjust.” That fact, combined with the fact that some people will not stay on medication, paints a bleak picture.

The Lookout Mountain Judicial Circuit has a mental health court, but it’s relatively new, and the sheriff’s office doesn’t know of any results yet through the court.

From sitting in on Georgia Jail Association meetings, Chambers has learned that “over the last five years, many senior jail administrators who have years of experience have left—taken early retirement, changed professions—because they’ve been overrun by mental health needs. There’s no true answer, there’s no resolve, and it’s a big ball of mess that they can’t do nothing about.”

“Everybody’s got their hands out for money from the state,” says Bradford, “and I know politicians have to get votes, but at some point, they have to do what’s right. It’s a problem all over the United States, and I don’t care if you’re a Republican city or Democrat city, we all need to come together when it comes to mental health. We need to fix stuff here first before we send money overseas.”