Dangerous waits for psychiatric evaluations?

Jail watch
By LANCE TAPLEY  |  August 15, 2007

A lawyer whose client tried to kill himself in the Knox County Jail while waiting a month to be evaluated at Riverview Psychiatric Center in Augusta says delays in getting inmates admitted to the state’s chief mental hospital have created a dangerous situation.

State officials admit delays for jail-inmate psychiatric evaluations have increased considerably, blaming an increased number of evaluation requests.

There have been five jail suicides in Maine in the past year and a half, according to Steven Sherrets, the state’s mental health criminal justice manager, but he didn’t believe any occurred while an inmate was waiting to go to Riverview; he didn’t have numbers on suicide attempts. Sherrets says he doesn’t know if a dangerous situation exists in the jails because of evaluation delays, but “I’m concerned any day there is a person in jail who needs additional services.”

Lawyer Barry Pretzel, of Rockland, says his 29-year-old client Raymond Boivin, who he says has a long history of drug-related crimes — and mental-illness treatment since he was 10 — has tried to commit suicide at least 40 times, including “ripping his veins out with his teeth.” Boivin recently tried to kill himself while in jail in Rockland for a bail violation on a criminal threatening charge, Pretzel says.

Ann LeBlanc, the Health and Human Services Department psychologist in charge of the evaluations at Riverview’s forensic unit, says the average delay in admission for a jail inmate advanced from 9 business days in 2005 to 12 in 2006, and to 14 so far this year. Counting weekends, “a delay of three weeks is not unusual,” she wrote in an early-August e-mail to fellow officials. The delays have been for up to 48 business days. Counting weekends, that would be over two months.

Sherrets, who works for both DHHS and the Department of Corrections, says 39 people in 2006 were sent to Riverview for criminal-justice-related evaluations. Already this year, the number is 37.

Lately there has been a broader controversy over whether the three-year-old hospital has enough capacity. A legislative staff study found that, in a five-month period in mid-2006, 85 percent of all people who were referred to Riverview were turned away because it was filled. DHHS countered by pointing out that nearly all those turned away received treatment in the 200-plus mental-health beds of the state’s private and community hospitals.

But jail inmates needing Riverview’s services can’t be placed elsewhere. In Maine, only Riverview has the capability to safely deal with them — in the 44-bed forensic unit that accounts for almost half the facility’s 92 beds. (“Forensic” means relating to court proceedings.) A judge commits inmates to Riverview to see if they are mentally competent to be tried for a crime, to determine their mental condition at the time of an offense, or to see if they can be restored to competency through treatment. A psychiatric assessment lasts from 30 days to a year.

Pretzel says getting inmates quickly into the hospital for evaluations can prevent suicide attempts and violent incidents in jail. Quick admission “gives both sides a basis for deciding how the case will be prosecuted and defended,” he says. Additionally, “If there’s a long wait, it’s much more difficult for a psychiatrist to accurately determine what the defendant’s mental condition was at the time of the crime.”

Sherrets says the state has assigned DHHS case managers to try to get mentally ill people “diverted” from the criminal-justice process into mental-health treatment — either while they are in jail or even before they are booked by a police officer.

Defense lawyer Pretzel suggests there needs to be a broader solution — the expansion “of mental-health services in general for those people who land in the jails and prisons.”

Democratic Governor John Baldacci and the Democratic-Party-controlled Legislature have repeatedly cut back on the state’s funding of mental-health services.

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