By Nadine Ono.
Brittany Lee, a Riverside County Behavioral Health Specialist recalled how one of her clients changed from refusing medication and participating in group therapy sessions to working toward his GED and supporting his fellow inmates. As she worked with him over several weeks, his mood began to change.
“Today we had group and he said he was feeling happy and he’s feeling like he’s progressing,” said Lee. “Even though he’s in jail, he’s doing these things for himself to maintain his stability, so that when he gets out, he won’t come back.”
Lee is one of the specialists embedded in Unit 16 at the Larry D. Smith Correctional Facility in Banning as part of a collaboration between the Riverside County Sheriff’s Department and the Riverside University Health System’s Behavioral Health Department. Lee and fellow specialists work with the more than 600 incarcerated men at the facility diagnosed with mental illness. It’s part of a countywide program to change the treatment of care to increase successful transitions of mentally ill inmates into the general detention population and eventually back to the community.
The Behavioral Health Specialists strive to give the inmates the same level of care they would find in other institutions outside jail. This includes the adoption of “day rooms,” where inmates attend both group and one-on-one therapy sessions. As they progress, they “step down” into other day rooms that correspond to their needs.
The program implementation was initiated by a lawsuit and a court-ordered cap on the jail population. It also coincided with the release of a jail utilization study conducted by CA Fwd’s Justice System Change Initiative.
“The structure of programming in 16 is specialized and geared toward treatment and stabilization,” said Behaviorial Health Services Supervisor Aaron Perez. “That’s sort of a unique thing to have a housing unit that’s built around stabilizing and treating mental illness. As a consequence of that, there are way more groups, way more day room times and special privileges. They are offered help to comply with treatment and the goal being that we’ll take someone who is either coming out of an acute crisis or someone who’s coming off the street with severe mental illness, get them stabilized and moved to a lower level of care.”
The unique collaboration also involves a dedicated custody staff from the Sheriff’s Department (CORE) who have been specifically trained to work with the mentally ill.
“The deputies in Unit 16 are selected consistently to be in there. And so they get to know the guys in 16 and the guys in 16 get to know them,” said Perez. “So when someone’s acting out, the deputy can say, ‘Oh, that’s so-and-so and I know he sometimes does that and I can respond this way.’ So the familiarity and rapport between deputies and inmates is at a much higher level.”
Behavioral Health Services Supervisor Yvonne Tran said working with the deputies has changed the culture inside the facility. “The number of fights have reduced, the number of deputies who have had to use force has reduced because they have learned how to talk to the client, how to deal with mental health more appropriately. They just don’t go directly to force, they have to try to calm them down first — de-escalation.”
She added that the number of grievances has also declined and a recent group evaluation showed that the clients are complimentary of the staff and want more group sessions.
Clinical Therapist Ernesto Guerrero said that the culture has also changed among the clients. “It’s pretty cool that they do have study sessions in the day room because that’s their time to come out of the cell and do whatever – they can make phone calls or watch TV or walk around. To spend that time doing group homework just kind of shows you where they’re at. It shows their motivation.”
Lee agreed, saying, “If they didn’t have groups, I don’t think they would be interacting with each other. They would be just sticking to their regular type of jail schedule. The groups help them have their study sessions together or build these bonds with one another. I think it really helps facilitate positive social interactions amongst each other.”
And the program is working. Guerrero spoke of one of his clients who was depressed, didn’t want to eat or take his medication and rarely came out of his cell to the day rooms. He encouraged the client to try a group session at least once and things began to change.
“He saw that it wasn’t just him going through things that he was going through. It was an opportunity to see that other people are going through this also and have these struggles,” said Guerrero.
The client progressed and was eventually transferred to the general detention population. “At the end of the group, he was very grateful that he got a chance to be part of the groups, wrote a poem about his experience from beginning to end. It was a great success story.”