INVESTIGATORS: Inmates with mental illness not being treated

MINNEAPOLIS (KMSP) - There’s a silent epidemic occurring in jails across Minnesota.  Many inmates with mental illness are not being treated and they can spend months waiting for the help they need due to a shortage of available spots at psychiatric facilities.   

The dimensions of Michael Schuler's hell went far beyond his solitary cell at the Hennepin County jail. "I remember having feelings like I was in hell,” said Schuler. "(I) remember thinking there were demons around me telling me to break my legs and cut myself."

After 40 days locked up, the delusions, the voices, became too much. He did the unthinkable, stabbing himself in the eyes with a pencil.

Schuler was arrested three years ago for missing a court date, while leaving Hennepin County Medical Center's psych unit, where he was being treated for Schizophrenia. His attorney said he received little psychiatric care while in jail, and at one point jailers even withheld his medication. 

"He was standing naked in his cell for days on end screaming unintelligibly in his own feces.  Doesn't take a large leap to understand he was in the wrong place," said defense attorney, William Lubov. "There was medical staff available to provide care for him and no one took realistic action to protect him. That's ghastly. That's middle ages."

Since then, Schuler has stabilized and is now living in a group home. Having lost an eye, he has settled a lawsuit he filed against the jail, for one million dollars. 

The Hennepin county jail has made some significant changes as a result of the Schuler case. 

RULE 20 GAP

Judge Kerry Meyer runs Hennepin County's Criminal Mental Health Court. The first job there is determining a person's competence.

"They should not be in the jail not best place for them, but we need a secure place to keep people when they are accused of very violent offenses and right now in Hennepin County we have the jail," said Meyer. 

A Rule 20 Assessment is when a psychologist evaluates an inmate in the jail to see if he's competent to stand trial, whether they can assist their attorney in their own defense and understand the charges against him.  According to data provided by the Minnesota Courts, statewide there have been 8,910 Rule 20 Evaluations between 2009-2014.    

In Hennepin County, if a suspect is found incompetent to stand trial in a criminal case, they're then referred for a civil commitment, in which the standard is whether "the person is a danger to themselves or others."

Many who are found incompetent for a criminal proceeding, don't meet that civil standard.  Basically, they are not sane enough to face criminal charges, but not sick enough to be civilly committed.   Those people fall into what's known as the ‘Rule 20 Gap.'  Meyer has been tracking those cases for the last year. 

She has found of the 119 suspects found incompetent to face criminal charges, less than half (46 cases) were civilly committed as mentally ill and dangerous. The majority (62 cases) didn't meet the standard, falling into the rule 20 gap. Those spent an average of 93 days locked up, before they were released from jail, without receiving treatment. 

Those people fell through the cracks. "They're not agreeing to social services, it’s being offered but they're not accepting and certainly not seeing improvement," said Meyer. Preliminary data Judge Meyer has collected so far in 2015 indicate that the number of days in jail has been cut by a third, and now averages 60 days.

HAPPENING IN JAILS ACROSS THE STATE

It's not just a big city problem. According to the Beltrami County Sheriff's Department as many as 70% of the people in that jail are struggling with mental illness.

"The country jails have turned into a holding pen for people with mental illness," said Sheriff Phil Hodapp. His jail population has grown 600-percent since the '80s.  Every incoming inmate is now screened to see if they have mental health issues.  Many are so-called "frequent flyers" who come through all the time.

Those who fall into rule 20 gap can spend four months or more in the jail, before being released without treatment.  Under a state law passed two years ago, those who quality for civil commitment must be transferred to a psychiatric facility within 48 hours. Hodapp says most get stuck on a waiting list.  "For us to find a bed with someone with mental illness we have to go hundreds of miles in any direction to have some place with adequate mental health facility," said the Sheriff.

BACK UP AT STATE MENTAL HOSPITALS

The law has only lead to a back-up at the state mental hospitals, like Anoka Metro. It's the state's second largest facility and the patients the facility receives are more dangerous.

Mohamed Hussein Hassan is a sex offender with a history of assaulting staff at Anoka Metro.  According to a police report, last February he attacked a worker, holding her down, licking her face, and forcing his tongue down her throat.  Since the 48-hour law went into effect, 482 jail inmates have been transferred to psychiatric facilities. During that same period at Anoka Metro, staff assaults have doubled.