A closer look: Advocates aim to keep mentally ill out of jail

The Kane County Treatment Alternative Court is in session from 2:30 to 4 p.m. every Wednesday in Associate Judge T. Clint Hull’s courtroom, 311.

The program, which started in 2006, is for people with mental illness who have been arrested. Its intent is to support them through diagnosis and therapy and keep them out of jail, Hull said – but it can serve only 20 people at a time.

“The cap is in place just because of how intensive the process is,” Hull said. “Everybody wants to try to serve more, and there is definitely a need, but not the resources at present time.”

Some Kane County residents who suffer from mental illness get arrested if their behavior is disruptive or dangerous, advocates said. That can happen when local mental health providers do not have enough state money to meet their needs.

Because of Illinois’ financial woes, Gov. Bruce Rauner’s proposed fiscal 2016 budget contains additional cuts to mental health services.

This is the second of a two-part series looking at the challenges.

Treatment Alternative Court monitors those in its program, where they are seen in court every week. But they also are getting treatment and with service providers seeing them, Hull said. Even the program coordinator does home visits, he said.

“The supervision and contact is so great, it’s really hard for them to have a tough time with so many supporting them in different directions,” Hull said. “It has to be labor intensive up front.”

Part of the process is to get participants stabilized, figure out what medications they need and get them to take their medications consistently, Hull said. Most rely on public transportation to get to their psychiatrist appointments – and if they miss a session, it takes another month before they are seen.

But Hull sees hope amid the current funding crisis for mental health services through a push for national awareness, and to end the stigma of mental illness.

“I’ve been part of criminal justice as a prosecutor or a judge since 1993,” Hull said. “I have never seen such a push to focus on the needs of the mentally ill. Despite funding issues, I’m really really encouraged to see the focus the problem is getting and response the community has to it. In my entire time, I have never seen such a focus on trying to help them versus just incarceration.”

So many with mental illness go to the Kane County Jail that the sheriff’s office lists them in monthly reports to the Kane County Board.

In June, for example, 82 out of a jail population of 512, or 16 percent, reported having mental illness, with 23 on suicide watch, according to a corrections report.

“Primarily, we are talking about inmates that are taking some kind of drugs for a medical condition, which would be considered a mental health issue,” Kane County Sheriff Don Kramer said. “Twenty-five percent of 500 inmates that have a psychological problem – it’s hard to manage that population.”

Kramer said caring for those with mental illness is a large drain on the jail’s health services. And although psychological services are provided by staff during the day, it is a problem if any mentally ill inmates have an episode at night, he said.

Although jail officers are well trained, Kramer said he is looking into getting 20 percent of them additional training in crisis intervention.

Kramer said he also was looking at creating a post-release program for people with mental health issues to follow up when they leave jail.

This would include helping them get home and keeping their appointments with the Association for Individual Development or the Ecker Center for Mental Health.

“It’s definitely a concern for us,” Kramer said.

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The state is cutting its budget for psychiatric service contracts and agencies such as Ecker Center and the Association for Individual Development – which serve people without insurance – are wondering what they are going to do.

Ecker Center Executive Director Karen Beyer said without the contracts for psychiatry services, people will not get medications and will not be able to participate in therapy. She said she is afraid they will end up homeless, arrested and in jail.

That also is a real concern for Denise Edwards of Geneva, who is executive director for the National Alliance on Mental Illness. Her office is located at Mercy Hospital in Aurora.

“We are not going to be able to get enough money from the private sector only,” Edwards said. “We need our state to get behind mental health and understand the importance of this – and understand – if we don’t spend money on prevention and treatment that their goals of cutting back the number of people in jails – they won’t be able to reach it because those numbers will increase if we don’t have enough funding for treatment.”

Edwards and other advocates say cutting state spending on mental health services is not going to save money in the long run.

“We also know if we can give people treatment early, prognosis is improved. That can save money as well,” Edwards said. “Without treatment, they are just cycling down to jails and homelessness. We can save tremendous dollars if we keep mentally ill people off the streets and out of the jails.”

One case in point is Cynthia Firtik, who said she has been treated for major depression since she was 23.

The 45-year-old South Elgin resident credits the psychiatrist she sees at the Ecker Center for Mental Health with getting her on the right medications, and for helping her receive the ongoing support she gets at the Elgin facility.

“I have not gone to the hospital since 2009,” Firtik said. “Before that, I was going to Rush [University Medical Center in Chicago] twice a year for admission and medication.”

Before the Ecker Center worked with her, Firtik said it took 10 years to get the right medication.

Firtik has a graduate degree in library science but said she can no longer work because of her mental illness. She is on Social Security disability, but said she volunteers as a peer recovery support therapist at the Ecker Center to help others with similar struggles.

“It’s been a long road,” Firtik said. “I was in really, really bad shape before I started coming in here. My sister was told to put me in a nursing home. My symptoms are now manageable. I live alone. I’m fully functional, and it’s important that my psychiatrist through Ecker be maintained. I have a wonderful doctor here – he listens to me like I’m a person.”

What is mental illness?

• A mental illness is a medical condition that impacts a person’s thinking, feeling or mood and may affect his or her ability to relate to others or function on a daily basis.

• Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder and borderline personality disorder.

• Research suggests multiple, interlinking causes for mental illness, such as genetics, environment and lifestyle.

• Mental illness is a biologically based brain disorder that cannot be overcome through will power and is unrelated to a person’s character or intelligence.

• One in five adults experiences a mental health condition every year and one in 20 suffer from a serious mental illness such as schizophrenia or bipolar disorder. Family, friends and communities also are affected.

• Mental illness can affect a person of any age, race, religion or income and is not the result of personal weakness, lack of character or poor upbringing.

• The best treatments for serious mental illnesses today are highly effective. From 70 percent to 90 percent have significant reduction of symptoms and improved quality of life with a combination of medication and psychosocial treatments and supports.

• The World Health Organization has reported that four of the 10 leading causes of disability in the U.S. and other developed countries are mental disorders. By 2020, major depressive illness will be the leading cause of disability in the world for women and children.

Sources: National Association for the Mentally Ill and the Kane County Mental Health Council

How they help

The following is a list of services that the Ecker Center for Mental Health provides for people with mental illness:

• Emergency mental health assessment and assistance 24/7

• Problem focused therapy

• Advocacy, referral and linkage to needed services

• Psychosocial rehabilitation

• An intensive outpatient program

• Psychiatric residential facilities

• Case management services to assist with housing, food, transportation, public assistance, financial and vocational services, living skills training, advocacy, counseling and outreach

• Access to Genoa Healthcare, an independent pharmacy inside of the Ecker Center building at 1845 Grandstand Place, Elgin.

• Services available in English, Spanish and several other languages

• Subsidized services are available to those living in northern Kane County or Hanover or Barrington townships in Cook County

• Intake specialists available from 1 to 4 p.m. Monday through Friday without an appointment

• Psychiatric emergency by calling or at the emergency room of Advocate Sherman Hospital

The following is a list of services that the Association for Individual Development provides for people with mental illness:

• Behavioral health

• Crisis and community outreach

• Outpatient mental health services

• Psychological evaluations

• Residential mental health

• The Living Room, a mental health crisis respite program alternative to hospital emergency rooms

• Individual and group counseling

• Managing symptoms of mental illness

• Assistance with obtaining Medicaid, Social Security and other benefits, and links and referrals to other community services

• Psychosocial rehabilitation to help people develop skills they need for daily living and for recovering from a mental illness.

Sources: Websites for the Association for Individual Development and the Ecker Center for Mental Health

On the Web

Visit KCChronicle.com to view a video of T. Clint Hull discussing Treatment Alternative Court for the mentally ill in Kane County.