It’s not uncommon for someone identified with mental health or substance abuse issues to sit in a jail cell for months after being diagnosed in Wyoming.
This placement, or lack thereof, is usually a result of the state having too few mental health facilities.
In effect, county jails turn into quasi-treatment centers, yet typically lack the proper infrastructure or trained staff to properly treat these prisoners.
“We’re not helping them, they’re not getting any treatment aside from what they need in the jail,” Elisa Butler, State Court Administrator for the Wyoming Supreme Court told the Legislature’s Joint Judiciary Committee on Tuesday.
Butler said this leads to a rotating cycle of the same people committing the same low-level crimes and further crowding county jails.
Gov. Mark Gordon’s office, the Legislature and the Wyoming judicial branch are developing a pilot diversion program to reduce the number of people jailed for misdemeanor charges who suffer behavioral and substance abuse disorders. Instead, they want these offenders to receive proper treatment.
The program would begin in Gillette, the first piece of a much larger behavioral health redesign the state is set to begin in July 2024.
One of the driving goals behind the redesign is to identify higher-risk, priority mental health issues.
Butler cited a study that found there are more than 10 times as many people with mental illness in prisons and jails than all of the psychiatric hospitals combined in the United States.
A few members of the Legislature and other state officials went to Miami last month to learn about the “Miami model.”
This jail diversion program is considered the gold standard for diverting people with serious mental illnesses and substance use disorders away from the criminal justice system and into comprehensive community-based treatment and support services.
Studies have found the program helps reduce crime, homelessness and demand on mental health services in the Miami area, as well as precipitated the closure of a jail.
“We understand in Wyoming it will be a stripped-down version of that,” Butler said.
She also said the pilot program would be analyzed as it progresses to ensure that it is effective. If successful, it would ideally expand throughout the state.
“I’m excited about this. I hope the pilot program works,” Republican state Sen. Wendy Schuler said. “I’m just jealous it’s not happening in my community.”
Schuler’s community of Evanston is home to the Wyoming State Hospital, where many people with mental health issues in the Cowboy State eventually find themselves.
“Many of the folks that finally get out, many of them stay in our community,” she said. “They maybe do alright for awhile and then they have issues. They stay in our jails.”
By The Numbers
In 2022, the Wyoming State Hospital performed 467 competency evaluations. These are performed when a person charged with a crime is speculated to not be fit to stand trial. If found incompetent, they have to be restored to competency before they can be prosecuted.
The wait time for these evaluations can sometimes be months in Wyoming, creating a burden on staff who must provide a place for defendants awaiting evaluation.
In 2022, 28% of these State Hospital evaluations were performed for misdemeanor cases, typically for low-level crimes rarely associated with significant jail time. Of 105 inpatient evaluations, there was an average wait time of 157 days, which suspects often spent in county jails.
Committee member Sen. Cale Case, R-Lander, said the statistic makes his head figuratively explode, calling it “an astounding waste of resources.”
“This is just astounding to me,” Case said. “We have people locked up for more than a half year to get them into a competency evaluation.”
Butler said 61% of people who received evaluations were determined fit to stand trial. After waiting months in jail for an evaluation, many already had done the maximum amount of time for their respective charges without ever being found guilty of a crime.
Needs To Happen At The Jail Level
Wyoming Supreme Court Chief Justice Kate Fox, one of the major proponents for the pilot program, said competency evaluations do nothing to restore a defendant back to mental health, serving as more of a status update.
Under the diversion program, these evaluations would be skipped altogether, replaced with a rudimentary jail screening.
If a person is determined to suffer from one of four major mental health categories with possible co-occurring substance abuse issues, they would then be diverted.
Rep. Mark Jennings, R-Sheridan, expressed doubt that all people should be diverted away from the criminal justice system and speculated that the pilot diversion program could be “putting the cart before the horse” by failing to first address rampant health staffing issues already impacting Wyoming.
“If we don’t have the people, we don’t have the people,” he said, adding that Wyoming lacks the resources Miami-Dade County has.
“Wyoming and Miami are two different places,” he said. “If I were homeless, I’m thinking I would head for Miami.”
Fox said by focusing the pilot in Gillette to start, the program could be adequately staffed, although it is unknown how much it will cost to run or when it would begin.
If the program expands, she said staffing would be an ongoing challenge, but remote counseling and out-of-state providers could be a couple of solutions.
“We’re working on it, and that’s not a reason to do it,” she said.
Andi Summerville, executive director of the Wyoming Association of Mental Health and Substance Abuse Centers, said although Wyoming’s shortage of mental health providers is at one of its worst points ever, there have been some improvements.
A number of bills passed during the 2023 legislative session that address the issue of health care staffing, including the establishment of licensed professional counselor and psychologist compacts.
Also passed was legislation requiring all evaluations on misdemeanor cases to be done on an outpatient basis unless there’s a compelling reason otherwise, and another allowing community health centers to perform mental illness examinations on an outpatient basis, which will reduce or at least expedite the mental health holds.
There are four community mental health centers throughout Wyoming, along with some health care providers that can perform evaluations.
Schuler said although she believes the new legislation will help, the crux of the state’s mental health issues is a lack of psychologists.
Wyoming’s treatment courts also already provide some alleviation for the issues the pilot program aims to address, but they are only for post-adjudication defendants who are mostly felons.
Rep. Art Washut, R-Casper, said he’s concerned that moving people out of the criminal justice system to already limited beds could squeeze out people suffering non-criminally related mental health issues.
There also are a handful of hospitals around the state that offer psychiatric units with beds for people suffering mental health issues.
One Piece Of The Puzzle
In an ideal world, Summerville said there would be one or two beds available in each county to house people suffering mental health and substance abuse issues.
The purpose of the diversion program would be to divert individuals earlier in the process, preventing offenders with mental health and substance abuse issues from ever entering the criminal justice system or as early as possible to treatment services.
Under the proposed diversion program, when someone with substance abuse issues is charged with a crime, they could be diverted to mental health services before being convicted, leaving the potential for their case to be dismissed down the road.
Summerville said the diversion program will be an important step for the state’s mental health services, addressing what she says is wanted by local sheriffs who often have to house people likely unfit for their facilities.
“What we know about mental health clients is they will end up in the system one way or another eventually,” she said. “The earlier that we can get them the less costly and better it is for them.”
Summerville said even if some patients still end up in crisis intervention programs, that’s still preferable to them ending up in the Wyoming State Hospital.