County jails ill-equipped to handle mental health issues
This story is the second part of a series. Part 1 ran on Tuesday, March 21. The article is a collaboration between Spotlight PA and the Pittsburgh Institute for Nonprofit Journalism, published as part of a Pittsburgh Media Partnership project.
Rachel Bridgeman, a Georgia woman who spent time in the Allegheny County Jail, was released around 5 p.m. on Sept. 22, and boarded a bus wearing only a white T-shirt provided by the jail and the clothes she was arrested in: a black dress and slide-on sandals.
Rachel got off the bus on Pittsburgh’s south side. Hungry and underdressed for the 50-degree weather, she walked into a nearby Rite Aid.
She chugged a bottle of water, she said, and eagerly ate a bag of chips. She began to shop, placing items in a cart. A Rite Aid employee called the police to report a “shoplifting in progress,” according to a police report. Within hours of her release, Rachel was arrested again for retail theft and defiant trespass, minor offenses that come with a maximum sentence of 15 months in jail.
In response to a survey sent by Spotlight PA and the Pittsburgh Institute for Nonprofit Journalism, leaders of more than 20 jails across Pennsylvania said jail can be a costly and harmful path for people who come to the facilities because of crimes that are likely a symptom of their mental illness.
But in Pennsylvania, jails are often the only place that can house a person whose symptoms have resulted in a call to the police.
Since the 1980s, Pennsylvania has closed 10 state-run psychiatric hospitals, reducing the number of people annually receiving state-funded mental health care from more than 10,000 to roughly 1,383 on average in 2021. Today, there are six hospitals left. And just two — Torrance and Norristown — handle competency-related therapy, with less than 400 beds available for that purpose.
Supporters of the closures argued that with advances in medicine, people who could otherwise live independently were being unnecessarily committed. With proper community resources, they said, people could live with their mental health conditions outside state hospitals.
But in the years since, civil rights groups, defense attorneys and corrections staff across the state have said the necessary community services never surfaced.
At the Snyder County Prison, “we appear to be a ‘dumping ground,’” Warden Scott Robinson wrote in response to the statewide survey. “It is very difficult to get detainees with serious mental health issues into an institution where they can receive proper care. Some cannot even control bodily functions and it is a serious drain, mental and physical, on our staff.”
Some jail leaders who responded to the survey said that they are not equipped to provide adequate care for someone with mental health issues. Only six counties — including Allegheny — rated their ability to address the mental health needs of detainees a four out of five or higher in the survey.
Christopher Slobogin, director of Vanderbilt Law School’s Criminal Justice Program, said individuals with mental illness are often arrested on minor charges and then funneled through the criminal system because communities lack the resources to take care of them.
“They get picked up for crimes because police say, ‘What are we supposed to do with them? We’ll just arrest them for trespass or something,’ and then take them to jail,” Slobogin said. “And their life is probably made much worse. Usually, the crimes they’re charged with are not a threat to society.”
Spotlight PA and PINJ obtained state court data on about 400 people who underwent evaluations for competency issues in the past five years. Though limited, the data confirm Slobogin’s assessment. Those defendants most often faced summary offenses, which are low-level crimes that typically result in little to no jail time, or misdemeanors, according to a Spotlight PA and PINJ analysis.
The most common charges — simple assault, reckless endangerment, terroristic threats, and harassment — can result from a person experiencing symptoms of their mental illness in public, said Witold Walczak, legal director of the ACLU of Pennsylvania.
“They don’t make sense. They’re loud. And people get scared,” he said.
People in these situations don’t need to go to state hospitals, Walczak said. Nor do they need jail, he added.
“They need help.”
When Rachel was booked into the Allegheny County Jail just hours after her release, her mental health — well-documented from her prior five-week-long detention — prompted a new competency evaluation.
A judge denied Rachel’s bail, pending the assessment. The Allegheny Office of the Public Defender has said this is a common practice in the county. The office has challenged the practice of revoking bail for competency issues alone, calling it illegal and unconstitutional.
The Mental Health Procedures Act “states, in no uncertain terms, that an accused cannot be denied pre-trial release based solely on the fact that he or she has been deemed incompetent,” the office wrote in a May 2022 filing.
Joseph Asturi, a spokesperson for the Allegheny courts, said the administration had no comment on the public defender’s challenge.
Kate Lovelace, a private defense attorney working in Allegheny County, represents clients with intellectual and psychiatric disabilities whose cases often raise competency concerns.
When her clients face charges for minor infractions, Lovelace tries to avoid the court’s competency system altogether. Even the process of being evaluated can lead to bias, she said.
“When you’re trying to get out of an abusive institution like this, you don’t hang your hat on anything that could make it worse,” she said.
Attorneys with the Defender Association of Philadelphia, a public firm that provides no-cost legal counsel, said they also tend to avoid the competency system when clients with severe mental illness face misdemeanor or nonviolent charges.
“It’s not in our clients’ best interest,” said Gregg Blender, chief of the firm’s mental health unit.
On Oct. 12, a judge found Rachel Bridgeman incompetent to stand trial. But she doesn’t remember anyone explaining to her what that meant.
She didn’t know she was waiting for one of only 359 beds available for competency patients at Torrance or Norristown State Hospitals.
Waiting for treatment in a state hospital can take months. In one Beaver County case, someone languished in jail for a year, according to officials.
In 2015, the ACLU of Pennsylvania sued the commonwealth after two people died in jail while on the list for a state hospital bed. Less than a year later, the Department of Human Services (DHS) settled the case and agreed to reduce wait times.
Pennsylvania’s wait times improved nearly to the point of ending court supervision of the settlement in 2019, said Walczak, the ACLU attorney.
At the beginning of 2020, it took 15 days or less to get a spot in a state hospital, he said.
But wait times shot up again when the pandemic hit. More recently, there are people who have been waiting for a bed for more than six months.
Brandon Cwalina, a spokesperson for the department, said in a written response to interview questions that the pandemic affected wait times because a patient must test negative for COVID-19 before being admitted to a state hospital unit, and that the unit must not have an outbreak of the virus.
But even those numbers could be flawed, Walczak said.
“For the first time in several years, we’re not quite sure how reliable or comprehensive the data is that we’re getting.”
That’s because at the county level, “sometimes these people are sitting in jail for months before you get to the point where the court actually issues an order, which triggers the start time for getting somebody into treatment,” Walczak said.
Those months would not be reflected in the data the department sends the ACLU, according to Walczak.
DHS declined to make officials available for an interview with Spotlight PA and PINJ to discuss larger issues surrounding the competency process and state hospitals.
Cwalina said the department attempts to admit a patient to Torrance or Norristown State Hospitals within 15 days of receiving “all necessary information/documentation.”
In 2022, Rachel spent 49 days waiting for a bed.
In that time, her medical records indicate that she was tased, placed in a solitary padded room and repeatedly injected with antipsychotic drugs.
The jail and Allegheny County denied requests from the Abolitionist Law Center and the newsrooms seeking reports documenting the force used against her.
A spokesperson for the Allegheny County Jail declined to comment on Rachel’s case, citing “personal medical information, and the safety and security of the facility.”
As Rachel’s condition worsened — her eyes blackened and bloodied, and her face swelled — at least one other woman on the acute mental health pod grew concerned enough to contact Jaclyn Kurin, a lawyer she knew at the Abolitionist Law Center. The center is a law firm that provides no-cost representation to people in jail. Someone needed to schedule a visit with Rachel Bridgeman, the incarcerated woman told Kurin. The situation was dire.
Rachel spoke with the attorney over a video call, bruises spreading like a Rorschach blot across her face. Kurin sent a letter asking the jail to take Rachel out of solitary confinement and improve her mental health care.
“Solitary confinement has caused Ms. Bridgeman substantial harm, including significant physical injuries,” the letter reads, “and ending her isolation is necessary to both protect her health and for the County to adhere to its legal obligations.”
After repeated visits with Kurin, Rachel began to feel more grounded. She started voluntarily taking her antipsychotic medicine. After Kurin sent the letter, the jail expanded her recreation privileges.
Rachel stopped banging her head on her cell. Finally, the voice was gone.
Spotlight PA is an independent, nonpartisan newsroom powered by The Philadelphia Inquirer in partnership with PennLive/The Patriot-News, TribLIVE/Pittsburgh Tribune-Review, and WITF Public Media. To read the complete investigation, visit spotlightpa.org/competence.
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