“Someone to listen”: Behavioral health professionals, not deputies, will soon respond to mental health crises in Denvers jails

Nikki Johnson walked into a housing unit in the Denver jail and heard a man yelling about his laundry and refusing to lock down in his cell.

Johnson, a psychologist and chief of mental health services at the Denver Sheriff Department, approached the small group of deputies who gathered near the man’s cell and asked if she could talk to the man, whom she knew. With their permission, she told the man that she would love to talk to him if he followed directions to lock himself inside his cell.

The man complied and Johnson sat and listened to him vent.

“He’s upset about various stressors happening in his life and wants to be heard,” Johnson said. “So I took the extra 10 to 20 minutes with him and listened to him — that’s really all it took. For him to know that someone was going to listen to him, he was willing to comply with the order to lock down.”

That’s exactly the kind of service Johnson hopes a new team of mental health professionals she’s hiring for the city’s two jails will be able to provide. The Denver Sheriff Department plans to hire 12 psychologists, counselors and social workers so that a mental health professional will be available 24/7 to help people incarcerated in the city’s jails who are experiencing mental health crises.

The department’s leaders hope that the new Crisis Response Team will help de-escalate crisis situations, minimize deputies’ workloads and provide better service to people in the jail. The team members will wear polo shirts and khaki pants, not law enforcement uniforms.

“Deputies are trained to provide safety and security to the facility and that’s the first and foremost job duty for them,” Johnson said. “Mental health professionals are trained to be empathetic, to listen, to be calm, to be present. When you bring both of those together we’re going to see more success in these crisis situations.”

Growth in mental health diagnoses

A large percentage of the people incarcerated in Denver’s two jails have mental health diagnoses. On Thursday, 40% of the 1,699 people in the two jails were classified as having a mental health need and 6% were on suicide alert.

The mental health conditions and severity vary widely, Johnson said, and can include schizophrenia, substance-induced psychotic disorder, bipolar disorder and personality disorders. Johnson hopes her team will be able to bring trauma-informed care to the jails, which can cause trauma themselves.

“We will assume people have trauma and will approach them in that manner,” Johnson said.

If successful, the program will reduce fights, use-of-force incidents, assaults on staff and recidivism, Denver Sheriff Elias Diggins said. Diggins also hopes the team will help people successfully transition from more restrictive housing units for people with severe behavioral challenges to general population units.

The percentage of people incarcerated with mental health conditions has grown tremendously in the 27 years that Diggins has worked at the sheriff’s department, he said. Part of that growth is an improvement in diagnosing peoples’ illnesses and more resources to do those evaluations, he said.

“For us, success is helping them while they’re in our custody and helping them transition to the community as well,” he said.

Diggins requested $1 million in the department’s 2022 budget to pay for the 12 positions allotted to the program. The budget has not yet been approved, but Diggins said he is optimistic it will be because there is support in the other branches of city government.

The team will include 11 mental health professionals — seven for the downtown jail and four at the county jail — and a supervisor. Johnson has started the hiring process for some of the positions and hopes to have the team operational in the downtown jail by the end of the year.

Once hired, the team’s members will spend their time inside the jails getting to know the people incarcerated there. They will be primarily stationed in intake and the housing units for people with severe mental health needs, but will also work in other areas of the jails. They won’t be working in offices and taking appointments, but will instead spend their days in the housing units so they can develop relationships with the people who live there.

“If a crisis does happen, they’ll be able to step in, help de-escalate the situation, be available and really have more time on their hands than the deputies might have,” Johnson said. “A lot of times the deputies are handling a housing unit with 64 inmates in it by themselves. So they might not have 10 minutes to have this guy vent about court because they’re escorting the nurse around to hand out medications or they’re delivering meals. Not that they don’t want to do that, but they don’t always have that time to drop everything and listen. A lot of times all it takes is someone to listen to them and hear them out and meet them where they’re at in that moment to prevent a situation from happening.”

The team is one of Johnson’s three major goals since joining the sheriff’s department in January. She also launched a competency restoration program at the county jail and plans to conduct an audit of all mental health services available in the jail system to look for gaps and overlap.

In the footsteps of STAR

The creation of the team in the jail mirrors the launch of Denver’s Support Team Assisted Response program last year to broad acclaim. The STAR program sends mental health professionals instead of police officers to 911 calls that involve mental health needs or homelessness with the goal of handling social problems with mental health professionals instead of police.

The jail’s Crisis Response Team will mirror the goals of the STAR program and a handful of jails across the country have similar programs, Diggins said.

Prison and jail leaders for decades have discussed mental health needs of the people they care for, but the conversation really picked up speed over the last five or 10 years, said Dr. David Stephens, a psychologist who specializes in mental health in correctional settings. Better screening has revealed the large percentage of incarcerated people who have trauma, mental illness or brain injuries.

“Correctional officials, sheriffs and even mental health professionals all have a much greater awareness of the presence of the mentally ill in the correctional systems,” he said. “We need a continuing awareness of the pervasiveness of trauma in the community. Addressing those needs will reduce incarceration rates.”

Jail administrators need to evaluate how their building affects the people who live there. Incessant, bright lighting and lack of sound absorption can cause mental health deterioration, he said. All jails also need to provide trauma-informed care.

But the most important way criminal justice systems can help people with mental health needs is to keep them out of jail and prison, Stephens said. Diversion programs that connect people to treatment outside of corrections facilities, like Denver’s Law Enforcement Assisted Diversion, and accessible community resources are crucial for bettering their health, he said.

“Helping them to avoid them being incarcerated in the first place is probably the best practice,” Stephens said.

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