By Taylor Knopf
People with mental health and substance use disorders frequently cycle in and out of jail. It can be difficult for someone to get better when floating between jails, homeless shelters, group homes and emergency departments.
Officials at the Pitt County Sheriff’s Department noticed this pattern and they’re making changes to reduce recidivism rates and get these people the help they need.
The Pitt County department has a jail “navigator” who helps place people into safe housing and reconnect them to benefits upon their release. The sheriff’s office is also preparing to launch a new treatment program for drug users housed in the jail.
“You can’t just bring them in, let them out, bring them in, let them out,” said Pitt County Sheriff Paula Dance. “We’ve got to give them something. It’s called hope. Sometimes that’s all it takes.”
She said people usually leave the jail — a short-term facility — without resources. She noted they commit community nuisance crimes or misdemeanor offenses to support their substance use and land right back in jail. And substance abuse in mental illness often go hand-in-hand.
“Our goal is to connect them with those resources in hopes that they can become productive, tax-paying, law-abiding citizens,” Dance said.
Dance, who was elected in November, campaigned on two issues: addressing the opioid crisis and a need for body cameras. She also made North Carolina history by becoming the first female, African-American sheriff in the state.
She’s looking forward to adding her official portrait to the courthouse wall among the long line of white, male sheriffs who came before her.
“Every wall needs a little color,” she said.
New heroin treatment program
Dance wasted no time once she was elected and made moves to get a new drug treatment program called SHARP (Sheriff’s Heroin Addiction Recovery Program) up and running. She’s already designated a special housing unit in the jail for inmates with substance use disorder who choose to enter the program.
It will be the first of its kind in North Carolina. The sheriff’s department based SHARP off practices and philosophies from programs in other states and the drug court model.
Dance and others are still working out some of the details, such as whether to include a medication-assisted treatment component.
She envisions a program with a six-hour structured day, Monday through Friday. Dance wants to work with community partners to bring in peer support specialists, educators and faith-based groups. She would like to offer a Narcotics Anonymous support group and classes in life skills, parenting, GED completion, resume writing and interview skills.
The SHARP unit is freshly painted with a classroom featuring inspirational quotes on the walls. There’s a small private office in the unit for one-on-one counseling sessions, education testing and telemedicine services.
However, funding questions remain. Dance asked the Pitt County Board of Commissioners for money to hire a SHARP program coordinator. She said it’s not looking promising that they will approve the new expense right now, but she said “we are going to make a way.”
“We have to do something on our end [to address the heroin problem],” she said. “Of course we enforce the laws, but it does not mean that we should not have compassion for our community.”
She said she’s fueled by supportive letters and emails received from community members who have lost loved ones to heroin overdoses.
Dance believes that SHARP will help inmates build face-to-face connections with people who can help them once they are released.
“That’s our main goal, to make those outside connections starting on the inside,” she said.
Building on mental health program
Connecting inmates to outside resources is the cornerstone to an already existing jail mental health navigator program.
In 2015, health care, law enforcement and local government representatives came together to brainstorm ways to reduce the number of people in jail with mental illness.
The group applied for and received a Justice & Mental Health Collaboration Program grant from the federal Bureau of Justice and signed onto the Stepping Up Initiative, which aims to reduce mental illness in jails. From there, they created a navigator position to connect the jail’s “frequent flyers” with mental illnesses to housing and resources upon release.
Venus Curry, a former corrections officer with a counseling background, became the first jail navigator in April 2017.
Curry starts her day in first appearance court where people are arraigned after arrest to look for people she may have worked with before. She said she’s worked to form relationships with the judge, prosecutors and caseworkers to identify people with mental illness entering the system.
Most of her work involves preparing for the inmate’s discharge back into the community.
One individual who Curry remembers well was a man diagnosed with schizophrenia who had violent tendencies. He attacked officers and racked up additional time in the jail. He stayed for more than three years.
No one came to visit him and he was housed in the jail by himself, she said. Upon release, Curry connected him with outpatient mental health services through Pathways to Life. She was worried about his socialization skills as he re-entered the community, and other officers told her they expected he would be back soon.
However, he’s been out and doing well for over a year. Curry said she’s seen him driving around town. He has benefits and is taking his medications. His family came back into his life, and he lives in a boarding house with two other men.
Basic human needs
Donna McLean, a nurse contracted to work with the county jail population, worked on the jail navigator program and helped create a screening tool for inmates with mental illness that would trigger a referral to the navigator. One change she’s observed since the program began is that everyone leaves the jail in a car.
Before that, she said it was not uncommon for a person to literally walk out of the jail doors with nowhere to go and no one to pick them up.
In doing research for this initiative, McLean said she found that “if people do not have a safe place to stay and food, there’s no chance they will attend a mental health appointment.”
She told the story of another inmate, a woman with an intellectual disability who had been aggressive at all her group home placements and was in and out of jail multiple times. She was no longer welcome in a number of area group homes.
McLean said that through the navigator program, her attorney and caseworker worked with Trillium, the local mental health managed care agency, and found a unique housing situation that finally suited her. McLean said she hasn’t seen the woman back in the jail in more than a year.
“We knew that it wasn’t going to do any good just to set them up an appointment to get to the psychiatrist when they left,” she said. “We need to make sure they actually had basic human conditions.”
Another issue McLean said she sees among the population she treats at the jail is a lack of insurance coverage. She didn’t have exact numbers but said likely 60 percent of the jail population is uninsured.
It can be tough to set them up with an appointment when they leave jail, she said, because no provider wants to take someone without Medicaid because they want to get paid. She said expanding the state’s Medicaid program would make more treatment options available to her patients once they leave the jail.
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What an inspiring article!
Amazing and so simple! I am one of these people. Recovery court saved my life. I’ve been sober for three years and I’m working as a peer support specialist. Had I had this opportunity years ago it could have saved me sooner. Hope it’s the key. And someone to believe you’re worth it. Resources we take for granted can save someone’s life that doesn’t know they exist.
It’s really great to see this. The jail navigator role sounds similar to what we were doing with the Critical Time Intervention model. Many of the most vulnerable in NC can’t access their basic needs and healthcare — and it’s encouraging to read about a local solution.