For mentally ill facing charges, growing recognition but elusive solutions – Press

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Tim Leslie still remembers the St. Paul house near Victoria Street and Selby Avenue where he’d regularly respond to calls as a patrol officer from a resident who was convinced there was something landing on the roof. There wasn’t, but police learned how to talk him down anyway.

“The first couple calls, it was, ‘We do this, too?’ ” he said.

Today he’s the Dakota County Sheriff, responsible for a jail where perhaps a third of the inmates have mental health needs. And like others with a hand in the criminal justice system, he’s trying to manage those needs while navigating the growing, thorny nexus between law enforcement and mental illness.

Gains in awareness and documentation have nudged the system toward improvement, experts and advocates say. But gaps in critical services remain, and alternatives for those who would be better off in treatment than in a holding cell remain elusive.


There’s “nothing new” about jailing the mentally ill, said Sue Abderholden, executive director of the National Alliance of Mental Illness in Minnesota.

Sue Abderholden, executive director of the National Alliance of Mental Illness in Minnesota (Courtesy photo)
Sue Abderholden, executive director of the National Alliance of Mental Illness in Minnesota (Courtesy photo)

“I look back at the 1970s,” she said. “You used to put them in an institution and throw away the key, and now you put them on the street or in jail.”

Reporting and diagnoses have improved markedly, however. Mental illness screening for all inmates became mandatory in 2007, and court-ordered mental health evaluations, known as Rule 20 exams, rose sharply over the past decade. In 2005, there were 543 across the state, according to court records. In 2015, there were nearly 3,100 (those figures miss some cases because not all paper records have been catalogued electronically).

In Hennepin County, the numbers went from 211 to 808 in the same 10-year span. In Ramsey County, there were two evaluations ordered in 2005 and 386 in 2015.

“We diagnose better than we used to,” said Pat Kittridge, Ramsey County’s chief public defender. “I don’t think we were aware of it or it wasn’t as pressing a need for us 25 years ago.”

The county started running a dedicated mental health court in 2005 — one of three in the state, along with Hennepin and St. Louis counties. Like other specialized courts for drugs or veteran issues, they take a hands-on approach to getting defendants to buy into treatment plans, with a goal of steering them away from incarceration and recidivism.

John Guthmann, a Ramsey County judge, said the courts recognize traditional criminal proceedings alone “aren’t necessarily going to change anything” for defendants with issues rooted in mental illness. 

“There’s a recognition that your contact with the court is temporary, but your need to prevent criminal activity is permanent,” he said. “So our goal is to get a permanent treatment plan in place that you’re following, that you’re buying into, and that is available to you.”


But getting people the services to make those plans successful is an ongoing struggle, particularly inside the criminal justice system. A report from the state Legislative Auditor’s office, released in March, detailed problems ranging from poor record-keeping to inappropriately long stays to a lack of training for correctional workers.

In testimony before state lawmakers about the report, Hennepin County Sheriff Rich Stanek — president of the Minnesota Sheriff’s Association — said untreated mental illness had hit “crisis levels” in the state, and that jails had become “de facto warehouses” for the mentally ill in lieu of alternatives like hospital beds or community placement options.

He also added that inmates with mental illness often stay jailed far longer than those who do not, often stay longer than their original sentence for an underlying crime, and often do not get better while in jail — rather they often get worse.

Tim Leslie (Courtesy photo)
Dakota County Sheriff Tim Leslie

Leslie, the Dakota County Sheriff, said his staff does its best to treat inmates who need it — screening on arrival, managing prescriptions, making psychologists available, keeping social workers connected with inmates. He recently hired a deputy who is working on a graduate degree in forensic psychology.

But he knows that won’t solve the underlying issue: Incarceration is a poor option for someone struggling with mental illness — and too often the only option.

“If you already have anxiety and we put you in a cell, I mean, come on,” Leslie said.

He described a current jail inmate with “severe behavioral issues” — he threw urine at a correctional officer while in custody awaiting sentencing. His family fears having him civilly committed; the judge worries he’ll be “eaten alive” in prison.

“There’s not a whole lot of good choices here,” he said. “We have to find a societal solution to it, and we haven’t been successful.”


Other states, like Florida, have experimented with “receiving centers” that serve as alternatives to jail for people in mental health crises. A proposal for three similar centers was put forth in the Minnesota State Legislature last year by state Sen. Barb Goodwin, A DFLer from Columbia Heights.

Minnesota State Sen. Barb Goodwin, DFL-Columbia Heights
Minnesota State Sen. Barb Goodwin, DFL-Columbia Heights

It had support from law enforcement agencies who said they were overwhelmed by mental health holds and wanted alternatives. Goodwin said neither jail nor the emergency room — another common landing place — made sense.

“They really just need mental health help, and maybe a crisis bed for a little while,” Goodwin said.

But the plan drew resistance from advocates, including NAMI, who argued it wasn’t a sustainable solution.

Instead, “what we wanted was to really build up our community mental health system so we don’t need that,” said NAMI’s Abderholden. “What are the things that work, and how can we build them to scale?”

For her, that means an expansion of existing, proven services like mobile crisis teams — professionals who can provide in-home services for short stretches — housing with supports, timely access to treatment and childhood services.

She cautioned that no single service or program would be enough.

“I just want people to understand there’s no simplistic answer,” she said. “I think it’s a multi-pronged solution.”

Goodwin says she sees things moving forward, if tenuously. In spite of her receiving center proposal faltering (no similar efforts are advancing in the current legislative session), she said bills are moving forward that would put more money into mental health services, especially jails and prisons.

Other proposals would mandate mental health crisis training for all police officers — not enough, Goodwin said, but a start.

Gov. Mark Dayton, who in March echoed Rich Stanek’s sentiment of a mental health crisis, named the state’s first task force on mental health in April and directed it to explore ways to overhaul the system.

“I see that there’s a pretty heavy-duty attempt to develop more mental health services, more so than in the past,” Goodwin said, “and that’s a good thing.”

Dan Bauman contributed to this story.

For mentally ill facing charges, growing recognition but elusive solutions – Press