Director: IDOC rebuilding mental health system

Dec. 18--SPRINGFIELD -- On a tour of the Pontiac Correctional Center shortly after he was hired to lead Illinois' prison system, John Baldwin met an inmate whose story convinced him that some reform measures demanded immediate action.

The prisoner told Baldwin during the October 2015 prison walk-through that he had 22 years left to serve in administrative segregation.

"When I asked him why he was there he said, 'I don't know,'" said Baldwin in a Pantagraph interview last week that also included IDOC chief of psychiatry, Dr. Michael Dempsey, and Dr. Melvin Hinton, chief of the agency's Office of Mental Health and Addiction Services.

Baldwin learned that "tons of low-level tickets" had landed the inmate in segregation for more than two decades -- an example of the type of disciplinary policy Baldwin has vowed to review since taking over the Department of Corrections.

"Part of this was his problem, but part of it is ours," said Baldwin.

The serious issues related to mental health treatment for IDOC inmates also quickly became a priority for Baldwin.

The state was in its eighth year of a federal lawsuit filed by Pontiac inmate Ashoor Rasho and later joined by 11,000 other mentally ill prisoners when Baldwin was hired away from the Iowa Department of Corrections.

The lawsuit is now settled with an agreement by the state to essentially build a new mental health system. Staff training, new residential treatment units and agreements with hospitals to provide care to inmates whose needs exceed those available at a prison are key components of the settlement that could cost $100 million to fully implement.

Last week, the state wrapped up two-day mental health training for 13,000 IDOC employees. Security, non-security and contract staff participated in the program developed under a partnership with the National Alliance on Mental Illness.

At Thursday's training session in Springfield, IDOC trainer Brad Hill focused on the medications used to properly treat mentally ill inmates.

Comments from a parole officer about whether mental illness is a matter of genetics or choice are illustrative of the challenge IDOC faces in its efforts to change the culture of a prison system that houses about 44,000 inmates. The trainer's explanation of how mental illness is diagnosed did not erase the officer's skepticism.

Workers who see inmates every day play a critical role in keeping mentally ill inmates stable, said Dempsey.

"What we're asking people to do is identify, not diagnose or treat mental illness. It's about patterns" and documenting changes in an inmate's behavior so issues can be addressed earlier, he said.

The state also is moving forward on its obligation to open four residential treatment units for seriously mentally ill inmates.

According to Baldwin, work was completed Thursday on renovating a former youth facility in Joliet that will provide 360 beds for mental health care when it opens early next year. Work also is finished on a mental health treatment area at the Logan Correctional Center in Lincoln, and bids have been accepted for a second unit there.

Bids are expected in early 2017 for units at the Dixon and Pontiac prisons.

A remaining challenge for IDOC is employing about 400 new staff needed for the expanded mental health system, said Hinton.

"It's very difficult," said Hinton, noting that Illinois is not unique in its shortage of mental health professionals. As part of its search for future staff, the state has opened a dialogue with the University of Illinois.

The same philosophical shift the IDOC has undertaken with its workers toward mental health applies equally to mental health workers who may have crossed the prison system off their list of potential employers, said Hinton.

"We want them to understand that the folks we treat are the same people they treated in the community. It's the same person," said Hinton.

Last summer, the union representing prison workers expressed concerns that IDOC was moving too fast with some of its mental health reforms. Moving inmates from segregation back into the general population before they were ready could expose correctional officers to violence, said the American Federation of State, County and Municipal Employees.

Beyond the mandate that staff have a safe working environment is the state's obligation to make sure workers have resources to help them deal with their high-stress jobs, said Baldwin. New programs to address those issues will be coming in 2017, he said.

Improvements in treating the state's mentally ill inmates could have long-term benefits throughout Illinois. About the same number of inmates that enter IDOC also are released each year -- most of them returning to the counties where they were convicted. Sending offenders home in better condition increases their chances for success, prison officials agreed.

A waiver of federal Medicaid rules filed by Illinois this year also could allow the state more flexibility in its use of federal dollars. The collaboration between 13 state agencies calls for boosts in mental health services, an area the state has cut in recent years. Part of that funding would be used to expand the link between prison and community services, said Hinton.

"We want discharge planning to start at intake. The goal is for them not to return," said Hinton.

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