"Jesus loves you."
It was about 3 a.m., and Felicia Lewis stood in the doorway to the bathroom of what she thought was her grandmother’s house.
Inside that bathroom was Terry Groover, gripping a phone, ready to call police.
Loud thumps coming from the front of her house awakened Groover, who ran to the bathroom to hide.
"Jesus loves you," Lewis said again, and gave her a hug.
Groover fled her North McCann Street home and dialed 911.
NEED TREATMENT? GO TO JAIL
Lewis was arrested and charged with residential entry. She was incarcerated at the Howard County jail.
But once she was there, jail staff began to notice Lewis displayed behavioral problems — problems serious enough to prompt mental health professionals to determine she needed help.
On May 29, she was transported to Community Howard Regional Health on an emergency-detention order, which allowed clinicians to hold and treat Lewis for 72 hours.
Five days later, Lewis escaped the hospital and entered a home on Terrace Drive. She was shot multiple times by the homeowner, according to court documents.
The Howard County jail is full of people like Lewis — people in need of mental health treatment with no criminal history whose illness causes them to act out and end up on the wrong side of the law.
“We are here for people who commit crimes,” said Howard County Jail Commander Capt. Harold Vincent. “Unfortunately, we see a lot of people commit crimes who have a mental illness. This is not the place for those folks.”
Ken Gardner, a master-level therapist clinician, serves as the jail’s on-call therapist. Gardner has dealt with most of the jail’s mentally ill inmates and seen some disturbing behavior that jail staff isn't equipped to deal with.
There are inmates suffering from acute depression who have tried to hang themselves, he said. One inmate with a severe mental illness would eat his own flesh to get attention.
“That’s the frustrating thing for jail officers,” Gardner said. “These are people who really need to be in a mental health facility where they can be medicated and treated daily.”
Despite that, the jail is the place where most people in Howard County suffering from a mental illness end up.
Howard County Sheriff Steve Rogers said the jail holds more people in need of mental health treatment or who have been in the mental health system than Community Howard Regional Health. Community Howard is designated as a community mental health center by the Indiana Department of Mental Health and Addiction.
The hospital serves Howard, Tipton and Clinton counties, which have a combined population of about 131,000.
In fact, more people receive mental health treatment at the Howard County jail than at any other facility in north central Indiana, the sheriff said.
Currently, more than 20 percent of the jail’s 375 inmates are on psychotropic drugs to help treat mental illnesses, Vincent said. More than 40 percent are involved in some kind of therapy or counseling.
“The jail environment is meant to contain people,” Gardner said. “We’re not in a position to house multiple mental health patients. The jail is the largest mental health provider in north central Indiana that shouldn’t be one.”
So how did a county jail built with just two padded rooms end up treating more mental illness than any other facility in the area?Like a lot of things, it comes down, at least in part, to money.
SHRINKING BUDGET
In 2012, Indiana cut more than $24 million, or 9 percent, from its mental health budget, according to a report published by the National Alliance on Mental Health.
It was the second biggest state cut to mental health funding in the country, next to Illinois.
It is part of a decades-long trend. Indiana lawmakers have trimmed money allocated to mental health for years, and the fallout can be seen at state hospitals, which either closed or dramatically reduced the number of beds available to mental health patients.
Last month, a Howard County judge ordered a 24-year-old Kokomo man accused of stabbing his father during a schizophrenic episode to be transported to Logansport State Hospital for treatment.
Howard County jail officials said it was more than five weeks before they could transport Zachariah Morgan, because all of the beds in Logansport were full.
“Even if there’s a court order to get people treatment, we usually end up sitting on them for months sometimes because there aren’t any beds available,” said Vincent.
Susan Moody, chief administrative and clinical officer of Community Howard’s Behavioral Health Division, estimated the number of beds at the remaining six state hospitals, including Logansport State Hospital, has been cut more than 60 percent over the last 20 years.
Moody said the lack of beds at state hospitals is alarming.
“These are people who need a bed in a state hospital, but there’s not one,” she said. “… It’s supply and demand, but there’s so much more demand for the state hospitals than there are beds for the people that need them. It’s very disturbing.”
A tough economic climate has also forced places like Community Howard Regional Health to cut workers, including staff working with mentally ill patients.
“They’ve cut back and shut down state hospitals,” Sheriff Rogers said. “Most communities can’t afford to have their own facilities that can handle the number of people out there who need help.”
Gardner agreed.
“That’s the challenge for Kokomo,” he said. “We’re a big, little community. We have big-city problems with the revenues and resources of a small community. … There’s just not enough services to go around.”
Without treatment options, mentally ill people may end up breaking the law. That means the number of inmates suffering from a schizophrenia, bipolar disease or other mental illnesses climbs and climbs.
“This whole situation is a stinky onion, and the more layers you pull off, the stinkier it gets,” Jail Commander Vincent said.
DOING WHAT THEY CAN
It's a bad situation, but the Howard County Sheriff's Department has adapted as best as it can.
Officers receive extensive, regular training on dealing with mentally ill people. The department hired jail therapist Gardner, who’s on call 24/7, to help diagnose and treat inmates.
Sheriff department officials meet regularly with clinicians at local hospitals and officials at mental health agencies to discuss how best to identify and treat mentally ill people who may be more prone to behave criminally because of their disease.
“Howard County has the interest and concern to fix this problem,” Gardner said. “What we lack is funding. The reality is, we do the best we can with the resources we have.”
One of the newest resources available to law enforcement agencies is a place called the Mulberry House — a first-of-its-kind facility that opened early last year in Kokomo that’s helped reduce the number of mentally ill inmates incarcerated at the jail.
The Mulberry House is a building with 15 apartments staffed by clinicians trained to deal with mental health issues. The building also doubles as a drop-in center for those who need a place to go.
Officers take people who are acting out, but not criminally, to the Mulberry House. It is a quiet place to calm down and talk.
“They have a safe haven there,” Sheriff Rogers said. “They can take it easy, settle down and deal with their issues.”
The facility was the brainchild of Erika Cornett, a doctor with offices at Community Howard. She applied for funding from the Department of Mental Health and Addiction and ended up getting enough money to implement the program.
Before the Mulberry House, the only options were jail or the emergency room for someone acting out from a mental illness, said Community Howard Clinical Officer Moody.
“Our local law enforcement does a great job of knowing who to bring here and who not to,” she said. “It works well, and it’s a win-win for the police and the person having issues.”
It's a step in the right direction, Rogers said, but hardly puts a dent in the number of inmates who need mental health treatment.
To do that, he said, it’s going to take major changes to the criminal justice system — and a lot more money.
Rogers is working to get the state Legislature on board to overhaul a system that’s woefully ineffective at treating the mentally ill.
TO THE STATEHOUSE
The sheriff said he took the first step to get lawmakers involved by contacting state Rep. Mike Karickhoff, R-Kokomo.
Karickhoff said he knows the situation at the jail is serious. He said he's currently drafting a letter addressed to House leadership requesting the issue be put on the agenda for discussion during the Legislature's summer study session.
With any luck, he said, the problem will get assigned to a committee, where lawmakers can hear testimony from people like Sheriff Rogers and others impacted by the lack of mental health services.
“Ours is kind of an extreme situation in Howard County, and it really illuminates the gaps in treating mentally ill people," Karickhoff said. "Jails are not hospitals, but they house a lot of people with these illnesses.”
But with the slow moving wheels of government, he said it may take some time before any substantial legislation addressing mental health issues ends up on the floor for a vote.
“I’m somewhat optimistic that we’ll have the chance to share with some of my colleagues about this problem," Karickhoff said. "The best thing we can really do is shine a light on this problem."
With more than 80 inmates at the jail in need of long-term mental health treatment, Rogers said that discussion needs to happen soon.
“This probably won’t be a popular topic at the Statehouse, but it’s something that needs to be talked about,” Rogers said. “At every level of the criminal justice system, people see there’s a real weakness handling these problems and taking care of these folks.”