Detention Center for Mentally Ill Still in Limbo

County officials agree that jail is not a good place to treat mental illness, but there is no money for an alternative

The consensus among Knox County officials seems to be that it's wrong to jail the non-violent mentally ill instead of treating them. But it appears that actually doing anything to halt the status quo will have to wait until the political will is found to spend the money needed to implement a solution.

Six months ago, hopes were still running high that the money could be found to build a "Safety Center" to help screen arrestees so the mentally ill could be diverted to treatment. But discussions have faltered as proponents struggle to come up with a funding scheme that would cover the estimated $20 million it will take to build and then operate the center over the next decade.

Most of those involved in the decision-making process, including Knox County Mayor Tim Burchett, agree that something needs to be done. The question comes down to dollars and cents in the midst of the worst economic recession to hit the United States in generations. That crisis is increasingly being mirrored by local government budgets, which have seen both less tax revenue and fewer federal dollars to pay for social programs, Burchett says.

"We have plenty of people who need money, but not a lot of it with the economy as it is," Burchett says. "No matter how worthy the program is, the books have to balance."

As the recession lingers and government budgets continue to contract, there has been a marked lack of enthusiasm from the general public for spending money on social programs. The joint city-county Ten-Year Plan to End Chronic Homelessness, for instance, was sent back to the drawing board last week (see "Who's in Charge of the Ten-Year Plan?"), and officials have hoped that the Safety Center would serve much the same population.

Unlike the publicly maligned Ten-Year Plan, however, the impetus to find some way to fund a Safety Center is driven in no small part by a desire to avoid the prospect of fending off a federal lawsuit due to jail overcrowding. In theory, the Safety Center would divert the mentally ill and those busted for petty crimes away from jail altogether by giving them a place to sober up and to screen them for mental problems.

"I'd say it's still on the drawing board," says John Gill, special counsel to District Attorney General Randy Nichols. "For everybody who is involved in it, it's just kind of like all the marbles have been thrown up in the air and we don't know where they're going to land."

A Safety Center would be an ideal way to relieve some of the pressure on the county jail, which has to deal with tens of thousands of arrestees each year, according to Knox County Sheriff Jimmy "J.J." Jones. Roughly a quarter of the people locked up in the Knox County Detention Facility are there because of untreated neurological disorders such as schizophrenia or bi-polar disorder, a state of affairs that has long disturbed officials like Jones who believe that treating sick people like common criminals is both immoral and a waste of taxpayer dollars.

"Police officers are not trained to deal with the mentally ill," Jones says. "We can give them their medicine while they're here, but that's not what these people need. We're spending half a million dollars a year on psychotropic drugs, and the debt to the taxpayers is enormous. Also, once they are arrested, these people lose their TennCare coverage so that institutions and hospitals and don't want to take them. It's a big issue, and we feel that a Safety Center would be a win-win."

As envisaged, the facility would be operated by the Helen Ross McNabb Center on Springdale Avenue in North Knoxville. The 10,000-square-foot building would operate 24 hours a day and would have around a dozen beds where "someone can spend three days if they are in a mental-health crisis," according to Helen-Ross McNabb CEO Andy Black.

Current plans call for Knox County to have a judge or judicial commissioner on duty at all hours who can be reached via a video feed from the Safety Center, Black explains. "When the police arrest someone, they would bring them to the Safety Center … and the judge would provide that person with the option of going through the Safety Center or going to jail," he says.

Jones chafes at the moral conundrum of being forced by circumstances to operate what he has described as "the biggest mental hospital in East Tennessee" with a staff trained to handle thieves, rapists, and killers rather than people who ideally would be living in hospitals or some type of assisted-care facility. He points out that officials may not like the idea of spending millions of dollars on a Safety Center, but that option is theoretically far cheaper than postponing action until jail overcrowding reaches the point where intervention from the federal courts becomes inevitable. Knox County was sued once for overcrowding in 1986, and the county is still dealing with the legal and fiscal fallout of that debacle. No one is eager to relive the experience.

Black and others have stressed repeatedly that they have no intention of taking violent offenders to the Safety Center. They anticipate that the vast majority of people who move through the facility would be men and women who have been booked for the types of minor, nonviolent offenses that the homeless and mentally ill often rack up. He hopes that as many as half of those brought to the center could be kept out of the criminal justice system entirely, which would make it far easier for the mentally ill to get effective treatment and eventually rebuild their lives.

The public intoxication statute alone yields an inordinate numbers of arrests each year in Knox County for a crime so minor that it normally triggers only a $50 fine plus time served by way of punishment, according to Gill, Jones, and other law enforcement officials. The charge isn't a great deal more serious than a traffic ticket, but the risk of lawsuits leads police to automatically incarcerate those who are deemed too intoxicated to care for themselves.

In theory, anyone who is suspected of being drunk or stoned in a public place is subject to arrest under the law, but in practice the police tend to use it as a means to take unruly partiers off the street before they can hurt themselves or someone else. In a town that features a hard-partying university campus as well as dozens of bars catering to the entire socioeconomic spectrum, it's perhaps not surprising that the cops end up collaring more than 4,000 men and women a year for P.I.

But the most frequent offenders usually don't drink in bars at all. The "hardcore" or chronically homeless, most of whom live in or around the downtown area in makeshift campsites, are far more likely to be arrested than their more well-to-do neighbors by virtue of the simple fact that they are technically in a public place even when they curl up in their sleeping bags or bedrolls for the night. The same factor means that they literally can't empty their bladders without risking an arrest for indecent exposure, while many other behaviors that other people can get away with in the privacy of their homes (such as playing music or raising their voices) can lead to a charge of disorderly conduct.

Getting the homeless off the streets isn't a simple matter. Study after study has shown that the majority of Knox County's chronically homeless are wrestling with severe, untreated mental disorders and more than a third of them have been hospitalized at some point in their lives due to mental illness. The lack of state or federal funding for mental-health care means that there are few beds to house even the most severely ill patients for extended periods in institutions like Lakeshore, which in turn means they end up living on the streets.

"Basically all the [police departments] are doing right now is holding them in jail until they sober up, which they have to do for liability reasons," Gill said. "They're taking up jail space, taking up bed space, and there's no real kind of intervention. Some people get arrested 60 times a year … Putting them in jail is not going to help anybody, and if it's not going to produce any results then that's something we need to find a better way to do."

Late last year, officials had hoped to obtain funding from the U.S. Department of Housing and Urban Development to finally begin building the Safety Center, but questions were soon raised over the legality of using the hoped-for federal dollars to cover the estimated $1.5 to $2 million in construction costs. Also, some County Commissioners as well as Burchett voiced concerns over the projected $2 million-a-year operating costs.

At the most recent meeting of the county's Criminal Justice Committee, Burchett appointed a new subcommittee comprised of prosecutors, police, mental health providers, judges and others "to look at best practices and other potential solutions."

Burchett says that he supports the Safety Center's premise and believes that more needs to be done for the mentally ill. But he also says that he is uncomfortable with the vague, ever-changing guesstimates about how much money the facility will actually end up saving taxpayers.

He went on to say, however, that "this isn't just a dollars and cents" subject. Burchett agrees that the current policy of criminalizing the mentally ill is morally intolerable and vowed to continued looking for solutions.

"This is the kind of thing that gnaws at my gut at night," Burchett says. "I don't want to see anybody mistreated, especially not the mentally ill … I'm deadly serious about this issue."