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Ohio struggles to deal with rising numbers of mentally ill inmates

Karen Kasler/Ohio Public Radio

The largest provider of mental health services in Ohio has become the state’s prison system. And the state is hoping to work with advocates in the mental health community to figure out how to deal with that.

Gary Mohr started in the prison system in 1976. He’s now its director. And Mohr says in those almost 40 years, the growth in the number of inmates coming into the system with mental health issues has shocked him.

“We take in 20,000 people a year,” Mohr said. “And over 20% of those people are, have a diagnosis of being mentally ill and require treatment - one out of every five.”

And Mohr estimates at quarter of those people – a thousand Ohioans a year – have never been in trouble with the legal system before.

“We try to run the best prison system we can – we’re proud of it – but it’s not place for those folks,” Mohr said.

That’s why the state says it’s trying to help keep some of those people out of the prison system or to get them help while they’re behind bars so they don’t return.

There’s a state program to send experts in to prisons to start working with mentally ill inmates 90 days before they’re released. And the state also put $1.5 million in the last budget to link up county jails and local alcohol, drug addiction and mental health boards to help connect people with treatment before they’re released.

At the Ohio statewide conference for the National Alliance on Mental Illness, or NAMI, stakeholders at all levels saw demonstrations of mental health training in action in a series of performances on five small stages meant to look like a courtroom, a jail cell, and the site of an arrest.

The first scene featured actors performing a scene not including someone who’d had mental health training, which involved lots of violent shouting, and a second scene to show the change when someone has been taught some crisis intervention techniques, in which the mentally ill person is spoken to calmly.

The organizers of the conference say those scenarios are based on real cases.

Dodie Melvin of NAMI of Knox/Licking County has been involved in advocacy for mentally ill people for years, and said the performances were helpful to her.

“These people have behaviors that we may not understand, but they’re people and they are due our respect. We should treat them with dignity as we would with any other illness.”

Former Ohio Supreme Court Justice Evelyn Stratton has been working on mental illness issues since she left the bench.

She says with 180 specialized dockets such as drug, mental health and veterans courts around the state, Ohio is doing better than many other states. But she says one recent action has really helped.

“Most of these people had no coverage and no mental health coverage until we got Medicaid expansion,” said Stratton. “And I don’t care what the legislature and what Republicans – and I’m a Republican – say about it. It’s the best thing that’s ever happened to us in terms of treating mental illness in this state.”

And prisons director Gary Mohr says the other thing that will help is funding in the budget for alternative sentencing and community based programs outside prisons.

“Whether it’s residential or non-residential, whether it’s mental health or other behavioral health programs, community based programs are twice as effective as prison programs, even if it’s the exact same program just delivered in a community setting – twice as effective at one-third the cost,” Mohr said.

Mohr says the problem has to be dealt with now – especially because of the huge numbers of women in the justice system. Mohr says forty years ago, there were 291 women behind bars in Ohio. Now there are 4,200 – and he says they are less violent than men but have higher rates of addiction and higher levels of mental illness.