Santa Barbara County Grand Jury a Vicious Cycle Incarceration of the Severely Mentally Ill*

Note: Missing finding numbers detected: F7

Conclusions 14

• CL1
  Although the Sheriff's Office hired a statistician in July 2022 to compile information about inmates suffering from mental health conditions, as of the date of this Report, the Jury was not provided with any information regarding the number of inmates who have substance abuse and/or mental health disorders or illnesses.
• CL2
  Santa Barbara County could not provide to the Jury the costs of incarcerating people who suffer have substance abuse, mild to moderate mental health disorders or serious mental illnesses compared with the costs of providing meaningful community treatment for such persons.
• CL3
  In December 2024, Santa Barbara County is mandated to create and implement the CARE Court program, which will run concurrent with AOT and an IST Solutions program.
• CL4
  For the first two quarters of FY2022-23, the Santa Barbara County Incompetent to Stand Trial caseload is one of the highest in the state.
• CL5
  Outreach efforts and referrals must be well coordinated based on the client's needs, diagnosis, current service status, and history;
• CL6
  Avoid unnecessary criminalization of mental illness;
• CL7
  Clinical providers must be adequately staffed, experienced, and able to engage demanding clients long-term;
• CL8
  Providers must be able to meet clients' essential needs, including adequate and coordinated County resources; Provide needed substance abuse treatment coordinated with mental health care;
• CL9
  Provide stable housing in the County for the mentally ill and those suffering from substance abuse in areas where housing is currently severely limited;
• CL10
  Provide clients with medications and dosages adjusted as needed, early medical appointments, and timely follow-ups;
• CL11
  Provide clients continuity of care and do not discharge them before their treatment plan is completed;
• CL12
  Use private-public partnerships to provide adequate system coordination and hospital bed space for those with mental health challenges, including those diagnosed with severe mental illness;
• CL13
  Prevent repeated hospitalization and release after only short stays without notification to the clinical provider; and
• CL14
  Only incarcerate and release clients with adequate coordination with the clinical provider. Finding 4 For the first two quarters of FY2022-23, the Santa Barbara County Incompetent to Stand Trial caseload is one of the highest in the state.

Observations 8

• OB1
  Outreach efforts must be fully staffed and maintain client relationships once a client is enrolled in treatment; Outreach efforts and referrals must be well coordinated based on clients' needs, diagnoses, current service status, and history;
• OB2
  AOT programs cannot become a substitute for crisis management treatment for the severely ill. The data demonstrated mental illness cases again become criminalized, and frequent victimization on the streets is ignored;
• OB3
  Clinical providers need more experienced staff, able to engage demanding clients on a long-term basis;
• OB4
  Providers are often unable to meet the essential needs of AOT clients due to inadequate and poorly coordinated county resources. First, many clients need substance abuse treatment coordinated with mental health care. Second, they need stable housing; however, housing slots that will accept these clients are limited. As a result, providers are often forced to compete for them;
• OB5
  Not all providers can offer early medical appointments and timely follow- ups; consequently, not all clients can have medications and dosages adjusted as needed;
• OB6
  AOT clients are often discharged before treatment is completed. Many are then re-referred; many clients are repeatedly re-engaged and re- enrolled, completely losing continuity of care;
• OB7
  Poor system coordination and inadequate hospital bed space often result in inadequate response to AOT clients in crisis. Clients are repeatedly hospitalized and released after only short stays without notification of AOT or the clinical provider. In addition, clients are jailed and again released without adequate coordination. As a result, hospital and jail days for AOT clients may be reduced without positively impacting on the client; and •
• OB8
  The court order, meant to enforce AOT client compliance through the "black robe effect," will only succeed in a system with good resources and sufficient providers with adequate experience. Santa Barbara County Superior Court's exceedingly high IST caseload Santa Barbara County Superior Court made 77 IST29 referrals to DSH in the first two quarters of FY 2022-23, compared with 90 during all of FY 2021-22. Santa Barbara's 77 referrals as of December 31, 2022, is one of the highest in the state. By contrast, and with twice the population, Ventura County had only 52 during the same period. If Santa Barbara's pace of IST referrals continues for the year, 154 IST referrals will result. Under the IST Solutions Program penalty charges accrue for excessive IST referrals.30 The Jury learned that penalties imposed on Santa Barbara County could run as high as six million dollars.

Agency Responses 3

Government agencies' official responses to this report's findings and recommendations. Click on a response to see the structured breakdown.

No Responses Found 1

Government entities assigned to respond to this report. No response documents have been linked in our database.