Marin County Grand Jury
• 2017-2018
Mental Health Care in Marin County Jail Follow Up Report
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 3 findings
F1
Lack of full compliance by the Sheriff and the Board of Supervisors with the
Related Recommendations (1)
R1
The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should ensure that mentally ill inmates are not kept in a safety cell longer than 24 consecutive hours unless the Jail psychiatrist certifies that no other remedy is available to prevent the inmate from harming themselves or others.
F2
Lack of full compliance by the Sheriff and the Board of Supervisors with the
Related Recommendations (1)
R2
Safety cells should never be used for mentally ill inmates as a substitute for adequate medication and/or other psychiatric treatment.
F3
HHS is not timely updating the HHS Detention Medical and Mental Health Services Marin County Jail Policy and Procedures Manual.
Related Recommendations (1)
R3
Any inmate placed in a safety cell should be evaluated by mental health staff within four hours for the appropriateness of the placement and the evaluation of possible alternative placements.
Additional Recommendations 10
These recommendations are not explicitly linked to specific findings.
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R4The Board of Supervisors should, , establish or contract with a local facility where sentenced inmates can receive involuntary administration of psychiatric medication.
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R5As provided in the joint settlement agreement regarding the Los Angeles County Jails, the Marin County Jail should identify and adopt, , policies that ensure mentally ill inmates are provided with 10 hours of unstructured out-of-cell time as well as 10 hours of structured therapeutic or programmatic time per week.
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R6The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should ensure that a psychiatrist be available at the Jail 8 hours per day, 5 days per week, and be available by telephone 24 hours per day, 7 days per week.
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R7The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should ensure that a Mental Health Crisis Specialist or a psychiatric nurse be available at the Jail 24 hours per day, 7 days per week.
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R8The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should immediately institute programs to provide appropriate professional (non-pharmacological) mental health therapy to all mentally ill inmates, particularly those incarcerated for longer than 7 days.
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R9The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should ensure that classification of inmates as mentally ill be reviewed by a member of the mental health staff within four hours of booking.
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R10All policies and procedures in the Sheriff’s Manual related to the care of inmates should be reviewed and updated within the next 6 months. As required by law, they should be reviewed and updated biennially thereafter. An immediate review should take place whenever code changes are made.
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R11The County should provide adequate funding to implement these recommendations.
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R12The Jail should inform HHS of procedural changes that affect HHS policies and procedures in the Jail.
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R13The County should provide adequate funding to implement these recommendations. Sheriff’s response: The Sheriff was not required to respond to this recommendation. Board of Supervisors’ response: “This recommendation requires further analysis. The County spends approximately $1.3 million annually to provide adequate behavioral health consistent with state and federal health and safety standards. In addition, the County spends additional state realignment funds to provide transitional services to inmates, including those inmates with mental health needs. Over the next few months, we will be considering proposals to enhance mental health services and potential funding sources. As part of the Stepping Up initiative the Board of Supervisors has asked HHS to bring recommendations for expanding services. These proposals are being developed and will be brought to the Board for funding consideration.” Analysis: As discussed in relation to other recommendations above, the courts have repeatedly found that a failure to provide adequate mental health care cannot be excused by a lack of facilities, personnel or funding.