The number of people booked into the Douglas County jail with serious mental illness dropped from 18% in 2014 to 10% in 2022 — and hit a low of 5.5% in 2018.

In November 2020, Brandon Scrimsher was sentenced to three months in the Douglas County jail.

The prospect of more time in jail was disheartening. Scrimsher, who has been diagnosed with bipolar disorder, said his mindset and mental health sank.

“I really kind of got … the attitude of, you know, this really sucks and why try,” Scrimsher said. “Nothing’s ever gonna get better.”

Despite his skepticism, Scrimsher found hope at the Douglas County jail. Case managers stationed inside the jail insisted he prepare for life outside — connecting him to mental health workers, classes and even housing when he was released.

For Scrimsher, the jail’s approach made a difference. Today, he’s enrolled in community college and working for a nonprofit to support people experiencing homelessness.

“Instead of just kicking me back out into the cold, like has always happened before, they actually sat down and worked with me,” Scrimsher said. “(They) made sure I had somewhere to go that was safe and had a roof over my head and was able to restart my life the correct way.”

Many jails in Kansas contend with high numbers of mentally ill inmates, according to a 2020 state report. Sedgwick County estimates 30% of its jail population has some sort of mental illness. Though the sheriff’s office and county have taken a multitude of steps to manage this — like implementing a mental health pod and an offender assessment program to divert people with mental illness from jail — it continues to struggle.

But in Douglas County, numbers have dropped. From 2014 to 2022, people with a serious mental illness booked into the Douglas County jail decreased from 18% to 10%. In 2018, the jail hit a low of 5.5%.

“The easy answer is that there was this real shift in culture within the criminal justice system through education, through identifying who we are trying to serve,” said Mike Brouwer, who served as Douglas County’s criminal justice coordinator from 2019 to 2021. “That really is what made the difference … and lowered the number.”

The harder answer is that Douglas County implemented a kaleidoscope of programs and policies to reduce its bookings of people with serious mental illness. It’s difficult to know which of the tweaks made the difference — or whether it was the collective impact of them all.

“I wish I could say … that we did this one thing, and this was what made it happen,” said Brouwer, whose job was to coordinate communication and collaboration between the court system, law enforcement, social service agencies and more. “But it really wasn’t one thing. It was a series of things.”

Political pressure prevented jail expansion

In 2014, the Douglas County sheriff alerted the community that the jail was overcrowded and needed an expansion.

But it was not a popular investment among voters. As discussions around expansion heated up in 2015 and 2016, a campaign led by interfaith activist group Justice Matters opposed it. And in 2018, a countywide ballot referendum to invest in a jail expansion failed.

As the conversation about jail expansion played out, the Douglas County sheriff still had an overcrowding problem. Meanwhile, people with mental illness started to make up a bigger portion of the jail population, said Douglas County Sheriff Jay Armbrister.

“We were getting this influx of folks with SMI [serious mental illness] that were new to us,” Armbrister said. “It just really kind of created this dynamic of where … not only were we over-full, we were buried under folks who just needed a lot of help that a jail cannot, frankly, give.”

With these two pressures in mind, Armbrister said the jail started piecing together a puzzle of new programs and policies.

Starting with data

In 2015, Douglas County signed onto the Stepping Up initiative, a national partnership to reduce the incarceration of people with mental illness. The national organization helps counties keep better data on mental illness in county jails.

Beginning in 2016, every person booked into the jail was given a brief mental health screening.

But it didn’t stop there. If someone indicated they had mental health issues during booking, jail staff would make note of it. In 24 to 48 hours, a jail-based mental health professional would follow up with the inmate to do a full mental-health assessment.

“Now you’re able to start gathering data on how many (people with serious mental illness) are coming in,” Brouwer said. “How long are they staying? Are they coming back? Just having that information now gives you justification for beginning to add some resources.”

The county’s commitment to data collection is one of the reasons it was named an innovator county by Stepping Up, said Audra Goldsmith, who works with counties at the Kansas Stepping Up Technical Assistance Center. In addition to data collection, the county’s Criminal Justice Coordinating Council has a full-time data analyst.

“If you look at, ‘How are we going to invest in said service?’ they have the data to be able to support and show a picture of where would be the best place to invest in,” Goldsmith said.

Integration of mental health professionals 

Another major resource the jail invested in was mental health professionals who are contracted through Bert Nash, the county mental health center. In 2016, the county doubled the number based at the jail from two to four, said Paul Leffingwell, the Forensic Services program manager at Bert Nash.

The clinicians create individualized treatment plans like counseling or medication referrals for people in jail who have mental illness. Because the clinicians work for the county mental health center, they can easily access mental health records for anyone who has worked with Bert Nash in the past. That helps staff coordinate mental health care, Leffingwell said.

“When they get booked into jail … we can just look up their treatment history and get a sense of, ‘What were they doing before they came to jail?’ ” he added. “ ‘How actively engaged were they in treatment? What kind of treatment were they receiving? Do they have a therapist, a case manager?’ ”

The mental health workers are also supposed to attend first court appearances — which take place over video — with any clients in the jail. Brouwer said clinicians can tell the judge what sort of treatment plan is being put into place and how the client will follow it.

“That made the judge feel a lot more comfortable about releasing them,” Brouwer said. “And then that also gave us the opportunity to get this person connected with services.”

Reentry program

Another key?

The sheriff’s reentry program, which helps connect people like Scrimsher with things like housing, jobs and identification cards as they leave jail.

After the county joined the Stepping Up initiative in 2015, the sheriff added mental health and medical resources to the reentry program.

“So when somebody leaves jail and they’re taking a drug that works to keep their SMI [serious mental illness] in check, we send them out the door with X-number of days worth of (medication),” Armbrister said. “Or we make sure that they make it to their doctor’s appointments or their meetings or whatever.”

For six months after release, the sheriff’s office reentry program will drive people to court or to mental health appointments. That’s important because the number one reason people are in the Douglas County jail is failure to appear in court.

“If us giving them a ride to court keeps them out of jail and taking up a jail bed, it’s entirely worth it for us to do that,” Leffingwell said.

The jail even recently implemented a system —called My Resource Connection — that connects reentry workers in the sheriff’s office with mental health workers outside the jail. The system automatically emails mental health workers outside the jail if their client is booked to facilitate that case management.

For Scrimsher, the reentry program connected him with a housing program that helped him with transportation and health care. They also bought him a laptop when he enrolled in community college.

“Even to this day, two years later, they still keep in contact with me,” Scrimsher said.

Keeping recidivism down is still a challenge

Much of this work is done on the back end of the criminal justice system — after someone with mental illness enters the jail. County officials then do what they can to make sure they don’t come back.

That effort has had some success in Douglas County. In 2018, 56% of the people booked with serious mental illness had multiple bookings in the calendar year. By 2021, that dropped to 50%.

But Armbrister, who is still seeing overpopulation in the county jail, would love to see numbers fall even further.

“We’re just barely … treading water,” Armbrister said.

Brouwer, Armbrister and Leffingwell said that tactics that divert people from jail and redirect them to mental health treatment — like crisis intervention training for police officers — have also been helpful in dropping the bookings of people with serious mental illness. But they said some should be expanded, like a mobile crisis team that dispatches mental health professionals in response to calls from a mental health crisis line.

And Leffingwell said it can still be difficult to provide mental health assistance for people once they get out of jail, especially those without a house.

“What do you do with folks who don’t have a place to go who have mental health needs or physical health needs?” Leffingwell said.

Going forward, Armbrister said the jail, community mental health center and other agencies will continue to work closely together. To keep numbers at the jail down, they don’t have another choice.

“We know that one person in jail for a year can cost over $200,000 in taxpayer dollars,” Armbrister said. “So even if you keep one person out, we’re still money ahead, in my opinion.

“But if we’re getting 5% and 6% of people not coming back to the jail, that’s totally worth it for us.”

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