The Denver jail keeps unreliable data on its mental health programs, is failing to adequately monitor its contracts with mental health providers and could not show whether its transgender inmates are housed according to their preference, according to an audit released Thursday.
The Denver Sheriff Department offers an array of programs to help inmates deal with mental health and substance abuse, but lacks an overall strategy that would lead to a bigger impact, says the report from Denver Auditor Timothy O’Brien.
“Mental illness isn’t a crime, and the goal is to work toward supportive programs that keep people from returning to the jail system,” O’Brien said in a news release. “People in jail with a history of mental health needs are at higher risk of cycling back through the system over and over if they do not get the care they need both in jail and when they return to the community.”
The jail has 20 active contracts and grants to provide services ranging from education, life skills, drug and alcohol assessment, and reentry into the community, but the department is not adequately monitoring those contracts or working on an overarching plan to reduce recidivism, the report said. One program, which provides therapy and community-reentry planning for people who are awaiting a mental competency evaluation, “appears inequitable” because it’s offered only to men living in the jail, the auditor said.
People booked into the jail receive a mental health assessment, including for drug and alcohol addiction issues, and then they are allowed to ask for help with those issues or other mental, medical or dental services. The audit focused on mental health services.
The report discovered inconsistencies and errors in the jail’s mental health data, including data that would help identify patterns of ineffective care. Also, the department is failing to provide adequate oversight of its numerous contractors. The audit described a system in which contractors send their invoices, and there is no followup regarding what services were actually provided.
“The department just pays the bill,” O’Brien said. “The lack of third-party contractor oversight is a citywide problem and risks inefficient use of taxpayer dollars.”
The audit also found that while sheriff department policy requires that deputies be able to identify mental health issues, the department could not provide documentation to prove it was following its training requirements. Staff are supposed to attend mental health classes.
The auditor recommended that the jail:
— Stop using paper records and transition to all-electronic records in order to better track program outcomes. Track outcomes for people who left jail and then entered community programs. The department “needs the resources necessary to bring their record keeping into this century for the sake of accuracy and continuity in the care,” the auditor said.
— Prioritize mental health services for those who cycle back into the jail system repeatedly. Provide people with chronic mental health issues more support when they are released from jail, including placement into community programs.
— Establish a centralized strategy so that mental health programs work together consistently.
— Offer all programs on both sides of the jail, for men and women.
— Determine within 72 hours of booking whether a person who is transgender prefers to house with women or men “to avoid the psychological damage of isolated housing.” Transgender people initially are housed alone for safety reasons but this “should not last longer than necessary,” the audit said.
The sheriff department plans to implement all of the recommendations and last year hired a first-ever chief of mental health services. Dr. Nikki Johnson already was addressing many of the issues identified in the audit, the department said.
“We have made mental health services a priority knowing the importance of addressing the mental health needs of individuals in custody,” Denver Sheriff Elias Diggins said in a news release. “Our goal is to provide best practices consistent with community mental health standards and to assist in the success of each individual as he or she reenters society.”
The jail’s mental health services are some of the best in the country, including connecting people with mental illness to community services when they leave the jail, according to the department.