Sheriff Needs Plan to Support Mental Health in Jail

Published on June 16, 2022

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DENVER – The Denver Sheriff Department needs to take a more strategic approach to mental health services in its jails to better support the goal of helping people avoid cycling back through the system, according to a new audit from Denver Auditor Timothy M. O’Brien, CPA.

“Mental illness isn’t a crime, and the goal is to work toward supportive programs that keep people from returning to the jail system,” Auditor O’Brien said. “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 Sheriff Department provides mental health services, both internally and through contractors. All individuals receive a mental health assessment when entering jail to help identify issues such as drug and alcohol addiction or behavioral conditions. Everyone in the jail system has the right to ask for help or information and to request medical, mental, and dental health services.

Our audit of mental health services and programs in Denver’s jails found that to successfully help individuals in need or those who are at high risk, the department needs to address several concerns.

First, the mental health programs are decentralized and lack a strategy to ensure consistency in the programs and planning for when individuals leave jail.

Second, the department has not clearly defined success and has not formally evaluated staffing and resource needs to support established goals and objectives.

Management said its behavioral health services are innovative and above the standard. However, it acknowledged the need to prioritize mental health services for people who cycle back through the system repeatedly. Management said people with chronic mental health conditions are not getting the resources they need as they leave jail and need to move into community service provider programs.

Whether an individual is seeking care while in jail, transferring, or leaving jail and transitioning to care through community service providers, consistency in the planning and the data tracking process could help the department improve care.

We found inconsistencies and errors in jail data for mental health care, including errors in information used to identify trends and concerns in mental health programs. The department is also still using paper records, which can create additional challenges for ensuring consistency in care.

“Paper records are an outdated practice,” Auditor O’Brien said. “The Sheriff Department needs the resources necessary to bring their record keeping into this century for the sake of accuracy and continuity in the care individuals receive in jail and as they return to the community.”

The Sheriff Department could also do more to ensure the quality of care in jails by keeping better oversight of its contractors.

“Right now, contractors send invoices to the jail and there is not enough further scrutiny; the department just pays the bill,” Auditor O’Brien said. “The lack of third-party contractor oversight is a citywide problem and risks inefficient use of taxpayer dollars and lower quality of deliverables.”

The audit team also recommended ensuring all programs are equitable by offering all of them to both the men’s and women’s sides of the jail. And management should ensure proper supporting documentation is retained and available to show it is assessing the housing needs of individuals identifying as transgender within 72 hours to avoid the psychological damage of isolated housing. This initial separate housing is for the safety of both the individual and other people in jail and should not last longer than necessary.

“Supporting mental health care in jails is a complex issue that does not always have just one right solution,” Auditor O’Brien said. “By moving quickly to lay out a plan, accurately tracking data, ensuring contractor oversight, and taking an equitable approach to mental health, the city could help individuals both while they are in the system and as they return to the community.”

The Sheriff Department agreed to all of our recommendation and says it hopes to have them all implemented in the next few months.

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