Mental health care in Los Angeles County jails is so inadequate that it's unconstitutional, the U.S. Department of Justice said Friday.
In a letter to the County of L.A., U.S. Attorney Andre Birotte and DOJ's Jonathan Smith wrote that the circumstances around a growing number of suicides and attempted suicides in the jails indicate that the county's violating the Eighth Amendment's ban on cruel and unusual punishment.
The DOJ has been monitoring mental health conditions in L.A. County jails for 12 years. In the past, the federal government has provided the county with periodic updates and suggestions, but has not reached the level of asking for court intervention.
The DOJ recommended the county negotiate reforms with the federal government and enter into a court-supervised settlement.
The L.A. County Sheriff's Department, which runs the jails, released a statement indicating they don't agree that conditions in the jails have reached unconstitutional levels.
"While we are concerned about the overall tenor and accuracy of today’s report, we remain committed to work with the DOJ to address its concerns and improve services to all inmates under our care," the statement said.
Citing specific cases, the letter detailed a number of alleged inadequacies in the jails:
- Inadequate mental health care to prevent inmates from becoming suicidal.
- An increase in the number of preventable suicides over the past year-and-a-half. In 2012, there were four suicides in L.A. County jails — in 2013, there were 10. There was also a 20 percent increase in suicide attempts in 2013. "Many of the suicides that occurred in the last two years were preventable," the letter said.
- Custody staff don't follow protocol. About "44 percent of those who self-harmed were housed in mental health housing at the time of the incident, indicating a lack of custodial supervision," the letter said. Sometimes, suicide checks on inmates are not performed, the letter said. KPCC reported last month on the case of an inmate who committed suicide while on suicide watch who was left alone for hours.
- Conditions in some of the jails are generally bad. Such conditions "may contribute to prisoners’ mental distress. Often, suicide precautions are punitive in nature, even depriving some prisoners of a mattress to sleep on," the letter says.
- Communication between mental health, health and jail staff is bad.
- The Sheriff's Department hasn't taken the issues seriously. "Fifteen suicides in 25 months produced almost no discernible change in the Jails’ custodial practices," the letter said.
The Sheriff's Department's statement does not address each allegation specifically, but notes the Department has been working to improve these issues for years.
"Every suicide and attempted suicide is of great concern to us," the statement said. "Both agencies are and have been fully committed to prevention efforts. We are disappointed that today’s report fails to fully recognize the additional progress made over the last year and a half to improve mental health services. The report also mischaracterizes and significantly understates the incredible efforts made to improve our suicide prevention practices."
Birotte and Smith also write that jails tend to be the receptacle for failings of other agencies, and are tasked with a difficult problem when it comes to the sheer number of mentally ill inmates in the system.
Birotte and Smith also said reform would be easier if the county found alternatives to jail for many mentally ill offenders.
"Many of the prisoners may well be safely and more effectively served in community-based settings at a lower cost to the County," they write. "The remedies that we seek in order to ensure that the conditions in the Jails meet the minimum required by the Constitution — that ensure that prisoners are safe and that staff are not placed at an unreasonable risk of harm — can be implemented more effectively if the number of prisoners needing mental health services is reduced."
That kind of change can't be ordered by the court, they said, but can be pursued by county leadership — something that's already underway to a degree in L.A.
Peter Eliasberg of the ACLU tells KPCC this letter has been coming for a long time — the DOJ has been telling the county about problems in the jails for years.
“People are dead now because of basic failures to exercise proper care," Eliasberg said, "which is particularly egregious because of the fact it was a finding back in 1997 that they had inadequate suicide prevention.”
Quote from Miriam Krinsky, executive director of the Citizens' Commission on Jail Violence, tells KPCC that it's important to note that the Sheriff's Department has made a lot of changes and progress in this area. But there's still a fundamental problem.
"The ongoing lack of leadership in fully turning the department around, and creating an environment where we put the right people in the jails, and we change the culture that's been embedded for many years in the Sheriff's Department in regards to how the mentally ill are treated," Krinsky said.
Supervisor Zev Yaroslavsky released a statement on the Justice Department's charges:
"The U.S Justice Department letter raises serious issues that cry out for the County to move aggressively now toward developing and implementing a diversion program that will treat mentally ill inmates in an environment far more conducive to success than the ailing county lockup. I feel certain the DOJ will not wait ten years for us to erect a new $2 billion jail, despite its promise of more humane and intensive treatment for the county’s thousands of mentally ill inmates. So it is crucial that the board revisit the jail construction issue sooner rather than later — and I believe the Justice Department's letter will incentivize the board to do precisely that."
This story has been updated.