Home Health Caught in the Revolving Door

Caught in the Revolving Door

This story was reported on in 2019 during the peak of activism towards reforming the jail system in Los Angeles. It appeared in the University of Southern California’s Story Space headed by the Annenberg School of Communication and Journalism. Culturas is highlighting this piece to honor World Day for International Justice.

Two years after the wrongful-death Department of Justice unveiled its plan to reform mental health care and use of force in the Los Angeles County jail system, inmate Juan Correa Jr. died in the Men’s County Jail in 2017. Sheriff’s deputies failed to call a supervisor when he experienced breathing problems.

A third of the 17,000 inmates in county jails from mental illness. Their numbers are rising, and jail capacity has exceeded by 120% in 2017 alone.

Correa was schizophrenic and his continued run-in with drugs since his teens had brought him in contact with the police many times. Usually, his drug-induced psychosis was contained in the walls of the Twin Towers Correctional Facility. But when a stray lit cigarette that had eluded deputies fell out of his pocket onto the carpet, Correa was tackled to the ground and moved to the general population division of the county jail. What followed was his incarceration, his death, and anger from the surrounding community.

Juan Correa Sr. at Dignity and Power Now’s family support meeting.
Photo by Bulbul Rajagopal

Juan’s psychotic fits were taking a turn for the worse, and that prompted his parents to admit him into Long Beach hospital one night. But according to his mother, “The hospital, instead of giving Juan help, took him to jail. We weren’t told about it until the next day.” She said he was transferred from the hospital to the “Behavioural ward” of the county jail in the same clothes. Juan’s clothes held a cigarette that he had asked the hospital staff for.

Then chaos struck.

“He tried to smoke in the room but he was out of his mind! How would he know. It fell on the blanket and that’s when the cops came. They kept asking him angrily if he did this and that’s when he incriminated himself. He said ‘yes’ under all that pressure, and he was mentally ill,” said his mother, Maria A. Correa.

Juan’s death in 2017 is only one event in the bloody history between the Los Angeles County Sheriff’s Department and the public, especially communities of color. The Bureau of Justice Statistics stated that in February of 2012, the Los Angeles County jail system housed 38% more prisoners than it was meant to. The eight “jail facilities” were overcrowded with 17,362 men and women. In comparison, all 63 county jails in New York statehouse only 15,300 inmates. Today, the county still battles overcrowding in its jails, and almost a third of its population – 5,600 out of 17,000 – are afflicted with mental illness.

The main complaint regarding Juan’s treatment in the Men’s Central Jail was that he was locked up in a cell in the general population wing–an area separate from where mentally ill inmates are treated. Jails stepping in to carry the job of hospitals has long being criticized. The issues of jail capacity and treatment of the mentally ill have become hot-button topics for both the Board of Supervisors and for the DA’s election.

“L.A. County Jail is the largest mental health facility in the county, and that’s just not right. People do not get better in jails. It has to be a last resort,” said Richard Ceballos, a veteran Los Angeles County prosecutor who is challenging District Attorney Jackie Lacey in next year’s election.

Advocacy groups and champions of mental health care are rejoicing in county supervisors’ decision to scrap a $3.5 billion mental health treatment facility, designed like Men’s Central Jail. The Board of Supervisors rejected the plan in August 2019. They have now shifted their focus to razing the Men’s Central Jail altogether.

But what now?

Organizations like Dignity and Power Now, its off-shoot Reform L.A. Jails, and the Youth Justice Coalition are now left confused as to the whereabouts of the $3.5 billion that was set aside for the makeshift treatment center. “That money came from construction bonds, the state gave it to LA county. Now that the jail contract has been canceled, us organizers told the Board of Supervisors that we can build alternatives,” said Dignity and Power Now’s membership engagement coordinator Reegie Bunch.

However, no money has been released yet. These groups believe the best alternatives are decentralized mental health treatment centers across the county and not a large state hospital. Bunch claims that the Board of Supervisors now wants to use this money to tear down the Men’s Central Jail instead. “They’re worried about being sued by the Department of Justice,” said Bunch.

Art dedicated to the late Juan Correa Jr..
Photo by Bulbul Rajagopal

According to the Los Angeles Almanac, the Men’s Central Jail exceeded its capacity by 120% in 2017. The Board of State and Community Corrections had rated the capacity to be 3,529. But the daily population on average stands at a whopping 4,236 inmates. Of these, 28% suffer from mental illness. The number of inmates in the Los Angeles County Jail system expanded by 86% from 2010 to 2017. Juan Correa, Jr. happened to be just one of the many caught in the crossfire.

Bunch and his colleagues are reassuring themselves with the belief that the Board “will take another three to four years to even think about what the Men’s Central Jail is going to look like.” “By then, we will have everyone out of incarceration,” he said confidently. The Board of Supervisors was unavailable for comment, and their team did not consent to speak on the record.

The law is not on their side

The stepping stones to a better future involve a drastic change in the framing of mental health laws itself.California has been weighed down by a 50-year-old law meant to prevent unnecessary hospitalizations (and often incarceration) for the mentally ill. But instead, it has been cutting them off from services they need. Signed into law in 1967 by then-Gov. Ronald Reagan, the Lanterman-Petris-Short Act was originally designed to protect the mentally ill from abuse. Decades later, it keeps them from accessing quick treatment.

County Medical Examiner Jonathan Lucas fielding questions from the Civilian Oversight Commission.

The act insists on preventing involuntary civil commitment of the mentally ill. It kicks in only when the level of danger escalates for the individual (also called the consumer), and they become “gravely disabled.” Anyone who is unable to provide food, clothing, and shelter for themselves due to their mental health falls into this category. But the looseness of this definition ensures that many who are in dire need of help fall through the cracks.

In the early 1990s, a team of medical and legal experts with the first-hand experience with California’s mental health laws banded to create a reform group. Barely five years after the Lanterman act reared its head, psychiatrist Elizabeth Galton, who worked for San Mateo County jail, noted its dire effects. Her journal documented an increase in the number of people with severe mental illness in jails. It had caught the eye of advocates and doctors like Carla Jacobs and Randall Hagar. So controversial was the mental health law, that even Assemblywoman Helen Thomson–of Laura’s Law fame–pitched in. Bound together by their personal horrors at the hands of the Act, this nucleus of professionals formed the LPS Reform Task Force.

“The consensus was that the law operated in many ways to frustrate, and not provide treatment. Prompt treatment was supposed to be given, and a lot of people said it wasn’t doing that,” said Hagar, one of the members of the Task Force’s steering committee.

“I became very involved with Carla and Helen Thomson in establishing Laura’s Law. That came about because Laura was murdered by a client who was considered dangerous, and there was no way to compel treatment in that case,” he said.

Hagar is also the Director of Government Relations for the California Psychiatric Association. Framing policies for the mentally ill has also brought him within the grim walls of the Men’s Central Jail. He did not see any mental health staff. “But the main issue is that “there is a mingling of mentally ill inmates with the general population in many instances.” The jail was built in the 1950s and Hagar said that it was never built to accommodate mentally ill inmates.

The Los Angeles County Jail is served by the Department of Health Services (DHS). They send their own staff to these jails to provide correctional health treatment. “In terms of treatment, mentally ill individuals receive assessment, psychiatric medication, and evaluation. Individual and group treatment are given according to the acuity of their mental illness,” said DHS media representative Rochessa Washington.

“A jail setting is a very hard place to provide therapeutic health measures,” Hagar said. “It’s difficult to medicate mentally ill inmates. It can bring about adverse consequences, including the use of force against them.”

Anthony Robles would agree. Before embarking on advocacy work for the Youth Justice Coalition (YJC), Robles frequently collided against the law. One such run-in had landed him in the central jail.

Anthony Robles beside the former juvenile lockups in what was previously the David V.Kenyon Juvenile Justice Facility. The building now serves as headquarters for the Youth Justice Coalition.
Photo by Bulbul Rajagopal

“It’s the smell that hits you first…and it’s dark,” Robles said. “The cells are the worst. I was in a four-man cell, and it was a tiny 8×8 square.” The dormitories, according to him, are better because there is more space to move around even though it’s packed. His dorm on the top floor had 200 people alone.

“But the most dehumanizing thing I saw in jail was how they treat people with mental illness. The deputies have them all on pills, so the inmates are out of it most of the time. The deputies expect them to follow their commands like that!” Robles snapped his fingers to signify. “It gave them an excuse to verbally abuse and manhandle these people.” He also pointed out that the staff administering these medicines were appointed by the county. No medical assistance from outside is permitted.

“Men’s Central is designed to punish you, to break you down, and to turn you into an animal,” he said. Robles is against jails as a whole and called for more treatment centers to be peppered across the county.

Hagar hailed local treatment: “The trend towards building alternative sites for people with mental illness, who have criminal justice contacts, is a good one but it should be local and the resources should be on the front-end in terms of providing opportunities for diversion.” He suggests that noting the histories of people in jails will throw up evidence that there were opportunities for intervention that were missed. “The LPS has a role in the way it’s currently drafted and implemented in sending people to jail.” Putting resources on the front end would prevent the consequences of being put in jail as a mentally ill person in the first place.

Currently, Hagar is working with a legislator who cannot be named due to the uncertainty of the plan, to allow individual cities to follow Laura’s Law even if the county to which they belong does not wish to do the same. “Laura’s Law does reduce arrests and length of jail stays. That’s a proven tool to use to decriminalize treatment of people with mental illness.”

“We use power mapping to understand who our allies and opposition are,” said Robles. The graph details the power key figures have, and whether they are more or less in agreement with YJC’s cause.
The top half contains people with the most power. The more they fall on the left, the more they are opposed to the interests of the advocacy group. Sheriff Alex Villanueva holds the post for having the most amount of power and opposition. Some members of the Board of Supervisors like Barger and Hahn also rest nearby.

Confusion and conflict still persist

Robles is also unsure about whose side the Board of Supervisors is truly on. “They’re more on our side in terms of what they say, but when they actually do things, it’s not what we want.”

YJC is currently working on moving all youth from the probation system. The Board wants to redirect them to the Department of Mental Health. “They will get over-diagnosed and over-medicated there,” said Robles. “We want them to be put in the Youth Development Department.” Both bodies have agreed to put the youth out of probation, but they are clashing on where the children will be placed from here on.

A large section of L.A. County’s authorities is trying to present themselves on the side of the public. But confusion still exists as to how to end injustices inflicted upon the mentally ill who are caught in the criminal justice system.

In a Civilian Oversight Commission meeting on Nov. 19, questions and allegations were raised regarding the practices of the County Coroner’s Office. Families of the deceased and social workers who were present raised the question of possible collusion between the Coroner’s Office and the Sheriff’s department to doctor reports of fatal use of force. “It’s always been a mysterious office…where is the coroner? It shouldn’t be mysterious, obviously, it’s sensitive work to deal with families,” said Commission Chair Patti Giggans.

Michele Infante, a caseworker for Dignity and Power Now was present too. She has been focusing on providing the Correas with legal help after Juan’s death. They are now pursuing legal action, and his parents have filed a wrongful-death lawsuit against the Los Angeles County Jail and the Sheriff’s Department.

Infante believes that Juan’s medical report from the coroner’s office may have been doctored. The report states his cause of death to be an enlarged heart. However, it also notes physical trauma to his body. “I don’t believe all his injuries have been listed in the correct chronological order, for one,” said Infante. “They’ve manipulated the body to not show the full extent of his injuries.”

She stressed the importance of transparency within the Coroner’s office:: “These families depend on doctors for answers. They don’t know what they’re looking at. Their assumption is that their child died of natural causes, which is not true.”

YJC’s Robles said that doctored medical reports are common when it comes to officer-involved deaths. “They always do that. A lot of the times they state the cause of death as a heart attack or they blame it on the drugs,” he said.

In YJC’s data, deaths that occur due to certain measures like the hobble restraint are counted as use-of-force homicide, according to Robles. The restraint has the inmate’s wrists tied to their ankles while they are in a seated position. It causes constant stress to fall upon their chest. “They suffocate because they’re kept in that state for a long time, and then their heart stops.”

The Coroner’s Office maintains that they are independent of the Los Angeles Sheriff’s Department(LASD). “The Los Angeles County Department of Medical Examiner-Coroner (DMEC) is a separate and independent agency from the Sheriff’s Department. The relationship between the agencies is that LASD must notify DMEC when there is a death at a jail since that death is under DMEC’s jurisdiction,” said Public Information Officer Sarah Ardalani in response to the allegations.

She went on to say that the “cause and manner of death findings are our own, without direction from any of the law enforcement agencies that we work with.”

According to the Coroner’s Office, DMEC is mandated by state law to inquire into and determine the circumstances, manner, and cause of all sudden, violent, or unusual deaths. These also include deaths where the decedent has not been seen by a physician 20 days prior to death.

YJC’s data alleges that the Sheriff’s department has killed at least 306 people through the use of force in street and jail encounters between 2000-2018, “making them the second deadliest department during this time span,” trailing behind the Los Angeles Police Department.

The county’s District Attorney candidates are also trying to enter the scene. Many of them were present at the Reform L.A. Jails discussion on ending mental health incarceration to launch themselves firmly into the public’s mind.

Former public defender and now a candidate for District Attorney, Rachel Rossi, attended the family support group meeting organized by Dignity and Power Now to hear the grievances of people who had lost loved ones to police violence in jails and street encounters. But her presence was chalked off to mere vote-seeking by a few. “The job of a DA is to prosecute, how can any of them help us? At the end of the day, they still work for Jackie Lacey,” said a Dignity and Power Now caseworker June Williams.

Joseph Iniguez, one of Rossi’s competitors, said the DA’s office has failed mentally ill. “Whoever the arresting agency is, they bring us information about the arrest. It falls on us to decide if we need to file charges, and it is at this critical stage where we fail them.”

Many ideas are in the pipeline to reform mental health treatment in jails, but little has been done. With the county still steeped in confusion and mired in controversy, Reform L.A. Jails is currently preparing for California’s Presidential Primary election day on March 3, 2020 They are planning to tackle the issue of sheriff deputy misconduct and alternative jails.

Bulbul Rajagopal
Bulbul Rajagopalhttps://bulbulrajagopal.contently.com/
Bulbul Rajagopal is a data and investigative reporter with a special interest in minority issues, soccer, and politics. Her extensive coverage in India and Los Angeles rewarded her with an affinity for crime reporting. During her downtime, Bulbul enjoys exploring her passion for food and its cultural impact amongst other things.
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