SALT LAKE CITY — Mental health screening for new inmates is one of several recommendations made by a state panel looking into the high number of deaths in Utah's county jails.
The 27-member working group, including three state lawmakers, released a report this week containing six proposals based on data and policy information provided by the Utah Commission on Criminal Juvenile Justice.
"It’s a complex problem. There's not a simple solution, but it's something we really need to address," said Rep. Carol Spackman Moss, D-Holladay, a member of the working group.
Though the report doesn't discuss costs for implementing the recommendations, they would come with high price tags.
Moss and Sen. Todd Weiler, R-Woods Cross, teamed up on a bill in the 2018 Legislature calling for the Utah Substance Use and Mental Health Advisory Council to form a panel to look at jail deaths and drug and alcohol treatment in county jails.
Both legislators says they're still delving into the recommendations to determine the next step.
"I don't think we're done," said Weiler, adding there may or may not be legislation coming in January.
The panel reported to a legislative committee last month that of the 71 inmates who died in county jails from 2013 to 2017, more than half took their own lives and nearly half of all deaths occurred within the first seven days behind bars.
The report found 38 of the 71 jail deaths were suicides, and 31 of all deaths happened in the first week — six on the first day — of incarceration. Of the remainder, 16 were due to illness, four from alcohol or drug intoxication, one accident and 12 were listed as other/unknown.
Each of the state's 26 county jails — Morgan, Wayne and Paiute do not operate jails — have their own inmate safety policies and procedures.
Sixteen jails have policies specifically addressing the treatment of an inmate experiencing withdrawal from alcohol or drugs, including use of opiates. Ten have policies on providing withdrawal medications, but only three use methadone, buprenorphine or naltrexone, according to the report.
Weiler said people using methadone under a doctor's prescription outside jail have it taken away when they're incarcerated.
"That really bothers me," he said. "What happened to the patient relationship with their doctor?"
Rep. Ed Redd, R-Logan, a member of the working group, said the report helps policymakers understand some of the issues they might be able to address to "make sure inmates have a non-lethal outcome during their stay in jail."
Assessing inmates for addiction or mental health conditions at the time of booking is key, he said.
"If you have screening tools that are adequate for the situation you're in, you're going to pick up people who are being incarcerated who might need more intensive treatment and evaluation and interventions rather than just housing them in jail," he said.
Redd, the contract medical director for the Cache County Jail, said it make sense to spend money up front to address inmates' challenges.
"In my mind, the sooner we understand what the real problems are and try to address the problems way upstream, I think we end up having better outcomes and spend less money getting them," he said.
Redd said it's also important that inmates get care after they're released because jail can become a "revolving door" for those who don't continue treatment.
The report recommends:
- The Legislature should work with counties to set priorities for effective health care in county jails, including the appropriate level of resources to provide medical, mental health and substance use screening, assessment and treatment.
- All inmates booked into county jails should undergo physical, behavioral health and suicide screenings before or immediately following booking.
- Explore ways to provide additional treatment services through telehealth technology in jails, including by interlocal agreements and pooled funding, with emphasis on shared treatment resources.
- A committee comprised of law enforcement, state substance abuse and mental health officials, doctors, behavioral health providers and others should survey existing policies, procedures and protocols for treatment in jails.
- Establish substance use and mental health treatment programs in jails that include referrals on release to community-based treatment and recovery support programs. Expand the Vivitrol pilot to additional counties and pass laws to maximize the availability of Medicaid funds.
- Provide tax incentives for medical, mental health and substance use professionals who provide treatment services for jail inmates.