Sheriff wants jail to be able to force drugs on mentally ill

The El Paso County Sheriff’s Office is crafting legislation that would let county jail officials forcibly medicate mentally ill inmates who won’t take prescribed drugs.

Sheriff Terry Maketa said the jail has become the de facto largest mental health treatment center in the county and needs the same authority as a mental hospital to force medication.

“We’re there. The day has arrived,” Maketa said last week. “We can stick our heads in the sand and pretend it is not an issue, but it is.”

After years of budget cuts to state mental health programs, the jails of Colorado have become the primary mental health providers in Colorado, according to sheriffs and mental health advocates.

According to the Sheriff’s Office, 18 percent to 22 percent of jail inmates here have “significant mental health issues.”

The jail employs one part-time and five full-time mental health counselors and a director of mental health, and it contracts with a psychiatrist. But when a severely mentally ill inmate won’t take medication, they lack the authority to force the issue.

The state mental hospital in Pueblo, which is supposed to take severely mentally ill inmates off the jails’ hands, has had its own problems. This year, two state officials nearly faced contempt of court charges because of the hospital’s inability to accept inmates from counties, despite court orders mandating they be treated there.

Maketa said severely mentally ill inmates who refuse treatment face long waits to get into the state hospital. The number who refuse is small, three to five a year, but growing, Maketa said.

“We’re kind of caught between a rock and a hard spot, because we can’t get them to the state hospital,” Maketa said.

He cited the case of one mentally ill inmate — whom he would not name — admitted to the jail on a parole violation. The man refused to take medication and began assaulting jail staff.

The jail’s tactical entry team had to be called every time officials had contact with him. He refused to eat and smeared feces all over his cell.

He was on the waiting list for the state hospital for eight weeks, and in that time, he dropped from 26th to 23rd, Maketa said. Finally, in frustration, Maketa called lawmakers, who pulled some strings and got him into the hospital.

Inmates taken to the state hospital are only kept there long enough to be stabilized, and when they return, they can refuse to take medication. The only recourse jail officials have is to ask a judge for a temporary court order to force treatment, which can be difficult to get and lasts only a few days.

“If we don’t have the authority to administer involuntary medication when they refuse, we start all over at level one with these people,” said Paula Presley, chief of the detentions bureau.

Few details of the legislation have been worked out. State Rep. Amy Stephens, R-Monument, has agreed to introduce legislation in the 2008 session.

“I think it’s a huge issue because I think so much of this is thrust on the jails,” said Stephens.

Maketa said the jail would not need to hire additional staff or expand facilities.