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Kentucky Jails Struggle With Mentally Ill Inmates

Prison cell bars
Prison cell bars


The recent banishment by police of a mentally ill man from Carroll County, Kentucky, to Florida appears to be an unusual occurrence.

But Adam Horine’s mental health struggles are common in a criminal justice system that contains an inordinate number of emotionally troubled men and women.

An estimated 15 to 25 percent of jail and prison inmates nationwide suffer from serious mental illness, according to the Treatment Advocacy Center, a national nonprofit organization that seeks to increase treatment options for the mentally ill.

By comparison, about 6 percent of the general population has a serious mental disturbance, the National Alliance on Mental Illness reports.

In April, Horine pleaded with a Carroll District Court judge during his arraignment on two misdemeanor charges: “I have mental illness and I say things I shouldn't say. But I would never hurt anybody. I never have.”

The judge ordered an immediate mental-health examination and transport to Eastern State Hospital in Lexington for a more thorough psychiatric assessment. Instead, Carrollton police removed Horine from jail and sent him to Florida, a move of dubious legality that is now under investigation by the attorney general’s office.

Reaction to the Carrollton Police Department’s handling of Horine’s case was both swift and vocal.

Kelly Gunning, director of advocacy and public policy for NAMI in Lexington, wrote in The Lexington Herald-Leader that Horine’s case “raises my already-too-high fear threshold and reminds me that the threats of ignorance and prejudicial acts abound.”

Vikki Franklin, director of community relations for Eastern State Hospital, where Horine now is undergoing treatment, said its average patient population of about 120 typically includes some 15 jail inmates from a 50-county region. Franklin said available space there is not an issue. But the inadequacy of resources elsewhere in the state and beyond clearly is problematic, according to mental health authorities.

There are as many as 350,000 mentally ill people in jails and prison nationally, according to the Treatment Advocacy Center. That’s 10 times more than the number in state mental hospitals, TAC says, and also is greater than the population of Lexington.

“Prisons and jails have become America’s ‘new asylums,’” according to TAC.

In Kentucky, about 25 percent of state prison inmates receive “psychiatric and/or psychological services,” according to Lisa Lamb, spokeswoman for the state Department of Corrections.

Figures for the frequency of mentally ill inmates in the state’s more than 80 jails are not readily available. But Steve Durham, deputy director of the Louisville Metro Department of Corrections, estimates that about one-fourth of the 1,700 inmates there are on medications designed to treat psychiatric disorders. Campbell County Jailer Jim Daley offered a similar estimate for the his detention center, which has about 570 inmates.

The jails in Louisville and Campbell County offer more services for mentally ill inmates than many others in the state. Still, Durham and Daley said their resources are inadequate.

“I should not have people in jail who have serious mental health issues,” Daley said. “Few if any jails have adequate resources to deal with severe mental health issues; we’re just not designed for that.

“If people have serious issues, it does them a disservice, because this is not the environment that will help them with their future," Daley added.

Dr. Sheila Schuster, executive director of the Kentucky Mental Health Coalition, said people with severe mental illnesses “are not getting the services they need. Then they end up getting into trouble and” land in the criminal-justice system—much like Adam Horine.

For those who are incarcerated, overall mental-health care is “much better” in the state’s prisons than in county jails, Schuster said. “The (state) Department of Corrections does a pretty good job of getting services to people identified in prison as being mentally ill. I think it’s much, much harder for jailers.”

In many county jails, Schuster said, inmates typically “won’t get any services unless they’re causing a problem.” Most medical care in jails is provided by nurses and a part-time, contract physician, she said, none of whom are likely to have specialized mental health training.

“If you’re mentally ill, you’re better off being in prison,” she said.

Schuster also said she has been lobbying for more money from Frankfort for mental health, especially for community-based services, “for 30 years.”

She added: “I haven’t had much success.”

Steve Shannon, director of the Kentucky Association of Regional Programs, a coalition of 11 mental health centers, agreed that mental health resources are too scarce.

“We don’t want to incarcerate people because they are mentally ill,” Shannon said. “We don’t arrest people for diabetes.”

Reporter R.G. Dunlop can be reached at rdunlop@kycir.org or (502) 814-6533.

This story was reported by Louisville Public Media's Kentucky Center for Investigative Reporting.

R.G. Dunlop is an award-winning investigative reporter whose work has exposed government corruption and resulted in numerous reforms. Email R.G. at rdunlop@lpm.org.